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Sample records for chronic exuding venous

  1. Clinical performance of a new silver dressing, Contreet Foam, for chronic exuding venous leg ulcers

    DEFF Research Database (Denmark)

    Karlsmark, T; Agerslev, R H; Bendz, S H

    2003-01-01

    OBJECTIVE: This study aimed to evaluate the safety and performance of a new sustained silver-releasing dressing, Contreet Foam (Coloplast A/S), in the treatment of moderately to highly exuding chronic venous leg ulcers in which healing is delayed due to the presence of bacteria. METHOD: The clini......OBJECTIVE: This study aimed to evaluate the safety and performance of a new sustained silver-releasing dressing, Contreet Foam (Coloplast A/S), in the treatment of moderately to highly exuding chronic venous leg ulcers in which healing is delayed due to the presence of bacteria. METHOD......'s effect on the peri-ulcer area. Blood samples were analysed for silver content. RESULTS: Twenty-three out of 25 patients completed the study. One ulcer healed and no wound infections occurred during the study period. A mean 56% reduction in ulcer area (from 15.6 to 6.9 cm2) was recorded during the four...... weeks, and there was a mean 25% reduction in granulation tissue from dull to healthy after one week. Wound odour reduced significantly after one week. Mean dressing wear time was 3.1 days, and there were only minimal incidences of leakage. Serum silver levels did not exceed reference values. CONCLUSION...

  2. Chronic Venous Disease under pressure

    NARCIS (Netherlands)

    S.W.I. Reeder (Suzan)

    2013-01-01

    textabstractIn chapter 1 we provide a general introduction of this thesis. Chronic venous disease (CVD) is a common medical condition that affects 2-64% of the worldwide population and leads to leg ulcers in 1% of the Western population. Venous leg ulceration (VLU) has an unfavorable prognosis with

  3. Chronic Venous Disease under pressure

    OpenAIRE

    Reeder, Suzan

    2013-01-01

    textabstractIn chapter 1 we provide a general introduction of this thesis. Chronic venous disease (CVD) is a common medical condition that affects 2-64% of the worldwide population and leads to leg ulcers in 1% of the Western population. Venous leg ulceration (VLU) has an unfavorable prognosis with regard to non-healing and recurrence rates. Annually 6% of the total healthcare costs are spent on the treatment of venous diseases. CVD results from ambulatory venous hypertension and is the conse...

  4. Doppler ultrasound study and venous mapping in chronic venous insufficiency.

    Science.gov (United States)

    García Carriazo, M; Gómez de las Heras, C; Mármol Vázquez, P; Ramos Solís, M F

    2016-01-01

    Chronic venous insufficiency of the lower limbs is very prevalent. In recent decades, Doppler ultrasound has become the method of choice to study this condition, and it is considered essential when surgery is indicated. This article aims to establish a method for the examination, including venous mapping and preoperative marking. To this end, we review the venous anatomy of the lower limbs and the pathophysiology of chronic venous insufficiency and explain the basic hemodynamic concepts and the terminology required to elaborate a radiological report that will enable appropriate treatment planning and communication with other specialists. We briefly explain the CHIVA (the acronym for the French term "cure conservatrice et hémodynamique de l'insuffisance veineuse en ambulatoire"=conservative hemodynamic treatment for chronic venous insufficiency) strategy, a minimally invasive surgical strategy that aims to restore correct venous hemodynamics without resecting the saphenous vein.

  5. Chronic cerebrospinal venous insufficiency and venous stenoses in multiple sclerosis

    DEFF Research Database (Denmark)

    Blinkenberg, M; Akeson, P; Sillesen, H;

    2012-01-01

    The traditional view that multiple sclerosis (MS) is an autoimmune disease has recently been challenged by the claim that MS is caused by chronic cerebrospinal venous insufficiency (CCSVI). Although several studies have questioned this vascular theory, the CCSVI controversy is still ongoing. Our...... aim was to assess the prevalence of CCSVI in Danish MS patients using sonography and compare these findings with MRI measures of venous flow and morphology....

  6. The chronic cerebrospinal venous insufficiency syndrome.

    Science.gov (United States)

    Zamboni, P; Galeotti, R

    2010-12-01

    Chronic cerebrospinal venous insufficiency (CCSVI) is a syndrome characterized by stenosies of the internal jugular and/or azygous veins (IJVs-AZ) with opening of collaterals and insufficient drainage proved by reduced cerebral blood flow and increased mean transit time in cerebral MRI perfusional study. The present review is aimed to give a comprehensive overview of the actual status of the art of the diagnosis and treatment of this condition. As far as the origin of venous narrowing is concerned, phlebographic studies of the IJVs and AZ systems demonstrated that venous stenoses were likely to be truncular venous malformations; mostly, they are intraluminal defects such as malformed valve, septa webs. CCSVI condition has been found to be strongly associated with multiple sclerosis (MS), a disabling neurodegenerative and demyelinating disease considered autoimmune in nature. In several epidemiological observations performed at different latitudes on patients with different genetic backgrounds, the prevalence of CCSVI in MS ranges from 56% to 100%. To the contrary, by using venous MR and/or different Doppler protocols, CCSVI was not detected with the same prevalence. Two pilot studies demonstrated the safety and feasibility in Day Surgery of the endovascular treatment of CCSVI by means of balloon angioplasty (PTA). It determines a significant reduction of postoperative venous pressure. Restenosis rate was found out elevated in the IJVs, but negligible in the AZ. However, PTA seems to positively influence clinical and QoL parameters of the associated MS and warrants further randomized control trials.

  7. Chronic Infection and Venous Thromboembolic Disease.

    Science.gov (United States)

    Epaulard, Olivier; Foote, Alison; Bosson, Jean-Luc

    2015-09-01

    Venous thromboembolic disease often arises as a complication of another pathological condition and/or triggering event. Infectious diseases result from both the direct action of the pathogens themselves and their effect on the immune system. The resulting inflammatory process and the coagulation and fibrinolysis processes share common pathways, explaining why infection is associated with thrombosis. In this brief overview, besides certain chronic infectious diseases, we also consider some acute infections, as the mechanisms are likely to be similar, particularly in the initial infective stage or the more acute episodes of a chronic infection. The infectious agent can be viral, bacterial, fungal, or parasitic. However, the literature on the link between infections and venous thromboembolism (VTE) is uneven, favoring infections that are found in more developed countries where physicians have access to VTE diagnostic tools. Thus, large epidemiological studies in this field are restricted to a limited number of the common chronic infectious diseases such as tuberculosis, while for other infections, particularly parasitic and fungal infections, the link with VTE is only evoked in a few scattered case reports.

  8. The controversy on chronic cerebrospinal venous insufficiency

    Directory of Open Access Journals (Sweden)

    Paolo Zamboni

    2013-08-01

    Full Text Available The objective of this review is to analyze the actual scientific controversy on chronic cerebrospinal venous insufficiency (CCSVI and its association with both neurodegenerative disorders and multiple sclerosis (MS. We revised all published studies on prevalence of CCSVI in MS patients, including ultrasound and catheter venography series. Furthermore, we take into consideration other publications dealing with the pathophysiologic consequences of CCSVI in the brain, as well as ecent data characterizing the pathology of the venous wall in course of CCSVI. Finally, safety and pilot data on effectiveness of endovascular CCSVI treatment were further updated. Studies of prevalence show a big variability in prevalence of CCSVI in MS patients assessed by established ultrasonographic criteria. This could be related to high operator dependency of ultrasound. However, 12 studies, by the means of more objective catheter venography, show a prevalence >90% of CCSVI in MS. Global hypo-hypoperfusion of the brain, and reduced cerebral spinal fluid dynamics in MS was shown to be related to CCSVI. Postmortem studies and histology corroborate the 2009 International Union of Phlebology (UIP Consensus decision to insert CCSVI among venous malformations. Finally, safety of balloon angioplasty of the extracranial veins was certainly demonstrated, while prospective data on the potential effectiveness of endovascular treatment of CCSVI support to increase the level of evidence by proceeding with a randomized control trial (RCT. Taking into account the current epidemiological data, including studies on catheter venography, the autoptic findings, and the relationship between CCSVI and both hypo-perfusion and cerebro-spinal fluid flow, we conclude that CCSVI can be definitively inserted among the medical entities. Research is still inconclusive in elucidating the CCSVI role in the pathogenesis of neurological disorders. The controversy between the vascular and the

  9. Clinical efficacy of dressings for treatment of heavily exuding chronic wounds

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    Wieg

    2015-06-01

    Full Text Available Cornelia Wiegand, Jörg Tittelbach, Uta-Christina Hipler, Peter Elsner Department of Dermatology, University Hospital Jena, Jena, Germany Abstract: The treatment of chronic ulcers is a complex issue and presents an increasing problem for caregivers everywhere. This is especially true in Germany, where more than 4 million chronic wounds are treated each year. Therapeutic decisions must be patient-centered and reflect wound etiology, localization, and healing status. The practice of using the same wound dressing during the entire healing period is no longer reasonable. Instead, multiple types of dressings may be needed for a single wound over its healing trajectory. Selection of the most appropriate dressing should be based on wound phase, depth, signs of infection, and level of exudate. Moisture balance is critical in wound care; dryness will hamper epithelial cell migration while excessive generation of fluid causes maceration at the wound margins. Hence, exudate management is a key issue in chronic wound therapy, particularly given that exudate from chronic wounds has a composition different from that of acute wound fluid. Several studies have shown that exudates from non-healing wounds contain significantly elevated levels of protease activity, increased formation of free radicals, and abundant amounts of proinflammatory cytokines, while concentrations of growth factors and protease inhibitors are markedly decreased. Application of dressings that remove and sequester excess amounts of wound fluid may not only help in restoring the correct balance of moisture, but also support the wound healing process by preventing tissue deterioration caused by abundant protease activity. Several types of dressings, such as hydrogels, hydrocolloids, alginates, hydrofibers, foams, and superabsorbent dressings, are reviewed here and evaluated with regard to their efficacy for highly exuding wounds. Keywords: chronic wounds, exuding, dressings, clinical efficacy 

  10. Iliocaval Confluence Stenting for Chronic Venous Obstructions

    Energy Technology Data Exchange (ETDEWEB)

    Graaf, Rick de, E-mail: r.de.graaf@mumc.nl [Maastricht University Medical Centre (MUMC), Department of Radiology (Netherlands); Wolf, Mark de, E-mail: markthewolf@gmail.com [Maastricht University Medical Centre (MUMC), Department of Surgery (Netherlands); Sailer, Anna M., E-mail: anni.sailer@mumc.nl [Maastricht University Medical Centre (MUMC), Department of Radiology (Netherlands); Laanen, Jorinde van, E-mail: jorinde.van.laanen@mumc.nl; Wittens, Cees, E-mail: c.wittens@me.com [Maastricht University Medical Centre (MUMC), Department of Surgery (Netherlands); Jalaie, Houman, E-mail: hjalaie@ukaachen.de [University Hospital Aachen, Department of Surgery (Germany)

    2015-10-15

    PurposeDifferent techniques have been described for stenting of venous obstructions. We report our experience with two different confluence stenting techniques to treat chronic bi-iliocaval obstructions.Materials and MethodsBetween 11/2009 and 08/2014 we treated 40 patients for chronic total bi-iliocaval obstructions. Pre-operative magnetic resonance venography showed bilateral extensive post-thrombotic scarring in common and external iliac veins as well as obstruction of the inferior vena cava (IVC). Stenting of the IVC was performed with large self-expandable stents down to the level of the iliocaval confluence. To bridge the confluence, either self-expandable stents were placed inside the IVC stent (24 patients, SECS group) or high radial force balloon-expandable stents were placed at the same level (16 patients, BECS group). In both cases, bilateral iliac extensions were performed using nitinol stents.ResultsRecanalization was achieved for all patients. In 15 (38 %) patients, a hybrid procedure with endophlebectomy and arteriovenous fistula creation needed to be performed because of significant involvement of inflow vessels below the inguinal ligament. Mean follow-up was 443 ± 438 days (range 7–1683 days). For all patients, primary, assisted-primary, and secondary patency rate at 36 months were 70, 73, and 78 %, respectively. Twelve-month patency rates in the SECS group were 85, 85, and 95 % for primary, assisted-primary, and secondary patency. In the BECS group, primary patency was 100 % during a mean follow-up period of 134 ± 118 (range 29–337) days.ConclusionStenting of chronic bi-iliocaval obstruction shows relatively high patency rates at medium follow-up. Short-term patency seems to favor confluence stenting with balloon-expandable stents.

  11. Compression therapies for chronic venous leg ulcers: interventions and adherence

    Directory of Open Access Journals (Sweden)

    Latz CA

    2015-01-01

    Full Text Available Christopher A Latz,1 Kellie R Brown,2 Ruth L Bush11Texas A&M Health Science Center College of Medicine, Bryan, TX, USA; 2Medical College of Wisconsin, Milwaukee, WI, USAAbstract: Compression therapy has been the mainstay for the treatment of lower extremity edema, venous insufficiency, and particularly, venous ulcerative disease. Though modern surgical treatments exist, none are completely effective without good compressive options to allow for decreased swelling and better oxygenation of damaged tissues. This review article will describe the pathophysiology and presentation of lower extremity venous ulcerations, as well as current options for compression therapy. The benefits, along with the major pitfall of nonadherence, will also be discussed.Keywords: venous disease, chronic venous insufficiency, venous ulceration

  12. [Lower limb venous angiodysplasia as a cause of chronic venous insufficiency: specific diagnosis and treatment].

    Science.gov (United States)

    Dan, V N; Sapelkin, S V; Karmazanovskiĭ, G G; Kuntsevich, G I

    2007-01-01

    The paper presents a current understanding of chronic venous insufficiency that develops in venous forms of dysplasia. Management of venous dysplasia must be based on multidisciplinary approach including comprehensive diagnosis (predominantly noninvasive), integrative surgical and non-surgical treatment. Modern therapy must be complex and carried out in highly specialized facilities. Best functional and esthetic results can be achieved only through combined therapy. When surgical or non-surgical interventions are inappropriate or impossible, management focus must be placed on clinical control of vascular anomaly (follow-up and compression-based conservative treatment) aimed at minimization of its unfavorable impact on vital functions and at quality of life improvement.

  13. To what extent might deep venous thrombosis and chronic venous insufficiency share a common etiology?

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    Malone, P Colm; Agutter, P S

    2009-08-01

    According to the valve cusp hypoxia hypothesis (VCHH), deep venous thrombosis is caused by sustained non-pulsatile (streamline) venous blood flow. This leads to hypoxemia in the valve pockets; hypoxic injury to the inner (parietalis) endothelium of the cusp leaflets activates the elk-1/egr-1 pathway, leading to leukocyte and platelet swarming at the site of injury and, potentially, blood coagulation. Here, we propose an extension of the VCHH to account for chronic venous insufficiency. First, should the foregoing events not proceed to frank thrombogenesis, the valves may nevertheless be chronically injured and become incompetent. Serial incompetence in lower limb valves may then generate ''passive'' venous hypertension. Second, should ostial valve thrombosis obstruct venous return from muscles via tributaries draining into the femoral vein, as Virchow illustrated, ''active'' venous hypertension may supervene: muscle contraction would force the blood in the vessels behind the blocked ostial valves to re-route. Passive or active venous hypertension opposes return flow, leading to luminal hypoxemia and vein wall distension, which in turn may impair vasa venarum perfusion; the resulting mural endothelial hypoxia would lead to leukocyte invasion of the wall and remodelling of the media. We propose that varicose veins result if gross active hypertension stretches the valve ''rings'', rendering attached valves incompetent caudad to obstructed sites, replacing normal centripetal flow in perforating veins with centrifugal flow and over-distending those vessels. We also discuss how hypoxemia-related venous/capillary wall lesions may lead to accumulation of leukocytes, progressive blockage of capillary blood flow, lipodermosclerosis and skin ulceration.

  14. Endovascular therapy for chronic cerebrospinal venous insufficiency in multiple sclerosis

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    Marc A. Lazzaro

    2011-07-01

    Full Text Available Recent reports have emerged suggesting that multiple sclerosis (MS may be due to abnormal venous outflow from the central nervous system, termed Chronic Cerebrospinal Venous Insufficiency (CCSVI. These reports have generated strong interest and controversy over the prospect of a treatable cause of this chronic debilitating disease. This review aims to describe the proposed association between CCSVI and MS, summarize the current data, and discuss the role of endovascular therapy and the need for rigorous randomized clinical trials to evaluate this association and treatment.

  15. Pycnogenol® in chronic venous insufficiency and related venous disorders.

    Science.gov (United States)

    Gulati, Om P

    2014-03-01

    The present review provides an update of the biological profile of Pycnogenol in the light of its use in the treatment of chronic venous insufficiency (CVI) and related venous disorders such as deep vein thrombosis (DVT), post-thrombotic syndrome, long haul air-travel-related leg oedema, venous ulcers and acute haemorrhoids. Pycnogenol is a French maritime pine bark extract produced from the outer bark of Pinus pinaster Ait. subsp. atlantica. Its strong antioxidant, anti-inflammatory and vasodilator activities, antithrombotic effects and collagen stabilizing properties make it uniquely able to target the multi facet pathophysiology of CVI and related venous disorders. Clinical studies have shown that it can reduce oedema of the legs in CVI, reduce the incidence of deep venous thrombosis during long haul flights and enhance the healing of venous ulcers and haemorrhoidal episodes by topical application and/or oral administration. This review highlights clinical research findings on the safety, compliance and efficacy of Pycnogenol, including its use in combination products.

  16. Use of a new silver barrier dressing, ALLEVYN Ag in exuding chronic wounds.

    LENUS (Irish Health Repository)

    Kotz, Paula

    2009-06-01

    Recognising and managing wounds at risk of infection is vital in wound management. ALLEVYN Ag dressings have been designed to manage exudate in chronic wounds that are at risk of infection; are displaying signs of local infection; or where a suspected increase in bacterial colonisation is delaying healing. They combine an absorbent silver sulfadiazine containing hydrocellular foam layer, with a perforated wound contact layer and highly breathable top film. The results presented are from a multi-centre clinical evaluation of 126 patients conducted to assess the performance of ALLEVYN Ag (Adhesive, Non Adhesive and Sacrum dressings) in a range of indications. Clinicians rated the dressings as acceptable for use in various wound types in 88% of patients. The majority of clinical signs of infection reduced between the initial and the final assessment. The condition of wound tissue and surrounding skin was observed to improve, and there was significant evidence of a reduction in the level of exudate from initial to final assessment (p < 0.001). Clinicians rated ALLEVYN Ag as satisfying or exceeding expectations in over 90% of patients. The evaluation showed the dressings to offer real benefits to patients and clinicians across multiple indications when used in conjunction with local protocols.

  17. Urinary hemosiderin: role in evaluation of chronic venous insufficiency

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    Ashish Lal Shrestha

    2012-08-01

    Full Text Available Chronic venous insufficiency (CVI leads to skin changes with dermal hemosiderin deposition. We studied the presence of hemosiderin in the urine to assess if this could be used as a biochemical marker for CVI. Hereby we present a case control study conducted in a tertiary care centre in South India. There were 100 cases with evidence of advanced CVI (the Clinical-Etiology-Anatomy-Pathophysiology classification: C5, C6 confirmed by duplex scanning. Controls were 50 patients with leg ulcers due to other etiologies. All patients were subjected to urinary hemosiderin testing. In all 100 patients with CVI (C5 and C6 disease axial venous reflux was confirmed by duplex ultrasound. Superficial venous reflux was noted in 71% of patients and deep venous reflux in 54.%. Primary venous insufficiency was the etiology in 81% of patients. Only 4/100 patients had detectable amounts of hemosiderin in the urine. Urine hemosiderin testing to determine presence or absence of CVI yielded the following values: positive predictive value-80%; negative predictive value-33%; sensitivity-4% and specificity-98%. The test could not be recommended as a marker of CVI. In Indian patients urinary hemosiderin is not a useful screening test in CVI.

  18. Clinical correlates of chronic cerebrospinal venous insufficiency in multiple sclerosis

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    Weinstock-Guttman Bianca

    2012-05-01

    Full Text Available Abstract Background Chronic cerebrospinal venous insufficiency (CCSVI is a vascular condition characterized by anomalies of the primary veins outside the skull that has been reported to be associated with MS. In the blinded Combined Transcranial (TCD and Extracranial Venous Doppler Evaluation (CTEVD study, we found that prevalence of CCSVI was significantly higher in multiple sclerosis (MS vs. healthy controls (HC (56.1% vs. 22.7%, p  The objective was to evaluate the clinical correlates of venous anomalies indicative of CCSVI in patients with MS. Methods The original study enrolled 499 subjects; 163 HC, 289 MS, 21 CIS and 26 subjects with other neurological disorders who underwent a clinical examination and a combined Doppler and TCD scan of the head and neck. This analysis was restricted to adult subjects with MS (RR-MS: n = 181, SP-MS: n = 80 and PP-MS: n = 12. Disability status was evaluated by using the Kurtzke Expanded Disability Status Scale (EDSS and MS severity scale (MSSS. Results Disability was not associated with the presence (≥2 venous hemodynamic criteria or the severity of CCSVI, as measured with venous hemodynamic insufficiency severity score (VHISS. However, the severity of CCSVI was associated with the increased brainstem functional EDSS sub-score (p = 0.002. In logistic regression analysis, progressive MS (SP-MS or PP-MS vs. non-progressive status (including RR-MS was associated with CCSVI diagnosis (p = 0.004, OR = 2.34, CI = 1.3–4.2. Conclusions The presence and severity of CCVSI in multiple sclerosis correlate with disease status but has no or very limited association with clinical disability.

  19. Review of venous anatomy for venographic interpretation in chronic cerebrospinal venous insufficiency.

    Science.gov (United States)

    Werner, John D; Siskin, Gary P; Mandato, Kenneth; Englander, Meridith; Herr, Allen

    2011-12-01

    Chronic cerebrospinal venous insufficiency (CCSVI) represents a recently described condition that may potentially contribute to the symptoms experienced by patients with multiple sclerosis. The evaluation of a prospective patient for CCSVI often involves an invasive evaluation with venography of the internal jugular and azygos veins. The purpose of this article is to review the normal anatomy of the internal jugular, vertebral, and azygos veins, as an understanding of these veins is necessary for appropriate interpretation of the venograms obtained to evaluate patients for CCSVI.

  20. Catheter venography and endovascular treatment of chronic cerebrospinal venous insufficiency.

    Science.gov (United States)

    Mandato, Kenneth; Englander, Meridith; Keating, Lawrence; Vachon, Jason; Siskin, Gary P

    2012-06-01

    Multiple sclerosis (MS) is a disorder characterized by damage to the myelin sheath insulation of nerve cells of the brain and spinal cord affecting nerve impulses which can lead to numerous physical and cognitive disabilities. The disease, which affects over 500,000 people in the United States alone, is widely believed to be an autoimmune condition potentially triggered by an antecedant event such as a viral infection, environmental factors, a genetic defect or a combination of each. Chronic cerebrospinal venous insufficiency (CCSVI) is a condition characterized by abnormal venous drainage from the central nervous system that has been theorized to have a possible role in the pathogenesis and symptomatology of MS (1). A significant amount of attention has been given to this theory as a possible explanation for the etiology of symptoms related to MS patients suffering from this disease. The work of Dr. Zamboni, et al, who reported that treating the venous stenoses causing CCSVI with angioplasty resulting in significant improvement in the symptoms and quality of life of patients with MS (2) has led to further interest in this theory and potential treatment. The article presented describes endovascular techniques employed to diagnose and treat patients with MS and CCSVI.

  1. Chronic venous leg ulcers – role of topical zinc

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    Maher SF

    2015-06-01

    Full Text Available Sara F Maher Physical Therapy Program, Department of Healthcare Sciences, Wayne State University, Detroit, MI, USA Abstract: Topical zinc has been used in the treatment of wounds for over 3,000 years, and is reported to have antiseptic, astringent, anti-inflammatory, antimicrobial, and wound healing properties. Fourteen studies were identified and reviewed, to assess the efficacy of this treatment modality as either a bandage or skin protectant in the treatment of venous ulcers. The authors of three studies reported improved healing time or success rate in wounds treated with zinc-based products. However, the authors of one study attributed the faster healing rate mainly to the extra compression (that improved venous blood return, delivered by the non-elastic paste bandage, and not by the zinc oxide alone. The quality of evidence is fair, as 50% of the studies were conducted prior to 2000 and 50% of the studies utilized fewer than 45 patients randomized to two or more groups. Other treatments have been reported to be more cost-effective than zinc, including hydrocolloids, four-layer compression systems, and CircAid Thera-boots. Finally, zinc was reported to be less comfortable, less easy to use, and caused increased pain, in comparison to other products on the market. This literature review, therefore, demonstrated that current evidence is insufficient to determine the effectiveness of zinc-based products in the treatment of venous wounds. Future research is needed focusing on larger, high-quality trials with an emphasis on quality of life issues and cost-effectiveness of treatment. Keywords: chronic wounds, leg ulcers, venous insufficiency, topical zinc

  2. Treatment of chronic venous leg ulcers by platelet gel.

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    Ficarelli, Elena; Bernuzzi, Gino; Tognetti, Elena; Bussolati, Ovidio; Zucchi, Alfredo; Adorni, Daniela; De Panfilis, Giuseppe

    2008-07-01

    Chronic venous leg ulcers (CVLU) are chronic wounds, associated with long-standing venous hypertension, which have a poor prognosis for healing. In the process of wound healing the first step is represented by platelet aggregation and subsequent release of growth factors and other mediators, which play a key role in the repair response. Platelet gel (PG), a hemocomponent obtained by mixing platelets, thrombin, and calcium, is able, when applied topically, to release platelet mediators that likely favor CVLU healing. However, unstandardized protocols have been described in studies utilizing PG for the regeneration of a number of tissues, including CVLU; the relative clinical outcomes were hence highly variable. In our experience the topical use of PG, together with the strict adherence to the principles of good wound care, quickly promoted increased granulation tissue, followed by a complete CVLU epithelization. Although further studies and trials are needed to establish the major outcome affecting rules for optimal indications, preparation, and use of PG for CVLU treatment, PG can be undoubtedly considered a useful tool, able to improve the management of CVLU.

  3. Local Treatment of Chronic Wounds in Patients With Peripheral Vascular Disease, Chronic Venous Insufficiency, and Diabetes

    NARCIS (Netherlands)

    Ruettermann, Mike; Maier-Hasselmann, Andreas; Nink-Grebe, Brigitte; Burckhardt, Marion

    2013-01-01

    Background: A chronic wound is defined as an area where the skin is not intact that fails to heal within eight weeks. Such wounds usually develop on the lower limbs as a complication of diabetes, venous insufficiency, or inadequate arterial perfusion. Most of the roughly 45 000 limb amputations perf

  4. Retinal abnormalities in multiple sclerosis patients with associated chronic cerebrospinal venous insufficiency

    OpenAIRE

    Aneta Adamczyk-Ludyga; Justyna Wróbeł; Marian Simka; Tomasz Ludyga; Paweł Latacz; Marek Kazibudzki

    2012-01-01

    Optical coherence tomography (OCT) is a non-invasive method for the assessment of optic nerve fibers and retinal ganglion cells. This study was aimed at the assessment of retinal abnormalities in multiple sclerosis patients in the context of chronic cerebrospinal venous insufficiency using OCT of the retina and the optic nerve. We examined 239 multiple sclerosis (MS) patients, including 220 patients with associated chronic cerebrospinal venous insufficiency and 19 MS patients without venous p...

  5. 77 FR 24718 - Scientific Information Request on Chronic Venous Ulcers Treatments

    Science.gov (United States)

    2012-04-25

    ... HUMAN SERVICES Agency for Healthcare Research and Quality Scientific Information Request on Chronic... for Scientific Information Submissions. SUMMARY: The Agency for Healthcare Research and Quality (AHRQ) is seeking scientific information submissions from manufacturers of chronic venous ulcer...

  6. Improvements of venous tone with pycnogenol in chronic venous insufficiency: an ex vivo study on venous segments.

    Science.gov (United States)

    Belcaro, Gianni; Dugall, Mark; Luzzi, Roberta; Hosoi, M; Corsi, Marcello

    2014-03-01

    This study evaluated the stretching and dilatation of venous segments ex vivo in subjects with primary varicose veins in comparison with comparable segments from subjects that used the supplement Pycnogenol (150 mg/d) for 3 months before surgery. Subjects with varicose veins and chronic venous insufficiency voluntarily used Pycnogenol for a period of at least 3 months. The segments of veins removed with surgery (in 30 subjects that had used Pycnogenol and in 10 comparable control subjects that had not used the supplement) were compared with normal, unused vein segments harvested for bypass grafting. The segments were suspended and a weight was attached to the distal part of the veins for 3 minutes and dilated with pressurized water. Digital images were recorded; the veins were measured before and after stretching to evaluate elongation. The manipulation of the vein segment was minimal. Tests were completed within 20 minutes after harvesting the veins. All segments were 4 cm long. The stretching test indicated a significantly higher level of passive elongation in control, varicose segments (2.29; 0.65 mm) in comparison with 1.39; 0.2 mm in vein segments from Pycnogenol-using patients. The dilation test showed an average higher dilation (2.19; 0.3 mm) in control varicose veins in comparison with varicose veins from Pycnogenol-using patients (1.32; 0.7 mm) (p Pycnogenol-using subjects (p Pycnogenol. Varicose segments had a more significant persistent dilatation and elongation in comparison with normal vein segments. Pycnogenol seems to decrease passive dilatation and stretching and gives vein walls a greater tonic recovery and elasticity that allows the vein to recover its original shape after dynamic stresses.

  7. [The peculiarities of diagnosis and treatment of chronic venous insufficiency and venous forms of lower extremity dysplasia].

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    Sapelkin, S V; Dan, V N; Karmazanovskĭ, G G; Kuntsevich, G I

    2006-12-01

    The authors present the modern viewpoint concerning the problem of chronic venous insufficiency in the cases of venous forms of dysplasia. The treatment of patients with of venous forms of dysplasia should be based on the principles of interdisciplinary approach, which stipulates both the careful diagnosis on the basis of mainly non-invasive methods and integration of surgical and conservative treatment methods. Today such treatment should be combined and conducted within the multi-purpose highly specialized institution. Only the combination of all treatment methods will allow achieving the best functional and esthetic results. In the cases when indications are absent and conduction of surgical or any other treatment method is impossible it is necessary control the venous anomaly (dynamical follow-up, compression as a basic variant of conservative therapy). It will allow minimizing the unfavorable influence on vital functions and improving the patient's life quality.

  8. Nursing diagnoses in patients with chronic venous ulcer: observational study

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    Glycia de Almeida Nogueira

    2015-06-01

    Full Text Available This study aimed to analyze nursing diagnoses in people with chronic venous ulcer. An observational, descriptive, quantitative research conducted in an ambulatory specialized in wound treatment, with a non-probabilistic sample of 20 patients.  Data collection was performed in an institutional form denominated Assessment Protocol for Clients with Tissue Lesions. Diagnoses were established by consensus among four researchers with experience in nursing diagnoses and wound treatments. From data analysis, 16 diagnoses were identified, with 100% of participants presenting: Impaired tissue integrity, Ineffective peripheral tissue perfusion, Risk of infection, Impaired physical mobility and Ineffective health self-control. These diagnoses are found in Safety/Protection, Activity/Rest and Health promotion domains, which from the clinical practice stand point should be priority focuses in nursing intervention and assessment.

  9. Smart medical stocking using memory polymer for chronic venous disorders.

    Science.gov (United States)

    Kumar, Bipin; Hu, Jinlian; Pan, Ning

    2016-01-01

    Proper level of pressure or compression generated by medical stocking or hosiery is the key element for successful treatment or management of chronic venous disorders such as oedema, leg ulcers, etc. However achieving the recommended compression level and, more importantly, sustaining it using stockings has been a major challenge to the health practitioners supervising the treatment. This work aims to investigate and design a smart compression stocking using shape-memory polymer that allows externally controlling the pressure level in the wrapped position on the leg. Based on thermodynamical rubber theories, we first derived several criteria that have to be satisfied simultaneously in order to achieve the controlled pressure adjustment using external heat stimuli. We then presented a case where such a stocking is developed using a blend yarn consists of selected shape-memory polyurethane and nylon filaments. Extensive experimental work has also been conducted to demonstrate the feasibility and explore the influencing factors involved.

  10. Chronic Stress Facilitates the Development of Deep Venous Thrombosis

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    Tao Dong

    2015-01-01

    Full Text Available The increasing pressure of modern social life intensifies the impact of stress on the development of cardiovascular diseases, which include deep venous thrombosis (DVT. Renal sympathetic denervation has been applied as one of the clinical approaches for the treatment of drug-resistant hypertension. In addition, the close relationship between oxidative stress and cardiovascular diseases has been well documented. The present study is designed to explore the mechanism by which the renal sympathetic nerve system and the oxidative stress affect the blood coagulation system in the development of DVT. Chronic foot shock model in rats was applied to mimic a state of physiological stress similar to humans. Our results showed that chronic foot shock procedure could promote DVT which may be through the activation of platelets aggregation. The aggravation of DVT and activation of platelets were alleviated by renal sympathetic denervation or antioxidant (Tempol treatment. Concurrently, the denervation treatment could also reduce the levels of circulating oxidation factors in rats. These results demonstrate that both the renal sympathetic nerve system and the oxidative stress contribute to the development of DVT in response to chronic stress, which may provide novel strategy for treatment of clinic DVT patients.

  11. The place of subfascial endoscopic perforator vein surgery (SEPS) in advanced chronic venous insufficiency treatment.

    Science.gov (United States)

    Pesta, Wiesław; Kurpiewski, Waldemar; Kowalczyk, Marek; Szynkarczuk, Rafał; Luba, Magdalena; Zurada, Anna; Grabysa, Radosław

    2011-12-01

    In spite of medical science development and initiation of new technologies in minimally invasive surgery, treatment of advanced chronic venous insufficiency at the 5(th) and 6(th) degree of CEAP classification is still a great clinical challenge. In case of no satisfactory results of non-surgical treatment of recurrent venous ulcers, scientists search for alternative therapeutic methods which could be more effective and lasting. Subfascial endoscopic perforator vein surgery (SEPS) as a method of reducing venous pressure in the superficial venous system could provide healing of the recurrent venous ulcer. In this study we present a review of contemporary opinions about the place and significance of subfascial endoscopic perforator vein surgery as a treatment of advanced chronic venous insufficiency.

  12. Endovascular Interventions for Acute and Chronic Lower Extremity Deep Venous Disease: State of the Art.

    Science.gov (United States)

    Sista, Akhilesh K; Vedantham, Suresh; Kaufman, John A; Madoff, David C

    2015-07-01

    The societal and individual burden caused by acute and chronic lower extremity venous disease is considerable. In the past several decades, minimally invasive endovascular interventions have been developed to reduce thrombus burden in the setting of acute deep venous thrombosis to prevent both short- and long-term morbidity and to recanalize chronically occluded or stenosed postthrombotic or nonthrombotic veins in symptomatic patients. This state-of-the-art review provides an overview of the techniques and challenges, rationale, patient selection criteria, complications, postinterventional care, and outcomes data for endovascular intervention in the setting of acute and chronic lower extremity deep venous disease. Online supplemental material is available for this article.

  13. Mean Platelet Volume in Patients with Chronic Venous Insufficiency

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    Mehmet Akif Sarıca

    2016-03-01

    Full Text Available Objective: the mean platelet volume (MPV is a good indicator of platelet activity; it is reported to increase in diseases associated with inflammatory processes and in vascular diseases. This study investigated the importance of mean platelet volume in patients with chronic venous insufficiency (CVI and whether the MPV was likely to be a predictor of the CVI. Methods: 117 patients who were diagnosed as CVI by colored Doppler Ultrasound (CDU method and 49 healthy volunteers (forming the control group were en­rolled to this study, which was planned retrospectively. The patients’ blood count values taken within one month before and after the CDU evaluation were recorded by the hospital information system. The complete blood count, routine biochemical tests and thyroid function tests of the patients diagnosed with CVI were compared to the control group. Results: Significant differences were not detected be­tween the patients and the control group in terms of the levels of creatinine, aspartate aminotransferase, total cholesterol, LDL cholesterol, HDL cholesterol, triglycer­ides, erythrocyte, sedimentation speed, leukocyte, hae­moglobin and thrombocyte (p>0.05. The thyroid stimulat­ing hormone and the MPV levels were significantly lower in the control group (p<0.05. Conclusion: MPV levels as an easy, cheap and practi­cal data extracted from complete blood count, were found higher in patients diagnosed with CVI compared to the control group. This may be originated from endothelium changes as an answer to venous hypertension and dila­tation in CVI. MPV can be used as a follow-up marker in CVI patients. J Clin Exp Invest 2016; 7 (1: 73-77

  14. The role of perforators in chronic venous insufficiency.

    Science.gov (United States)

    O'Donnell, T F

    2010-02-01

    The treatment of incompetent calf perforating veins (ICPVs) has been ascribed an important role in the therapeutic strategy for reducing superficial venous hypertension in patients with advanced chronic venous insufficiency (C4-C6). Since the open approach to ligation of ICPVs was developed by Linton over 70 years ago, there has been an evolution toward less invasive techniques with lower morbidity. This paper will review the evidence for interruption of ICPVs through a series of systematic analyses of (1) subfascial endoscopic perforating surgery (SEPS) and (2) percutaneous thermal ablation techniques (PAPS). The effectiveness and morbidity of each approach will be discussed as well as the strength of evidence supporting that technique. While there are numerous case series that suggest that SEPS is beneficial for ulcer healing and for the prevention of ulcer recurrence, the sole two RCTs that have compared either open division or SEPS for ICPVs have failed to show a statistical advantage for ICPV ablation. The results of these studies are clouded by the inclusion of patients who received concomitant treatment of their great saphenous vein (GSV). The evidence for PAPS is based on a few (n = 5) case series in peer-reviewed journals, which are limited by small patient populations, limited follow-up, and a focus on surrogate outcomes (occlusion of the perforator) rather than clinical or functional outcomes. Moreover, most of these series were carried out in patients with mild disease. Sclerotherapy of ICPVs, by either liquid or foam, shows promise, but requires greater evidence. Our current approach for limbs with C4-C6 disease is to treat the GSV first and limit treatment of ICPVs to those with high volume flow and large-diameter ICPVs. [corrected

  15. Cardiovascular and Interventional Radiological Society of Europe Commentary on the Treatment of Chronic Cerebrospinal Venous Insufficiency

    NARCIS (Netherlands)

    J.A. Reekers; M.J. Lee; A.M. Belli; F. Barkhof

    2011-01-01

    Chronic cerebrospinal venous insufficiency (CCSVI) is a putative new theory that has been suggested by some to have a direct causative relation with the symptomatology associated with multiple sclerosis (MS) [1]. The core foundation of this theory is that there is abnormal venous drainage from the b

  16. [Clinico-histopathological correlations of venous wall modifications in chronic venous insufficiency].

    Science.gov (United States)

    Mironiuc, A; Palcau, L; Andercou, O; Rogojan, L; Todoran, M; Gordan, G

    2008-01-01

    The interest manifested for the conjunctive tissue pathology leaded to the study of the structural disorder that appears in the varicose veins walls. The study is a prospective one initiated in March 2007 made on 11 patients with varicose disease hospitalized at Cluj-Napoca within Surgery Clinic no. II. The purpose of this study is to point out the histopathological modifications in the varicose venous wall (great saphenous vein cross, communicating veins, perforating veins), as well as the correlation of histopathological results with the evolutive stage of chronic vein insufficiency (CEAP classification) and with the clinical score at these patients. The histopathological (HP) results for 2 of the patients revealed hypertrophy of the media, intimal hyperplasia (stage II) corresponding to a CEAP 3. Six patients were integrated in HP stage III due to the partial intimal fibrosis corresponding to a CEAP 6 for one case, CEAP 4 one case, CEAP 3 four cases. One patient had HP stage I with CEAP 3 and two patients had HP stage IV corresponding to CEAP 5, respectively CEAP 6.

  17. [Disorders of statics of the foot and chronic venous insufficiency].

    Science.gov (United States)

    Peresa, M; Krajcar, J

    1987-01-01

    The aim of this study was to confirm a fact known in the relevant literature that there is a correlation between static anomalies of the sole, and varicose veins, a consequence of the decreased quality of the conjunctive tissue. We cite genetic and dynamic factors by way of explanation. To confirm the fact that deformities of the sole of the foot are linked with chronic venous incompetence and influence the functional capacity of the muscular pump, the authors have analysed in young subjects the contractile capacity of the pump even when the index of reduction in the sole of the foot was quite low. The muscular pump in the calf is a compensatory system from the point of view of functional capacity. The authors noted that the velocimetric parameter of speed of flux in the femoral vein is a sensitive parameter and changes rapidly, rising with even minimal activity in the calf. The authors think that acquired deformities are one of the most frequent causes of the poor functioning of the muscular pump in the calf.

  18. Chronic venous disease - Part I: Inflammatory biomarkers in wound healing.

    Science.gov (United States)

    Ligi, Daniela; Mosti, Giovanni; Croce, Lidia; Raffetto, Joseph D; Mannello, Ferdinando

    2016-10-01

    Venous leg ulcers (VLUs) produce wound fluid (WF), as a result of inflammatory processes within the wound. It is unclear if WF from different healing phases of VLU has a peculiar biochemical profile and how VLU microenvironment affects the wound healing mechanisms. This study was conducted to evaluate the cytokine/chemokine profiles in WF from distinct VLU phases, in WF- and LPS-stimulated monocytes and treated with glycosaminoglycan Sulodexide, a therapeutic option for VLU healing. WF and plasma were collected from patients with VLU during active inflammatory (Infl) and granulating (Gran) phases. Demographics, clinical characteristics and pain measurements were evaluated. WF, plasma, and THP-1 supernatants were analyzed for 27 inflammatory mediators by multiplex immunoassay. Our results demonstrated that: 1) pain was significantly increased in patients with Infl compared to Gran VLU; 2) cytokine profile of Infl WF was found to be statistically different from that Gran WF, as well significantly increased respect to plasma; 3) LPS- and WF-stimulation of THP-1 cells significantly increased the expression of several cytokines compared to untreated cells; 4) Sulodexide treatment of both LPS- and WF-stimulated THP-1 monocytes was able to significantly down-regulate the release of peculiar inflammatory mediators. Our study highlighted the importance to understand biomolecular processes underlying CVI when providing treatment for chronic VLU. Identification of inflammatory biomarkers in leg ulcer microenvironment, may provide useful tools for predicting healing outcome and developing targeted therapies.

  19. Computed Tomograpy Venography diagnosis of iliocaval venous obstruction in advanced chronic venous insufficiency

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    Fabio Henrique Rossi

    2014-12-01

    Full Text Available Objective:Iliocaval obstruction is associated with venous hypertension symptoms and may predispose to deep venous thrombosis (DVT. Ultrasonography may fail to achieve noninvasive diagnosis of these obstructions. The possibility of using Computed Tomography Venography (CTV for these diagnoses is under investigation.Methods:Patients with CVI graded at CEAP clinical classes 3 to 6 and previous treatment failure underwent evaluation with CTV. Percentage obstruction was rated by two independent examiners. Obstruction prevalence and its associations with risk factors and CEAP classification were analyzed.Results:A total of 112 limbs were prospectively evaluated. Mean patient age was 55.8 years and 75.4% were women. Obstructions involved the left lower limb in 71.8% of cases and 35.8% of patients reported a medical history of deep venous thrombosis. Overall, 57.1% of imaging studies demonstrated venous obstruction of at least 50% and 10.7% showed obstruction of >80%. The only risk factor that was found to be independently associated with a significantly higher incidence of >50% venous obstruction was a medical history of DVT (p=0.035 (Fisher's exact test. There was a positive relationship between clinical classification (CEAP and degree of venous obstruction in the limbs studied (Chi-square test for linear trend; p=0.011.Conclusion:Patients with advanced CVI are often affected by obstructions in the iliocaval venous territory and CTV is able to diagnose the degree of obstruction. There is a positive association between degree of obstruction and both previous history of DVT and severity of symptoms of CVI.

  20. Recommendations for the medical management of chronic venous disease: The role of Micronized Purified Flavanoid Fraction (MPFF).

    Science.gov (United States)

    Bush, Ronald; Comerota, Anthony; Meissner, Mark; Raffetto, Joseph D; Hahn, Steven R; Freeman, Katherine

    2017-04-01

    Scope A systematic review of the clinical literature concerning medical management of chronic venous disease with the venoactive therapy Micronized Purified Flavonoid Fraction was conducted in addition to an investigation of the hemodynamics and mechanism of chronic venous disease. Methods The systematic review of the literature focused on the use of Micronized Purified Flavonoid Fraction (diosmin) which has recently become available in the US, in the management of chronic venous disease. The primary goal was to assess the level of evidence of the role of Micronized Purified Flavonoid Fraction in the healing of ulcers, and secondarily on the improvement of the symptoms of chronic venous disease such as edema. An initial search of Medline, Cochrane Database for Systematic Reviews and Google Scholar databases was conducted. The references of articles obtained in the primary search, including a Cochrane review of phlebotonics for venous insufficiency, were reviewed for additional studies. Studies were included if patients had a diagnosis of chronic venous disease documented with Doppler and Impedance Plethysmography. Studies excluded were those that had patients with arterial insufficiency (Ankle Brachial Index chronic venous disease patients because of its favorable safety profile. The Working Group for chronic venous disease concurs with previous guidance by the International European Society for Vascular Surgery in 2015 which recommended the use of Micronized Purified Flavonoid Fraction for the healing of venous ulcers, alone and adjunctive to compression therapy, and for the reduction in symptoms of chronic venous disease such as edema.

  1. Chronic cerebrospinal venous insufficiency in patients with Ménière's disease.

    Science.gov (United States)

    Filipo, R; Ciciarello, F; Attanasio, G; Mancini, P; Covelli, E; Agati, L; Fedele, F; Viccaro, M

    2015-01-01

    To analyze the presence of chronic cerebrospinal venous insufficiency parameter and vascular abnormalities, in the internal jugular veins (IJVs) and/or vertebral veins in sitting and supine posture, in patients with Meniere's disease compared to healthy general population. A prospective study on 32 patients affected by definite Ménière was performed from February 2012 to January 2013. All subjects underwent an echo-color Doppler examination of the cerebrospinal venous flow. 21 of the 32 Menieric patients showed a statistically significant reflux in the intracranial veins versus healthy (65.6 vs 25%; P venous system present in patients affected by definite Meniere. This vascular impairment significantly affects the vascular areas more directly involved in the venous drainage of the inner ear. Thus venous stasis may be considered a further pathogenetic mechanism for development of Meniere's disease.

  2. Inverse relation between aldosterone and venous capacitance in chronically treated congestive heart failure.

    Science.gov (United States)

    Rietzschel, E; Duprez, D A; De Buyzere, M L; Clement, D L

    2000-04-15

    The purpose of this study was to examine if there is a relation between the aldosterone escape phenomenon and venous capacitance of the upper and lower limbs in patients with long-term congestive heart failure (CHF) receiving chronic treatment with angiotensin-converting enzyme (ACE) inhibitors. The study group consisted of 16 subjects with ischemic CHF in New York Heart Association functional class II (age 59 +/-2 years, ejection fraction 24+/-4%), stabilized under a constant drug regimen comprising furosemide, captopril 50 mg 3 times daily, and digoxin for at least 3 months. Thirteen apparently healthy volunteers, aged 50+/-4 years acted as controls. Forearm and calf venous capacitances were measured simultaneously by venous occlusion plethysmography using mercury-in-silastic strain gauges. The equilibration technique was used to derive venous capacitance from the recorded pressure-volume curves. Active renin, angiotensin II, and aldosterone levels were determined on venous blood samples obtained in the supine position. Angiotensin II (paldosterone (paldosterone escape phenomenon). In CHF, forearm venous capacitance was 2.19+/-0.18 ml/100 ml; calf venous capacitance was 2.83+/-0.27 ml/100 ml. Aldosterone significantly and inversely correlated with venous capacitance in both upper (r = -0.586; p = 0.017) and lower (r = -0.625; p = 0.01) limbs. No correlations were found between forearm or calf venous capacitance and renin or angiotensin II. In patients with heart failure chronically treated with diuretics and full ACE inhibition, venous capacitance is inversely correlated with aldosterone through the mechanism of aldosterone escape, creating the potential for further deterioration of the CHF process.

  3. Rapid relief of signs/symptoms in chronic venous microangiopathy with pycnogenol: a prospective, controlled study.

    Science.gov (United States)

    Cesarone, M R; Belcaro, G; Rohdewald, P; Pellegrini, L; Ledda, A; Vinciguerra, G; Ricci, A; Gizzi, G; Ippolito, E; Fano, F; Dugall, M; Acerbi, G; Cacchio, M; Di Renzo, A; Hosoi, M; Stuard, S; Corsi, M

    2006-01-01

    The aim of this study was to investigate the clinical efficacy of oral Pycnogenol (Horphag Research Ltd, UK) in patients with severe chronic venous insufficiency. Patients with severe venous hypertension (chronic venous insufficiency, ankle swelling) and history of venous ulcerations were treated with Pycnogenol. Patients received oral Pycnogenol (50 mg capsules, 3 times daily for a total of 150 mg daily) for 8 weeks. A group of 21 patients was included in the treatment group and 18 equivalent patients were observed as controls (no treatment during the observation period). All 21 patients (age 53 years; range, 42-60 years; M:F=11:10) in the treatment group completed the 8-week study. Also the 18 controls completed the follow-up period. There were no drop-outs. The average ambulatory venous pressure was 59.3 (SD 7.2; range 50-68) with a refilling time shorter than 10 seconds (average 7.6; SD 3). There were no differences in ambulatory venous pressure or refilling time between the treatment and control patients. The duration of the disease-from the first signs/symptoms-was on average 5.7 years (SD 2.1). At 4 and 8 weeks, in all Pycnogenol-treated subjects, microcirculatory and clinical evaluations indicated a progressive decrease in skin flux, indicating an improvement in the level of microangiopathy; a significant decrease in capillary filtration; a significant improvement in the symptomatic score; and a reduction in edema. There were no visible effects in controls. In conclusion, this study confirms the fast clinical efficacy of Pycnogenol in patients with chronic venous insufficiency and venous microangiopathy. The study indicates the significant clinical role of Pycnogenol in the management, treatment and control of this common clinical problem. The treatment may be also useful to prevent ulcerations by controlling the level of venous microangiopathy.

  4. Surgical treatment of severe chronic venous insufficiency caused by pulsatile varicose veins in a patient with tricuspid regurgitation.

    Science.gov (United States)

    Casian, D; Gutsu, E; Culiuc, V

    2009-04-01

    A case of severe chronic venous insufficiency caused by pulsatile varicose veins in a 46-year-old man with tricuspid regurgitation is presented. Active venous leg ulcer complicated with recurrent venous bleeding and inefficacy of conservative management serve as indications for surgical treatment. This case demonstrates the possibility of radical surgical correction of pathological venous reflux by means of saphenofemoral ligation, foam sclerotherapy and subfascial endoscopic perforator surgery.

  5. Acute on Chronic Venous Thromboembolism on Therapeutic Anticoagulation

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    Byron Bassi

    2013-01-01

    Full Text Available A case of proximal venous thromboembolism in a patient who presented to the ED with lower extremity pain is presented. Making this diagnosis is very important as fifty percent of patients with symptomatic proximal DVTs will go on to develop PE without treatment. This report underscores the utility of bedside ultrasonography in the emergency department.

  6. Elastic compression treatment of chronic superficial venous insufficiency of the lower limbs based on Doppler venous pressure index measurements

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    Leonardo Corcos

    2015-03-01

    Full Text Available Ineffectiveness or discomfort from graduated elastic compression stockings (GES in patients with chronic venous insufficiency (CVI and/or varicose veins of the lower limbs (VVLL can depend of inappropriate counter pressure applied. Counter pressure was calculated by Doppler venous pressure index (VPI. The aim of this study was to verify the value VPI in the choice of GES. A total of 1212 LL of 606 patients subjected to VPI measurements VPI correlated with the various sites of reflux (R and C of Clinical-Etiology-Anatomy-Pathophysiology (CEAP classification. The difference between standing VPI the and normal values=counter pressure to be applied by GES. Questionnaire to 96 patients with CVI/VVLL wearing GES. Mean VPI values: greater saphenous (GSV>smaller saphenous; GSV with isolated venous reflux (R at the leg>GSV at the thigh; additional R in perforators increases VPI in all the districts; superficial R increases VPI in PT. Relation between VPI/C of CEAP: P<0.05-0.0001; 81/83/96 (97.5% patients improved; 0 complained. R in GSV at the leg and in perforators increases VPI in deep veins. Few discrepancies VPI/CEAP can be expected. Standing VPI is highly predictive. The best choice of GES can be based on the VPI measurement.

  7. Retinal abnormalities in multiple sclerosis patients with associated chronic cerebrospinal venous insufficiency

    Directory of Open Access Journals (Sweden)

    Aneta Adamczyk-Ludyga

    2012-06-01

    Full Text Available Optical coherence tomography (OCT is a non-invasive method for the assessment of optic nerve fibers and retinal ganglion cells. This study was aimed at the assessment of retinal abnormalities in multiple sclerosis patients in the context of chronic cerebrospinal venous insufficiency using OCT of the retina and the optic nerve. We examined 239 multiple sclerosis (MS patients, including 220 patients with associated chronic cerebrospinal venous insufficiency and 19 MS patients without venous pathology. The following OCT parameters were assessed: average ganglion cell complex thickness, global loss volume, focal loss volume and average retinal nerve fibre layer thickness. Abnormalities in the azygous and internal jugular veins were evaluated using catheter venography. We found a higher prevalence of abnormal OCT parameters in the patients with previous history of optic neuritis, not only on the side of inflammatory event, but also in the contralateral eye, which is in line with already existing body of evidence. The new and intriguing discovery is that we found statistically significant higher prevalence of abnormal OCT values in multiple sclerosis patients with unilateral stenosis of internal jugular vein. Patients who were not found venous abnormalities, as well as those presenting with pathologic azygous or bilateral internal jugular venous outflows, did not demonstrate a changed frequency of abnormal OCT parameters. Potential association between venous malformations and eye manifestations of multiple sclerosis, as has been demonstrated in this report, justifies further studies on this topic.

  8. Chronic venous insufficiency patterns in lower extremity veins detected by Doppler Ultrasound

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    Özhan Özgür

    2013-12-01

    Full Text Available Objective: The aim of this study was to reveal patterns ofchronic venous insufficiency of lower extremity detectedby color Doppler ultrasound and clarify its clinical implicationsin the patients with varicose veins symptoms.Methods: Between 2006 to 2011, a total of 2006 patientspresented with symptoms of venous insufficiency wereincluded in study. A total of 3938 lower extremity venoussystems were examined using color Doppler US. Weclassified four patterns considering combinations of superficialand deep venous insufficiency.Results: Of 2006 patients, 966 had either single venousinsufficiency (790, 82% or combined insufficiency (176,18%. Superficial venous insufficiency was observedat the saphenoefemoral junction (SFJ in 25.5%, at theGreat Saphenous Vein (GSV in 57.6%, at the GiacominiVein in 2.4%, at the saphenopopliteal junction in 1.8% andfinally at the Small Saphenous Vein (SSV in 9.1% of thepatients. We found multilevel venous insufficiency showingconnections at the rate of 51%. We described fourpatterns as Pattern 1: SFJ insufficiency combined withGSV (97.9%, GSV branching (7.1%, and perforatingvein (20.8% insufficiency, Pattern 2: Deep venous insufficiencycombined with SFJ (63.6%, GSV (76.4%, andSSV (16.4% insufficiency, Pattern 3: SPJ insufficiencycombined with SSV insufficiency (95.5% and Pattern 4:Giacomini Vein insufficiency combined with GSV (67.9%and SSV (75% insufficiency.Conclusion: Chronic venous insufficiency may show fourdifferent patterns. Our results revealed that SFJ and GSVinsufficiency combination and deep venous insufficiencyand GSV insufficiency combinations are the most commoninsufficiency patterns seen in lower extremity.Key words: Doppler ultrasound, varicose veins, venous insufficiency

  9. Limits and possibilities experienced by nurses in the treatment of women with chronic venous ulcers

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    Marcelo Henrique da Silva

    2014-08-01

    Full Text Available Objective To understand the experiences and expectations of nurses in the treatment of women with chronic venous ulcers. Method Phenomenological research was based on Alfred Schütz, whose statements were obtained in January, 2012, through semi-structured interviews with seven nurses. Results The nurse reveals the difficulties presented by the woman in performing self-care, the perceived limitations in the treatment anchored in motivation, and the values and beliefs of women. It showed professional frustration because venous leg ulcer recurrence, lack of inputs, interdisciplinary work and training of nursing staff. There was an expected adherence to the treatment of women, and it emphasized the need for ongoing care, supported self-care and standard practices in treatment. Conclusion That treatment of chronic venous leg ulcers constitutes a challenge that requires collective investment, involving women, professionals, managers and health institutions.

  10. Chronic kidney disease stages 1-3 increase the risk of venous thrombosis

    NARCIS (Netherlands)

    Ocak, G.; Verduijn, M.; Vossen, C. Y.; Lijfering, W. M.; Dekker, F. W.; Rosendaal, F. R.; Gansevoort, R. T.; Mahmoodi, B. K.

    2010-01-01

    P>Background: End-stage renal disease has been associated with venous thrombosis (VT). However, the risk of VT in the early stages of chronic kidney disease (CKD) has not yet been investigated. The aim of this study was to investigate whether CKD patients with stage 1-3 disease are at increased risk

  11. [EXPERIENCE OF SEVERE CHRONIC VENOUS INSUFFICIENCY OF THE LOWER EXTREMITIES TREATMENT].

    Science.gov (United States)

    Ponomarenko, A V

    2015-06-01

    The results of treatment of 246 patients on different forms of chronic venous insufficiency of the lower extremities were presented. The leading diagnostic criterion when choosing tactics consider patients ultrasound duplex scanning with color mapping. Patients in the presence of large ulcers basic treatment is autodermoplasty. The complex treatment include pharmacotherapy, the use of elastic compression hosiery.

  12. Clinical unity and community empowerment: the use of smartphone technology to empower community management of chronic venous ulcers through the support of a tertiary unit.

    Directory of Open Access Journals (Sweden)

    Edel Marie Quinn

    Full Text Available BACKGROUND: Chronic ulcers affect roughly 60,000 Irish people, at a total cost of €600,000,000, or €10,000 per patient annually. By virtue of their chronicity, these ulcers also contribute a significant burden to tertiary outpatient vascular clinics. OBJECTIVE: We propose utilizing mobile phone technology to decentralise care from tertiary centres to the community, improving efficiency and patient satisfaction, while maintaining patient safety. METHODS: Bespoke mobile software was developed for Apples iPhone 4 platform. This allowed for the remote collection of patient images prospectively and their transmission with clinical queries, from the primary healthcare team to the tertiary centre. Training and iPhones were provided to five public health nurses in geographically remote areas of the region. Data were uploaded securely and user end software was developed allowing the review and manipulation of images, along with two way communication between the teams. Establishing reliability, patients were reviewed clinically as well as remotely, and concordance analysed. Qualitative data were collected through focus group discussion. RESULTS: From October to December 2011 eight patients (61-83 yrs, mean 75.3 yrs with chronic venous ulceration and their five public health nurses were recruited. Data were transmitted using 3 G, Edge, GPRS and WiFi, at a mean speed of 69.03 kps. Concordance was 100% for wound bed assessment, 80% for skin integrity/colour and 60% for exudate assessment. Focus group analysis explored the concept, practicalities and future applications of the system. CONCLUSIONS: With an evolving national data network, the secure transmission of clinical images is a safe alternative to regular clinic appointments for patients with chronic venous ulceration. With further development, and packaged as a freely downloadable application, this has the potential to support the community care of chronic wounds.

  13. Use of a hydrocapillary dressing in the management of highly exuding ulcers: a comparative study

    DEFF Research Database (Denmark)

    Norkus, A; Dargis, V; Thomsen, J K

    2005-01-01

    OBJECTIVE: To evaluate the safety and performance of Alione Hydrocapillary dressing (Coloplast A/S) in the management of highly exuding chronic venous leg ulcers and compare it with two hydropolymer dressings,Tielle and Tielle Plus (Johnson & Johnson). METHOD: A comparative clinical trial was con...... performed as well as or better than the comparator dressings for all study parameters and more patients preferred the test dressing to their previous dressing compared with the comparator dressings....

  14. Horse chestnut – efficacy and safety in chronic venous insufficiency: an overview

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    Marlena Dudek-Makuch

    2015-10-01

    Full Text Available ABSTRACTThe extract from horse chestnut seeds (Aesculus hippocastanumL., Sapindaceae, standardised for the content of aescin, is used as the treatment for chronic venous insufficiency. It has anti-inflammatory and anti-oedematous properties and indicates a positive effect on the venous tone, rheological properties, and blood coagulability. The mechanism of horse chestnut seed extract/aescin activity was proposed on the basis of in vitro and in vivo studies, and its effectiveness was documented with numerous randomised clinical trials. The results of the studies have proven that horse chestnut seed extract not only significantly improves subjective symptoms in patients with chronic venous insufficiency like calf spasm, leg pain, pruritus, fatigue, but it also reduced leg volume, the ankle and calf circumference. The preparations containing horse chestnut seed extract are very popular and they have similar effectiveness as compression therapy and a preparation with O-(β-hydroxyethyl-rutosides. Moreover, horse chestnut seed extract has been proven to be safe and very well tolerated. The study was to present the results of the studies that have been conducted so far and that have confirmed the effectiveness of use of horse chestnut seed extract or aescin as the treatment for chronic venous insufficiency.

  15. Evaluation of quality of life and photoplethysmography in patients with chronic venous insufficiency treated with foam sclerotherapy

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    Felipe Coelho Neto

    2015-06-01

    Full Text Available BACKGROUND: Ultrasound-guided foam sclerotherapy plays a major role in treatment of chronic venous insufficiency, providing clinical and hemodynamic improvement to patients undergoing treatment.OBJECTIVES: To examine the relationships between venous refilling time and impact of venous disease on quality of life and between changes in venous refilling time and improvement of symptoms after ultrasound-guided foam sclerotherapy for chronic venous insufficiency.METHODS: Thirty-two patients classified as C4, C5 or C6 answered a questionnaire on quality of life and symptoms and their venous filling time was measured using photoplethysmography before and 45 days after treatment of chronic venous insufficiency with ultrasound-guided foam sclerotherapy.RESULTS: Statistically significant improvements were observed in quality of life scores and in venous filling time and in the following symptoms: aching, heavy legs, restless legs, swelling, burning sensations, and throbbing (p<0.0001. A similar improvement was also seen in the work and social domains of quality of life (p<0.0001.CONCLUSIONS: As confirmed by questionnaire scores and venous refilling times, ultrasound-guided foam sclerotherapy demonstrated efficacy and resulted in high satisfaction levels and low rates of major complications.

  16. Decreased brain venous vasculature visibility on susceptibility-weighted imaging venography in patients with multiple sclerosis is related to chronic cerebrospinal venous insufficiency

    Directory of Open Access Journals (Sweden)

    Hojnacki David

    2011-10-01

    Full Text Available Abstract Background The potential pathogenesis between the presence and severity of chronic cerebrospinal venous insufficiency (CCSVI and its relation to clinical and imaging outcomes in brain parenchyma of multiple sclerosis (MS patients has not yet been elucidated. The aim of the study was to investigate the relationship between CCSVI, and altered brain parenchyma venous vasculature visibility (VVV on susceptibility-weighted imaging (SWI in patients with MS and in sex- and age-matched healthy controls (HC. Methods 59 MS patients, 41 relapsing-remitting and 18 secondary-progressive, and 33 HC were imaged on a 3T GE scanner using pre- and post-contrast SWI venography. The presence and severity of CCSVI was determined using extra-cranial and trans-cranial Doppler criteria. Apparent total venous volume (ATVV, venous intracranial fraction (VIF and average distance-from-vein (DFV were calculated for various vein mean diameter categories: .9 mm. Results CCSVI criteria were fulfilled in 79.7% of MS patients and 18.2% of HC (p Conclusions MS patients with higher number of venous stenoses, indicative of CCSVI severity, showed significantly decreased venous vasculature in the brain parenchyma. The pathogenesis of these findings has to be further investigated, but they suggest that reduced metabolism and morphological changes of venous vasculature may be taking place in patients with MS.

  17. The bacteriology of chronic venous leg ulcer examined by culture-independent molecular methods

    DEFF Research Database (Denmark)

    Thomsen, Trine R; Aasholm, Martin S; Rudkjøbing, Vibeke B;

    2010-01-01

    , such as 16S rRNA gene sequencing, fingerprinting, quantitative polymerase chain reaction, and fluorescence in situ hybridization. Each wound contained an average of 5.4 species but the actual species varied between wounds. The diversity determined by culture-based methods and the molecular biological methods...... was different. All the wounds contained Staphylococcus aureus, whereas Pseudomonas aeruginosa was in six out of 14 wounds. Molecular methods detected anaerobic pathogens in four ulcers that were not detected with anaerobic culture methods. Quantitative polymerase chain reaction was used to compare the abundance......The bacterial microbiota plays an important role in the prolonged healing of chronic venous leg ulcers. The present study compared the bacterial diversity within ulcer material from 14 skin graft operations of chronic venous leg ulcers using culture-based methods and molecular biological methods...

  18. Chronic venous disease - Part II: Proteolytic biomarkers in wound healing.

    Science.gov (United States)

    Ligi, Daniela; Mosti, Giovanni; Croce, Lidia; Raffetto, Joseph D; Mannello, Ferdinando

    2016-10-01

    Venous leg ulcers (VLU) are characterized by sustained proteolytic microenvironment impairing the healing process. Wound fluid (WF) reflect the biomolecular activities occurring within the wound area; however, it is unclear if WF from different healing phases have different proteolytic profiles and how VLU microenvironment affects the wound healing mechanisms. We investigated the proteolytic network of WF from distinct VLU phases, and in WF- and LPS-stimulated THP-1 monocytes treated with glycosaminoglycan sulodexide, a well known therapeutic approach for VLU healing. WF were collected from patients with VLU during inflammatory (Infl) and granulating (Gran) phases. WF and THP-1 supernatants were analyzed for nine matrix metalloproteinases (MMP) and four tissue inhibitors of metalloproteinases (TIMP) by multiplex immunoassays. Our results demonstrated that: 1) WF from Infl VLU contained significantly increased concentrations of MMP-2, MMP-9, MMP-12, TIMP-1, and TIMP-2 compared to Gran WF; 2) WF from Gran VLU showed significantly increased levels of MMP-1, MMP-7, MMP-13, and TIMP-4 compared to Infl WF; 3) LPS- and WF-stimulation of THP-1 cells significantly increased the expression of several MMP compared to untreated cells; 4) Sulodexide treatment of both LPS- and WF-stimulated THP-1 significantly down-regulated the release of several MMPs. Our study provides evidence-based medicine during treatment of patients with VLU. WF from Infl and Gran VLU have different MMP and TIMP signatures, consistent with their clinical state. The modulation of proteolytic pathways in wound microenvironment by glycosaminoglycan sulodexide, provide insights for translating research into clinical practice during VLU therapy.

  19. Sociopsychological factors in women with chronic pelvic pain with and without pelvic venous congestion.

    Science.gov (United States)

    Fry, R P; Beard, R W; Crisp, A H; McGuigan, S

    1997-01-01

    Social and psychological factors have long been proposed as being of importance in a sizeable subgroup of women complaining of unexplained chronic pelvic pain (CPP). The aim of this study was to examine this in two subgroups of CPP patients, thereby eliminating pain alone as the determining variable. Consecutive attenders at a clinic for CPP were assessed on a range of somatic, historical, social, and psychological variables using detailed interviews and questionnaires. They were subsequently allocated to one of two groups, based on the presence or absence of pelvic venous congestion (PVC). Significant associations emerged between some social arrangements, paternal parenting, and patterns of hostility in the group with pelvic venous congestion. The groups also differed in patterns of family illness, and the congested group tended to report more childhood sexual abuse (CSA). Clear case definition in CPP is important. In the subgroup with pelvic venous congestion early social experience may play an important role. Father-daughter relationships may be particularly relevant. Hostility patterns may influence the development of the condition. CSA does not appear to play a specific role in all unexplained CPP cases, but may have relevance for the subgroup with pelvic venous congestion.

  20. A STUDY ON DIAMETER OF PERFORATORS AND CLINICAL SEVERITY OF CHRONIC VENOUS INSUFFICIENCY

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    Visakh

    2015-10-01

    Full Text Available BACKGROUND : Perforator incompetence is an important part of assessment of chronic venous insufficiency ( CVI, but the criteria for perforator incompetence and the relationship with clinical severity is not well established. AIM: To study whether measurement of diameter of perforator correlates with clinical severity of venous insufficiency. MATERIALS AND METHODS: One hundred and forty five consecutive patients ( 168 limbs with varicose veins were evaluated with Doppler study of lower limb veins. Clinical severity and diameter of perforators were assessed. RESULTS: 23% of patients with clinically mild disease had perforator diameter of 3mm or more , whereas , 62% of moderate and severe disease patients had incompetent perforator. Average diameter of perforator in CVI class 1 & 2 patients was 1.44mm whereas , in class 3 & 4 patients , it was 3.31mm and 3.58mm in class 5 & 6 patients. CONCLUSION : Diameter of perforator compare favourably with clinical severity of chronic venous insufficiency. This study may help to evolve patient management guidelines in perforator incompetence treatment

  1. Matrix Metalloproteinases as Regulators of Vein Structure and Function: Implications in Chronic Venous Disease.

    Science.gov (United States)

    MacColl, Elisabeth; Khalil, Raouf A

    2015-12-01

    Lower-extremity veins have efficient wall structure and function and competent valves that permit upward movement of deoxygenated blood toward the heart against hydrostatic venous pressure. Matrix metalloproteinases (MMPs) play an important role in maintaining vein wall structure and function. MMPs are zinc-binding endopeptidases secreted as inactive pro-MMPs by fibroblasts, vascular smooth muscle (VSM), and leukocytes. Pro-MMPs are activated by various activators including other MMPs and proteinases. MMPs cause degradation of extracellular matrix (ECM) proteins such as collagen and elastin, and could have additional effects on the endothelium, as well as VSM cell migration, proliferation, Ca(2+) signaling, and contraction. Increased lower-extremity hydrostatic venous pressure is thought to induce hypoxia-inducible factors and other MMP inducers/activators such as extracellular matrix metalloproteinase inducer, prostanoids, chymase, and hormones, leading to increased MMP expression/activity, ECM degradation, VSM relaxation, and venous dilation. Leukocyte infiltration and inflammation of the vein wall cause further increases in MMPs, vein wall dilation, valve degradation, and different clinical stages of chronic venous disease (CVD), including varicose veins (VVs). VVs are characterized by ECM imbalance, incompetent valves, venous reflux, wall dilation, and tortuosity. VVs often show increased MMP levels, but may show no change or decreased levels, depending on the VV region (atrophic regions with little ECM versus hypertrophic regions with abundant ECM) and MMP form (inactive pro-MMP versus active MMP). Management of VVs includes compression stockings, venotonics, and surgical obliteration or removal. Because these approaches do not treat the causes of VVs, alternative methods are being developed. In addition to endogenous tissue inhibitors of MMPs, synthetic MMP inhibitors have been developed, and their effects in the treatment of VVs need to be examined.

  2. Risk factors for chronic cerebrospinal venous insufficiency (CCSVI in a large cohort of volunteers.

    Directory of Open Access Journals (Sweden)

    Kresimir Dolic

    Full Text Available BACKGROUND: The role of intra- and extra-cranial venous system impairment in the pathogenesis of various vascular, inflammatory and neurodegenerative neurological disorders, as well as in aging, has not been studied in detail. Nor have risk factors been determined for increased susceptibility of venous pathology in the intra-cranial and extra-cranial veins. The aim of this study was to investigate the association between presence of a newly proposed vascular condition called chronic cerebrospinal venous insufficiency (CCSVI and environmental factors in a large volunteer control group without known central nervous system pathology. METHODS AND FINDINGS: The data were collected in a prospective study from 252 subjects who were screened for medical history as part of the entry criteria and participated in the case-control study of CCSVI prevalence in multiple sclerosis (MS patients, and then were analyzed post-hoc. All participants underwent physical and Doppler sonography examinations, and were assessed with a structured environmental questionnaire. Fullfilment of ≥ 2 positive venous hemodynamic (VH criteria on Doppler sonography was considered indicative of CCSVI diagnosis. Risk and protective factors associated with CCSVI were analyzed using logistic regression analysis. Seventy (27.8% subjects presented with CCSVI diagnosis and 153 (60.7% presented with one or more VH criteria. The presence of heart disease (p = .001, especially heart murmurs (p = .007, a history of infectious mononucleosis (p = .002, and irritable bowel syndrome (p = .005 were associated with more frequent CCSVI diagnosis. Current or previous smoking (p = .029 showed a trend for association with more frequent CCSVI diagnosis, while use of dietary supplements (p = .018 showed a trend for association with less frequent CCSVI diagnosis. CONCLUSIONS: Risk factors for CCSVI differ from established risk factors for peripheral venous diseases. Vascular

  3. The vegetal biomembrane in the healing of chronic venous ulcers Biomembrana vegetal na cicatrização de úlceras venosas crônicas

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    Marco Andrey Cipriani Frade

    2012-02-01

    Full Text Available BACKGROUND: The vegetal biomembrane has been used to treat cutaneous ulcers. OBJECTIVES: To assess the role of the vegetal biomembrane on the chronic venous ulcers treatment compared to treatment with collagenase cream. METHODS: Fourteen patients were selected to be treated with vegetal biomembrane and 7 with Fibrase®(CONTROL, followed clinically and photographically by the Wound Healing Index by ImageJ during 120 days and biopsied on the 1st and 30th days for histological examination. RESULTS: The vegetal biomembrane was better in promoting healing of the ulcers, especially on the inflammatory phase, confirmed by abundant exudation and wound debridement than the CONTROL group, on the 30th day. There was a greater tendency to angiogenesis followed by re-epithelialization with highest wound healing index on the 90th and 120th days. CONCLUSION: A combined analysis of clinical and histopathological findings suggests that the vegetal biomembrane acted as a factor inducing wound healing, especially on the inflammatory phase, confirmed by abundant exudation of the lesions promoting the transformation of the microenvironment of the chronic venous ulcers, and also stimulating angiogenesis and subsequent re-epithelialization.FUNDAMENTOS: A biomembrana vegetal tem sido usada para tratamento de úlceras cutâneas. OBJETIVOS: Avaliar a ação da biomembrana vegetal no tratamento de úlceras venosas crônicas, comparando-a ao tratamento à base de colagenase. MÉTODOS: Foram selecionados 14 pacientes tratados com biomembrana vegetal e sete com Fibrase® (grupo controle, acompanhados clínico-fotograficamente pelo índice de cicatrização das úlceras (ICU por 120 dias, por meio do software ImageJ, e biopsiados no primeiro e 30º dias para estudo histopatológico. RESULTADOS: A biomembrana vegetal foi superior em relação ao controle na cicatrização das úlceras no 30º dia, especialmente na fase inflamatória, confirmada pela exsudação abundante e

  4. Endothelial function impairment in chronic venous insufficiency: effect of some cardiovascular protectant agents.

    Science.gov (United States)

    Carrasco, Omar F; Ranero, Alejandra; Hong, Enrique; Vidrio, Horacio

    In segments of human varicose veins, endothelial function was assessed by measuring relaxation induced by acetylcholine in noradrenaline-precontracted preparations. In addition, concentration-response curves to acetylcholine were obtained before and after incubation with the arterial endothelium protectant agents captopril, losartan, troglitazone, pravastatin, or simvastatin. The antivaricose agent escin was also tested. Mean acetylcholine-induced relaxation of varicose venous rings was about 13%, approximately one third of that reported for control saphenous veins. Concentration-response curves to acetylcholine were ''u'' shaped, the result of endothelium-mediated relaxation at low concentrations, superseded by subsequent smooth muscle contractile responses. Relaxation was enhanced by the endothelium-protecting agents and by escin, troglitazone being the least, and simvastatin the most effective. It was concluded that endothelial dysfunction is present in varicose veins, that this anomaly can be reverted by cardiovascular protecting agents, and that it can play a role in the pathogenesis and treatment of chronic venous insufficiency.

  5. Pharmacodynamics and pharmacokinetics of Veliten (rutine, alpha-tocopherol and ascorbic acid) in patients with chronic venous insufficiency.

    Science.gov (United States)

    Auteri, A; Pasqui, A L; Bruni, F; Di Renzo, M; Bova, G; Chiarion, C; Delchambre, J

    1994-01-01

    The aim of this study was to evaluate the pharmacodynamics and pharmacokinetics of a single oral dose of Veliten in 12 patients affected by chronic venous insufficiency. In particular, the pharmacokinetics of two components of Veliten, namely rutine and alpha-tocopherol, were considered, while with respect to pharmacodynamics, studies were made of venous function, haemocoagulative and fibrinolytic balance, and haemorheological parameters. Correlation between such changes and plasma drug levels was also evaluated. We found a significant increase of venous tone, venous capacity and venous distension after drug intake, as well as a significant activation of fibrinolysis (globally evaluated with euglobulin lysis time), related to a slight increase of plasminogen tissue activator. These changes appeared concomitantly with maximal plasma levels of rutine. We did not find any modifications of coagulative and haemorheological parameters.

  6. Extra- and transcranial echo colour Doppler in the diagnosis of chronic cerebrospinal venous insufficiency.

    Science.gov (United States)

    Van den Berg, P J; Visser, L H

    2012-03-01

    A new venous disorder, chronic cerebrospinal venous insufficiency (CCSVI), has been proposed in patients with multiple sclerosis (MS). It is a vascular condition characterized by an impaired cerebrospinal venous drainage due to obstructions in the main extracranial cerebrovenous outflow routes (i.e. internal jugular veins [IJV] and/or azygos veins). In this review, the studies which assessed the prevalence of CCSVI in MS by echo colour Doppler (ECD) will be discussed. The technical aspects of determination of the five CCSVI criteria: (1) reflux in the IJV and/or vertebral veins in supine and upright position, (2) reflux in the deep cerebral veins, (3) high-resolution B-mode proximal IJV stenosis, (4) flow not Doppler detectable in IJVs and/or vertebral veins (VVs) and (5) reverted postural control of the main cerebrovenous outflow pathway are described in detail. We conclude that so far there are many studies with contradictory results, and as yet a strong scientific base to support the evidence for a causative relationship of CCSVI and MS is lacking. Recent studies call into question the validity of using ECD as a proper and reliable test for the diagnosis of CCSVI. One explanation for the variety in interpretation of the individual CCSVI criteria, with the wide-ranging percentages CCSVI, could be the different methods by using ECD to determine various criteria.

  7. Is chronic HIV infection associated with venous thrombotic disease? A systematic review.

    Science.gov (United States)

    Klein, S K; Slim, E J; de Kruif, M D; Keller, T T; ten Cate, H; van Gorp, E C M; Brandjes, D P M

    2005-04-01

    Infection with the human immunodeficiency virus (HIV) is still a major health problem world-wide. HIV infection has changed into a chronic infection with the chance of developing long-term complications. Vascular complications are frequently reported in the current literature. HIV and treatment by highly active antiretroviral therapy (HAART) are associated with many cardiovascular risk factors. An increased risk of arterial cardiovascular complications was found in a number of studies. However, data about the risk of venous thrombotic disease (VTE), including potentially fatal conditions as pulmonary embolism, were limited. In a systematic review of the literature, ten relevant epidemiological studies were identified that investigated the risk of venous thrombotic disease in HIV-infected patients. The incidence was increased two- to tenfold in comparison with a healthy population of the same age. However, these studies were mainly retrospective cohort studies that were prone to selection bias, confounding factors were not always mentioned and in all but three control populations were missing. An increased risk of venous thrombotic disease in HIV-infected patients could be explained by the presence of a hypercoagulable state, characterised by an increase in procoagulant factors, such as endothelial TF expression and thrombogenic properties of microparticles, and a decrease in anticoagulant factors, including AT III, HC II and the protein C pathway. Furthermore, the risk of VTE was associated with an increased risk of infections and autoimmune haemolytic anaemia, and was weakly associated with HAART. All together, quite some evidence pointed towards a relationship between HIV infection and venous thrombotic disease, but the association still needs to be established in properly designed epidemiological studies.

  8. Bridging the gap between chronic cerebrospinal venous insufficiency and Ménière disease

    Directory of Open Access Journals (Sweden)

    Dario C. Alpini

    2016-07-01

    Full Text Available Ménière disease (MD is a chronic illness of the inner ear that affects a substantial number of patients every year worldwide. Because of a dearth of well-controlled studies, the medical and surgical management of MD remains quite empirical. The main reason is that it is very difficult to investigate patients affected with Certain MD due to the post-mortem criterion necessary for this diagnostic grade. Although endolymphatic hydrops (EH is the worldwideaccepted mechanism of MD, the causes that induce it are still not clear. In fact MD has been correlated mostly to a wide and different disturbances ranging from trauma to sleep disorders. It is nowadays sufficiently demonstrated that chronic cerebrospinal venous insufficiency (CCSVI is very frequent in MD. Even if CCSVI may potentially induce EH through a pure hydraulic mechanism CCSVI, per se does not explain how the various disorders correlated with MD may interact with CCSVI and provoke EH. The aim of this review is an attempt to approach MD into the context of the more recent findings about the global brain waste clearance system, to which inner ear is anatomically and functionally connected, in order to build a reasonable model of MD pathogenesis. The major part of the diseases correlated to MD may act on the inner ear disturbing the glymphatic (GS and/or brain lymphatic system (BLS activity. The venous system interplays with GS and BLS. In this model CCSVI is considered more than a direct cause of MD rather the anatomical predisposition to develop the disease. In this model EH, and then MD, is the consequence of a failure of the compensation of the congenital venous abnormalities, anatomical compensation as collateral pathways and/or functional compensation as GS and BLS. In this model the major part of the disturbances correlated to MD and the various treatment proposed find their appropriate placement.

  9. Extracellular matrix assessment of infected chronic venous leg ulcers: role of metalloproteinases and inflammatory cytokines.

    Science.gov (United States)

    Serra, Raffaele; Grande, Raffaele; Buffone, Gianluca; Molinari, Vincenzo; Perri, Paolo; Perri, Aldina; Amato, Bruno; Colosimo, Manuela; de Franciscis, Stefano

    2016-02-01

    Chronic venous ulcer (CVU) represents a dreaded complication of chronic venous disease (CVD). The onset of infection may further delay the already precarious healing process in such lesions. Some evidences have shown that matrix metalloproteinases (MMPs) are involved and play a central role in both CVUs and infectious diseases. Two groups of patients were enrolled to evaluate the expression of MMPs in infected ulcers and the levels of inflammatory cytokines as well as their prevalence. Group I comprised 63 patients (36 females and 27 males with a median age of 68·7 years) with infected CVUs, and group II (control group) comprised 66 patients (38 females and 28 males with a median age of 61·2 years) with non-infected venous ulcers. MMP evaluation and dosage of inflammatory cytokines in plasma and wound fluid was performed by means of enzyme-linked immunosorbent assay test; protein extraction and immunoblot analysis were performed on biopsied wounds. The first three most common agents involved in CVUs were Staphylococcus aureus (38·09%), Corynebacterium striatum (19·05%) and Pseudomonas aeruginosa (12·7%). In this study, we documented overall higher levels of MMP-1 and MMP-8 in patients with infected ulcers compared to those with uninfected ulcers that showed higher levels of MMP-2 and MMP-9. We also documented higher levels of interleukin (IL)-1, IL-6, IL-8, vascular endothelial growth factor and tumour necrosis factor-alpha in patients with infected ulcers with respect to those with uninfected ulcers, documenting a possible association between infection, MMP activation, cytokine secretions and symptoms. The present results could represent the basis for further studies on drug use that mimic the action of tissue inhibitors of metalloproteinases in order to make infected CVU more manageable.

  10. The use of central venous lines in the treatment of chronically ill children.

    Science.gov (United States)

    Barczykowska, Ewa; Szwed-Kolińska, Marzena; Wróbel-Bania, Agnieszka; Ślusarz, Robert

    2014-01-01

    Treatment of chronic diseases in children is a special medical problem. Maintaining constant access to the central vascular system is necessary for long-term hemato-oncological and nephrological therapies as well as parenteral nutrition. Providing such access enables chemotherapic treatment, complete parenteral nutrition, long-term antibiotic therapy, hemodialysis, treatment of intensive care unit patients, monitoring blood pressure in the pulmonary artery and stimulation of heart rate in emergency situations as well as treatment of patients suffering from complications, especially when chances of access into peripheral veins are exhausted. Continuous access to the central vascular system is desirable in the treatment of chronically ill children. Insertion of a central venous catheter line eliminates the unnecessary pain and stress to a child patient accompanying injection into peripheral vessels. In order to gain long-term and secure access to the central venous system, respecting the guidelines of the Center for Disease Control and Prevention contained in the updated 'Guidelines for the Prevention of Intravascular Catheter-Related Infections' is necessary.

  11. Cardiovascular and Interventional Radiological Society of Europe commentary on the treatment of chronic cerebrospinal venous insufficiency.

    LENUS (Irish Health Repository)

    Reekers, J A

    2011-02-01

    Chronic cerebrospinal venous insufficiency (CCSVI) is a putative new theory that has been suggested by some to have a direct causative relation with the symptomatology associated with multiple sclerosis (MS) [1]. The core foundation of this theory is that there is abnormal venous drainage from the brain due to outflow obstruction in the draining jugular vein and\\/or azygos veins. This abnormal venous drainage, which is characterised by special ultrasound criteria, called the "venous hemodynamic insufficiency severity score" (VHISS), is said to cause intracerebral flow disturbance or outflow problems that lead to periventricular deposits [2]. In the CCSVI theory, these deposits have a great similarity to the iron deposits seen around the veins in the legs in patients with chronic deep vein thrombosis. Zamboni, who first described this new theory, has promoted balloon dilatation to treat the outflow problems, thereby curing CCSVI and by the same token alleviating MS complaints. However, this theory does not fit into the existing bulk of scientific data concerning the pathophysiology of MS. In contrast, there is increasing worldwide acceptance of CCSVI and the associated balloon dilatation treatment, even though there is no supporting scientific evidence. Furthermore, most of the information we have comes from one source only. The treatment is called "liberation treatment," and the results of the treatment can be watched on YouTube. There are well-documented testimonies by MS patients who have gained improvement in their personal quality of life (QOL) after treatment. However, there are no data available from patients who underwent unsuccessful treatments with which to obtain a more balanced view. The current forum for the reporting of success in treating CCSVI and thus MS seems to be the Internet. At the CIRCE office and the MS Centre in Amsterdam, we receive approximately 10 to 20 inquiries a month about this treatment. In addition, many interventional radiologists

  12. The care of patients with varicose veins and associated chronic venous diseases: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum.

    Science.gov (United States)

    Gloviczki, Peter; Comerota, Anthony J; Dalsing, Michael C; Eklof, Bo G; Gillespie, David L; Gloviczki, Monika L; Lohr, Joann M; McLafferty, Robert B; Meissner, Mark H; Murad, M Hassan; Padberg, Frank T; Pappas, Peter J; Passman, Marc A; Raffetto, Joseph D; Vasquez, Michael A; Wakefield, Thomas W

    2011-05-01

    The Society for Vascular Surgery (SVS) and the American Venous Forum (AVF) have developed clinical practice guidelines for the care of patients with varicose veins of the lower limbs and pelvis. The document also includes recommendations on the management of superficial and perforating vein incompetence in patients with associated, more advanced chronic venous diseases (CVDs), including edema, skin changes, or venous ulcers. Recommendations of the Venous Guideline Committee are based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system as strong (GRADE 1) if the benefits clearly outweigh the risks, burden, and costs. The suggestions are weak (GRADE 2) if the benefits are closely balanced with risks and burden. The level of available evidence to support the evaluation or treatment can be of high (A), medium (B), or low or very low (C) quality. The key recommendations of these guidelines are: We recommend that in patients with varicose veins or more severe CVD, a complete history and detailed physical examination are complemented by duplex ultrasound scanning of the deep and superficial veins (GRADE 1A). We recommend that the CEAP classification is used for patients with CVD (GRADE 1A) and that the revised Venous Clinical Severity Score is used to assess treatment outcome (GRADE 1B). We suggest compression therapy for patients with symptomatic varicose veins (GRADE 2C) but recommend against compression therapy as the primary treatment if the patient is a candidate for saphenous vein ablation (GRADE 1B). We recommend compression therapy as the primary treatment to aid healing of venous ulceration (GRADE 1B). To decrease the recurrence of venous ulcers, we recommend ablation of the incompetent superficial veins in addition to compression therapy (GRADE 1A). For treatment of the incompetent great saphenous vein (GSV), we recommend endovenous thermal ablation (radiofrequency or laser) rather than high ligation and inversion stripping

  13. A Clinical Comparison of Pycnogenol, Antistax, and Stocking in Chronic Venous Insufficiency.

    Science.gov (United States)

    Belcaro, Gianni

    2015-12-01

    This 8-week registry study was a comparative evaluation of Pycnogenol (French Maritime Pine Bark extract; Horphag Research, Geneva) and Antistax (grape leaf extract [GLE, Boehringer Ingelheim, Germany]) in controlling symptoms of chronic venous insufficiency (CVI). "Standard management" for CVI is compression; a group of comparable subjects was monitored to evaluate the effects of stockings. The registry included 183 patients (166 completing). Supplementation with Antistax (two tablets of 360 mg/d) or Pycnogenol (100 mg/d) was used. The groups were comparable for age, symptoms, venous incompetence, and microcirculation (with increased capillary filtration and skin flux) at inclusion. At 8 weeks, the rate of swelling (p Pycnogenol (p Pycnogenol (p Pycnogenol. An analog scale quantified symptoms. At 8 weeks, pain and edema were decreased with Pycnogenol and elastic compression (p Pycnogenol (p Pycnogenol was decreased by 40%. Induration was reduced only in the Pycnogenol group (p Pycnogenol were lower (96; 3.3 Euros) in comparison with the other groups (132;1.4 Euros for GLE and 149; 2.2 Euros for compression).

  14. Chronic cerebrospinal venous insufficiency in multiple sclerosis: clinical correlates from a multicentre study

    Directory of Open Access Journals (Sweden)

    Bastianello Stefano

    2011-10-01

    Full Text Available Abstract Background Chronic cerebrospinal venous insufficiency (CCSVI has recently been reported to be associated with multiple sclerosis (MS. However, its actual prevalence, possible association with specific MS phenotypes, and potential pathophysiological role are debated. Method We analysed the clinical data of 710 MS patients attending six centres (five Italian and one Canadian. All were submitted to venous Doppler sonography and diagnosed as having or not having CCSVI according to the criteria of Zamboni et al. Results Overall, CCSVI was diagnosed in 86% of the patients, but the frequency varied greatly between the centres. Even greater differences were found when considering singly the five diagnostic criteria proposed by Zamboni et al. Despite these differences, significant associations with clinical data were found, the most striking being age at disease onset (about five years greater in CCSVI-positive patients and clinical severity (mean EDSS score about one point higher in CCSVI-positive patients. Patients with progressive MS were more likely to have CCSVI than those with relapsing-remitting MS. Conclusion The methods for diagnosing CCSVI need to be refined, as the between-centre differences, particularly in single criteria, were excessively high. Despite these discrepancies, the strong associations between CCSVI and MS phenotype suggest that the presence of CCSVI may favour a later development of MS in patients with a lower susceptibility to autoimmune diseases and may increase its severity.

  15. Association of Mild to Moderate Chronic Kidney Disease With Venous Thromboembolism Pooled Analysis of Five Prospective General Population Cohorts

    NARCIS (Netherlands)

    Mahmoodi, Bakhtawar K.; Gansevoort, Ron T.; Naess, Inger Anne; Lutsey, Pamela L.; Braekkan, Sigrid K.; Veeger, Nic J. G. M.; Brodin, Ellen E.; Meijer, Karina; Sang, Yingying; Matsushita, Kunihiro; Hallan, Stein I.; Hammerstrom, Jens; Cannegieter, Suzanne C.; Astor, Brad C.; Coresh, Josef; Folsom, Aaron R.; Hansen, John-Bjarne; Cushman, Mary

    2012-01-01

    Background-Recent findings suggest that chronic kidney disease (CKD) may be associated with an increased risk of venous thromboembolism (VTE). Given the high prevalence of mild-to-moderate CKD in the general population, in depth analysis of this association is warranted. Methods and Results-We poole

  16. Internet-based social networking and its role in the evolution of chronic cerebrospinal venous insufficiency.

    Science.gov (United States)

    Vera, Chido; Herr, Allen; Mandato, Kenneth; Englander, Meridith; Ginsburg, Lauren; Siskin, Gary P

    2012-06-01

    The Internet is being seen as a growing resource for health-related information for a large number of patients. It is undeniable that its widespread presence has led to the growth of awareness that chronic cerebrospinal venous insufficiency (CCSVI) as an entity that may contribute to the symptoms experienced by patients with multiple sclerosis (MS). Social networking and file-sharing Web sites have brought patients with MS together from all over the world and have facilitated the distribution of personal experiences and information derived from medical research as it relates to CCSVI. As a result, there has been an accelerated growth in the number of patients seeking treatment for this syndrome in light of the possibility that it may improve their present condition. This article will review this phenomenon, the Internet-based resources available to MS patients seeking information about CCSVI, and the responsibilities of physicians as they participate in these online discussions.

  17. Repair of Chronic Achilles Ruptures Has a High Incidence of Venous Thromboembolism.

    Science.gov (United States)

    Bullock, Mark J; DeCarbo, William T; Hofbauer, Mark H; Thun, Joshua D

    2016-11-23

    Background Despite the low incidence of deep vein thrombosis (DVT) in foot and ankle surgery, some authors report a high incidence of symptomatic DVT following Achilles tendon rupture. The purpose of this study was to identify DVT risk factors inherent to Achilles tendon repair to determine which patients may benefit from prophylaxis. Methods One hundred and thirteen patient charts were reviewed following elective and nonelective Achilles tendon repair. For elective repair of insertional or noninsertional Achilles tendinopathy, parameters examined included lateral versus prone positioning and the presence versus absence of a flexor hallucis longus transfer. For nonelective repair, acute Achilles tendon ruptures were compared to chronic Achilles tendon ruptures. Results Of 113 Achilles tendon repairs, 3 venous thromboembolism (VTE) events (2.65%) occurred including 2 pulmonary emboli (1.77%). Seventeen of these repairs were chronic Achilles tendon ruptures, and all 3 VTE events (17.6%) occurred within this subgroup. Elevated body mass index was associated with VTE in patients with chronic Achilles ruptures although this did not reach significance (P = .064). No VTE events were reported after repair of 28 acute tendon ruptures or after 68 elective repairs of tendinopathy. Two patients with misdiagnosed partial Achilles tendon tears were excluded because they experienced a VTE event 3 weeks and 5 weeks after injury, prior to surgery. Conclusion In our retrospective review, chronic Achilles ruptures had a statistically significant higher incidence of VTE compared with acute Achilles ruptures (P = .048) or elective repair (P = .0069). Pharmaceutical anticoagulation may be considered for repair of chronic ruptures. Repair of acute ruptures and elective repair may not warrant routine prophylaxis due to a lower incidence of VTE.

  18. Correlation between arterial and venous blood gas analysis parameters in patients with acute exacerbation of chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Novović Miloš

    2012-01-01

    Full Text Available Introduction. Arterial blood gas (ABG analyses have an important role in the assessment and monitoring of the metabolic and oxygen status of patients with acute exacerbation of chronic obstructive pulmonary disease (COPD. Arterial puncture could have a lot of adverse effects, while sampling of venous blood is simpler and is not so invasive. Objective. The aim of this study was to evaluate whether venous blood gas (VBG values of pH, partial pressure of carbon dioxide (PCO2, partial oxygen pressure (PO2, bicarbonate (HCO3, and venous and arterial blood oxygen saturation (SO2 can reliably predict ABG levels in patients with acute exacerbation of COPD. Methods. Forty-seven patients with a prior diagnosis of COPD were included in this prospective study. The patients with acute exacerbation of this disease were examined at the General Hospital EMS Department in Prijepolje. ABG samples were taken immediately after venous sampling, and both were analyzed. Results. The Pearson correlation coefficients between arterial and venous parameters were 0.828, 0.877, 0.599, 0.896 and 0.312 for pH, PCO2, PO2, HCO3 and SO2, respectively. The statistically significant correlation between arterial and venous pH, PCO2 and HCO3, values was found in patients with acute exacerbation of COPD (p<0.001. Conclusion. When we cannot provide arterial blood for analysis, venous values of the pH, Pv,CO2 and HCO3 parameters can be an alternative to their arterial equivalents in the interpretation of the metabolic status in patients with acute exacerbation of COPD, while the values of venous Pv,O2 and Sv,O2 cannot be used as predictors in the assessment of oxygen status of such patients.

  19. Cardiac tamponade arising from a venous source following anterograde dissection re-entry coronary angioplasty to a chronic total occlusion.

    Science.gov (United States)

    Danson, E; Arena, F; Sapontis, J; Ward, M; Bhindi, R

    2016-10-01

    Cardiac tamponade is a rare complication of coronary intervention to chronic total occlusions (CTO PCI). We report a case of persistent bleeding from a venous source following successful anterograde dissection-reentry (ADR) CTO PCI. Pericardiocentesis was performed 1 h post-procedure for tamponade. Persistent bleeding was investigated with contrast transesophageal echocardiography, pericardial manometry and blood analysis. Coronary venography revealed subtle extravasation from a cardiac vein adjacent to the site of luminal re-entry. Coronary venous perforation using ADR CTO PCI has not previously been described; however, the volume of blood loss may be significant and surgical exploration may be appropriate.

  20. Prevalence of deep venous thrombosis in patients with acute exacerbation of chronic obstructive pulmonary disease

    Institute of Scientific and Technical Information of China (English)

    DUAN Sheng-chen; YANG Yuan-hua; LI Xu-yan; LIANG Xiao-ning; GUO Rui-jun; XIE Wan-mu; KUANG Tu-guang; DAI Hua-ping; WANG Chen

    2010-01-01

    Background Acute exacerbation of chronic obstructive pulmonary disease (COPD) is always associated with a high incidence and mortality. Because of the presence of some concomitant risk factors such as immobilization, bronchial superinfection, patients who are admitted for acute exacerbations of COPD are generally considered to be at moderate risk for the development of venous thromboembolism. In this study, we investigated the prevalence and the clinical manifestations of deep venous thrombosis (DVT) in patients with acute exacerbation of COPD.Methods From March 2007 to March 2009, 520 consecutive patients were included in this study. On admission, color Doppler ultrasound of lower extremities in all cases was performed for diagnosing DVT. Patients with DVT were compared with those without DVT from such aspects as demographics, symptoms, physical signs and risk factors.Results Among the 520 patients, DVT was found in 46 cases (9.7%). In patients with DVT, the duration of hospitalization was longer (P=0.01), and the mechanical ventilation requirement increased (P <0.001). Other indicators for patients with more possibility of DVT were immobility exceeding 3 days (P <0.001); pneumonia as concomitance (P=0.01); respiratory failure type Ⅱ (P=0.013); current smoking (P=0.001). Lower extremity pain was more common in DVT cases in comparison to those without DVT (34.8% vs. 15.2%, P=0.01 ).Conclusions The acute exacerbation of COPD patients, who were immobilized for over 3 days, complicated by pneumonia and had respiratory failure type Ⅱ, had a higher risk of DVT. In addition, DVT detection awareness should be increased in cases that had a lower extremity pain.

  1. O-(beta-hydroxyethyl)-rutosides systemic and local treatment in chronic venous disease and microangiopathy: an independent prospective comparative study.

    Science.gov (United States)

    Belcaro, Gianni; Rosaria Cesarone, Maria; Ledda, Andrea; Cacchio, Marisa; Ruffini, Irma; Ricci, Andrea; Ippolito, Edmondo; Di Renzo, Andrea; Dugall, Mark; Corsi, Marcello; Marino Santarelli, Anna Rita; Grossi, Maria Giovanna

    2008-01-01

    O-(beta-hydroxyethyl)-rutosides (HR) is used to treat chronic venous disease and signs and symptoms of chronic venous insufficiency (CVI), varicose veins, and deep venous disease. This independent prospective controlled trial (a registry study) evaluates how the efficacy of HR at the local level (perimalleolar region) can be increased by the administration of a topical HR gel. The study is based on evaluation of microcirculatory variables in patients with severe CVI (ambulatory venous pressure, > 56 mm Hg) and venous microangiopathy. Patients are treated using 1 of the following 3 regimens: oral treatment with 1 g sachets of HR (2 g/d total) plus topical HR 2% gel applied 3 times daily at the internal perimalleolar region; oral treatment only (same dosage), or light elastic compression stockings. Laser Doppler skin flux at rest, skin flux at the perimalleolar region, and transcutaneous PO2 and PCO2 are measured at baseline and at the end of the treatment period. A comparable group of healthy individuals without treatment is observed for 8 weeks. In the treatment groups, flux is increased, PO2 is decreased, and PCO2 is increased compared with normal skin. At 4 and 8 weeks, the improvement in skin flux (which is decreased by all measurements), the increase in PO2, and the decrease in PCO2 (indicating microcirculatory improvement) are statistically significantly greater in the combined oral plus topical treatment group (P < .05). No adverse effects, tolerability problems, or compliance issues are noted. These results indicate an important role of HR in the treatment and control of CVI and venous microangiopathy.

  2. Cost-effective use of silver dressings for the treatment of hard-to-heal chronic venous leg ulcers

    DEFF Research Database (Denmark)

    Jemec, Gregor B E; Kerihuel, Jean Charles; Ousey, Karen

    2014-01-01

    AIM: To estimate the cost-effectiveness of silver dressings using a health economic model based on time-to-wound-healing in hard-to-heal chronic venous leg ulcers (VLUs). BACKGROUND: Chronic venous ulceration affects 1-3% of the adult population and typically has a protracted course of healing....... METHODS: A decision tree was constructed to evaluate the cost-effectiveness of treatment with silver compared with non-silver dressings for four weeks in a primary care setting. The outcomes: 'Healed ulcer', 'Healing ulcer' or 'No improvement' were developed, reflecting the relative reduction in ulcer...... area from baseline to four weeks of treatment. A data set from a recent meta-analysis, based on four RCTs, was applied to the model. RESULTS: Treatment with silver dressings for an initial four weeks was found to give a total cost saving (£141.57) compared with treatment with non-silver dressings...

  3. Nutritional profile of older adults with chronic venous leg ulcers: a pilot study.

    Science.gov (United States)

    McDaniel, Jodi C; Kemmner, Kaitlyn G; Rusnak, Sarah

    2015-01-01

    The purpose of this cross-sectional descriptive pilot study was to describe daily intake of select nutrients important for efficient wound healing and general health in a sample of older adults (64.25 ± 9.49 years of age) with chronic venous leg ulcers (CVLUs; N = 12), compared to recommended dietary allowances (RDA). Anthropometric data were also collected. Compared to RDA, participants on average consumed lower vitamin C (60.03 ± 49.73 mg/d) and higher sodium (3197.07 ± 1455.04 mg/d), sugar (181.21 ± 115.45 g/d), and saturated fat (33.75 ± 1.06 g/d). They also demonstrated a relatively high plasma n-6/n-3 polyunsaturated fatty acid ratio, a biomarker of inflammation (11.25 ± 1.99). The mean body mass index indicated extreme obesity (41.48 ± 11.47). A multidisciplinary treatment approach that includes routine dietary assessments followed by tailored dietary interventions may improve wound healing and long-term health outcomes in this population.

  4. Chronic Complications After Femoral Central Venous Catheter-related Thrombosis in Critically Ill Children.

    Science.gov (United States)

    Sol, Jeanine J; Knoester, Hennie; de Neef, Marjorie; Smets, Anne M J B; Betlem, Aukje; van Ommen, C Heleen

    2015-08-01

    Prescription of thromboprophylaxis is not a common practice in pediatric intensive care units. Most thrombi are catheter-related and asymptomatic, without causing acute complications. However, chronic complications of these (a)symptomatic catheter-related thrombi, that is, postthrombotic syndrome (PTS) and residual thrombosis have not been studied. To investigate these complications, critically ill children of 1 tertiary center with percutaneous inserted femoral central venous catheters (FCVCs) were prospectively followed. Symptomatic FCVC-thrombosis occurred in 10 of the 134 children (7.5%; 95% confidence interval [CI], 2.4-9.5). Only FCVC-infection appeared to be independently associated (P=0.001) with FCVC-thrombosis. At follow-up 2 of the 5 survivors diagnosed with symptomatic thrombosis developed mild PTS; one of them had an occluded vein on ultrasonography. A survivor without PTS had a partial occluded vein at follow-up. Asymptomatic FCVC-thrombosis occurred in 3 of the 42 children (7.1%; 95% CI, 0.0-16.7) screened by ultrasonography within 72 hours after catheter removal. At follow-up, mild PTS was present in 6 of the 33 (18.2%; 95% CI, 6.1-30.3) screened children. Partial and total vein occlusion was present in 1 (3%) and 4 (12%) children, respectively. In conclusion, children on pediatric intensive care units are at risk for (a)symptomatic FCVC-thrombosis, especially children with FCVC-infection. Chronic complications of FCVC-thrombosis are common. Therefore, thromboprophylaxis guidelines are warranted in pediatric intensive care units to minimize morbidity as a result of FCVC-thrombosis.

  5. Percutaneous transluminal angioplasty in a patient with chronic cerebrospinal venous insufficiency and persistent left superior vena cava.

    Science.gov (United States)

    Lupattelli, T; Benassi, F; Righi, E; Bavera, P; Bellagamba, G

    2014-04-01

    Chronic cerebrospinal venous insufficiency (CCSVI) is a syndrome characterized by stenoses of the internal jugular veins (IJVs) and/or azygos veins and formation of collateral venous channels. A case of a 57-year-old patient with CCSVI in whom the venous outflow from the left IJV to the right atrium occurred through a venous anomaly, the persistent left superior vena cava (PLSVC), is reported. PLSVC is caused by persistence of the left anterior cardinal vein that drains blood from the limb effluent from the left and the left side of head and neck into coronary sinus (Type a), or in the left atrium (Type b). PLSVC can be associated either with innominate vein hypoplasia or other congenital heart abnormalities. Because of evidence of left innominate vein hypoplasia, angioplasty was not performed using the ordinary route but passing with the balloon directly through the PLSVC up to the left IJV. Finally, angioplasty was carried out in a standard manner in the right IJV as well as in the azygous vein. Confirmation angiogram revealed complete reopening of all treated vessels with no evidence of peri- and postoperative complications. The patient was discharged home the following day in good general conditions. PLSVC is a rare congenital vein anomaly but in case of concomitant innominate vein hypoplasia may prove to be a valuable alternative to treat patients with IJV diseases.

  6. GM-CSF Exhibits Anti-Inflammatory Activity on Endothelial Cells Derived from Chronic Venous Disease Patients

    Directory of Open Access Journals (Sweden)

    Veronica Tisato

    2013-01-01

    Full Text Available Twenty patients affected by chronic venous disease (CVD in tertiary venous network and/or saphenous vein were analyzed before surgical ablation by echo-color-doppler for the hemodynamic parameters reflux time (RT and resistance index (RI, a negative and a positive prognostic factor, respectively. RT and RI were next correlated with relevant in vitro parameters of venous endothelial cells (VEC obtained from surgical specimens, such as cell migration in response to serum gradient, proliferation index, intercellular adhesion molecule (ICAM-1 and vascular cell adhesion molecule (VCAM-1 expression, as well as cytokines release. Of interest, ICAM-1 expression in patient-derived VEC cultures correlated positively with RT and negatively with RI. Moreover, RT showed a positive correlation with the baseline osteoprotegerin (OPG expression by VEC and an inverse correlation with VEC proliferation index. On the other hand, RI correlated positively with TNF-related apoptosis inducing ligand (TRAIL expression. Among the cytokines released by VEC, GM-CSF showed a positive correlation with VEC proliferation and TRAIL expression and a negative correlation with OPG, ICAM-1 and VCAM-1 expression. Since in vitro recombinant GM-CSF induced VEC proliferation and counteracted the induction of ICAM-1, VCAM-1 and OPG upon exposure to TNF-α, our data suggest an anti-inflammatory activity of GM-CSF on venous endothelial cells.

  7. Factors affecting patients’ self-management in chronic venous disorders: a single-center study

    Directory of Open Access Journals (Sweden)

    Barański K

    2016-08-01

    Full Text Available Kamil Barański,1,2 Jerzy Chudek2,3 1Department of Epidemiology, Medical School in Katowice, 2Department of Pathophysiology, Medical University of Silesia, Katowice, 3Angiology Outpatient Clinic “Combi-Med,” Częstochowa, Poland Background: The conservative treatment of chronic venous disorders (CVDs includes pharmacotherapy, compression therapy, physiotherapy, and changes in lifestyle. These methods are available without prescription and not reimbursed by Polish National Health Service. Adherence to therapy is affected by poorly characterized patient-related factors. Objective: The aim of the study was to perform an assessment of factors that affect the usage and resignation from conservative methods in CVD self-management. Methods: A structured interview concerning self-management was carried out with 407 consecutive CVD patients of mean age 64.4 years (range: 23–87 years. All the patients had recently undergone Doppler examination and were classified in accordance with Clinical, Etiology, Anatomy, and Pathophysiology (CEAP classification. Results: Pharmacotherapy was the most frequently (85.0% of respondents used method in CVD self-management. Obese (odds ratio [OR] =1.75 [95% confidence interval {CI} 0.99–3.05] and subjects with longer duration of the disease (OR =1.74 [95% CI 1.16–2.62] were more likely to use venoactive drugs, while females used ointments commonly containing heparin (OR =1.82 [95% CI 1.08–3.03]. Compression therapy was perceived by respondents as the most difficult method in self-management (OR =2.50 [95% CI 1.61–3.88] and was also recognized as the most effective method of treatment (OR =13.9 [95% CI 7.35–26.4]. Longer duration of CVD (≥15 years increased (OR =1.78 [95% CI 1.16–2.71] while obesity decreased (OR =0.38 [95% CI 0.20–0.72] the utilization of compression therapy. Females were more likely to adhere to lifestyle changes than males (OR =1.68 [95% CI 0.97–2.90]. Physiotherapy was rarely

  8. PredyCLU: a prediction system for chronic leg ulcers based on fuzzy logic; part I - exploring the venous side.

    Science.gov (United States)

    de Franciscis, Stefano; Fregola, Salvatore; Gallo, Alessandro; Argirò, Giuseppe; Barbetta, Andrea; Buffone, Gianluca; Caliò, Francesco G; De Caridi, Giovanni; Amato, Bruno; Serra, Raffaele

    2016-12-01

    Chronic leg ulcers (CLUs) are a common occurrence in the western population and are associated with a negative impact on the quality of life of patients. They also cause a substantial burden on the health budget. The pathogenesis of leg ulceration is quite heterogeneous, and chronic venous ulceration (CVU) is the most common manifestation representing the main complication of chronic venous disease (CVD). Prevention strategies and early identification of the risk represent the best form of management. Fuzzy logic is a flexible mathematical system that has proved to be a powerful tool for decision-making systems and pattern classification systems in medicine. In this study, we have elaborated a computerised prediction system for chronic leg ulcers (PredyCLU) based on fuzzy logic, which was retrospectively applied on a multicentre population of 77 patients with CVD. This evaluation system produced reliable risk score patterns and served effectively as a stratification risk tool in patients with CVD who were at the risk of developing CVUs.

  9. [The possible uses of balneotherapy in treating chronic venous insufficiency of lower limbs].

    Science.gov (United States)

    Petraccia, L; Mennuni, G; Fontana, M; Nocchi, S; Libri, F; Conte, S; Alhadeff, A; Romano, B; Messini, F; Grassi, M; Fraioli, A

    2013-01-01

    The Chronic Venous Insufficiency (CVI) of inferior limbs is a widespread disease, with an increasing incidence as a consequence of longer life expectance, life-style, obesity, smoking, use of drugs as oestrogens and progestins and working conditions. Medical therapy is still lacking for evidence of efficacy, and compression therapy is useful only in preventing a worsening of this condition. Surgical treatment is the only radical therapy effective for the advanced phases of the disease. In this context spa balneotherapy can be considered as a possible chance to improve some subjective and objective symptoms of CVI of inferior limbs, and to prevent worsening of this condition. The authors performed a review of the relevant scientific literature concerning the treatment of CVI of inferior limbs with mineral water balneotherapy, in order to evaluate its effects on objective and subjective symptoms and its effectiveness to prevent further worsening. We searched the PubMed/Medline, Cochrane Library, Embase, Web of Science databases for articles published between 1990 and 2011 on this topic. To this end, the authors selected few clinical-controlled and case-controlled studies; patients affected from CVI of inferior limbs were treated with balneotherapy at health spas with sulphureous, sulphate, salsojodic or salsobromojodic mineral waters. Baths in mineral waters were often associated with idromassotherapy and vascular pathway. Effects of spa balneotherapy are related to some aspecific properties, like hydrostatic pressure, osmotic pressure and water temperature, partly related with specific chemico-physical properties of the adopted mineral water. The controlled clinical studies on spa therapy showed significant improvement of subjective (such as itch, paresthesias, pain, heaviness) and objective symptoms (namely edema and skin discromias). These studies suggest that spa balneotherapy may give a good chance of secondary prevention and effective therapy of CVI of inferior

  10. Improvement of signs and symptoms of chronic venous insufficiency and microangiopathy with Pycnogenol: a prospective, controlled study.

    Science.gov (United States)

    Cesarone, M R; Belcaro, G; Rohdewald, P; Pellegrini, L; Ledda, A; Vinciguerra, G; Ricci, A; Ippolito, E; Fano, F; Dugall, M; Cacchio, M; Di Renzo, A; Hosoi, M; Stuard, S; Corsi, M

    2010-09-01

    The aim of this study was to evaluate the clinical efficacy of standardized French maritime pine bark extract Pycnogenol in patients with severe chronic venous insufficiency (CVI). 98 subjects with symptomatic CVI and edema were randomly assigned to one group treated with 150 mg Pycnogenol a day only, another group with stockings only and a third group with both Pycnogenol and elastic stockings. The average ambulatory venous pressure (AVP) at inclusion was 58+/-7 mm Hg (range 48-60 mm Hg) with a refilling time (RT)Pycnogenol alone was more effective than compression alone for all parameters (pPycnogenol in the management, treatment and control of CVI also in combination with compression.

  11. Evidence for a genetic role in varicose veins and chronic venous insufficiency.

    Science.gov (United States)

    Krysa, J; Jones, G T; van Rij, A M

    2012-10-01

    There is a strong body of circumstantial evidence which implicates genetics in the aetiology and pathology of varicose veins and venous ulcer disease. The aim of this review is to consider the current knowledge of the genetic associations and the ways in which new genetic technologies may be applied to advancing our understanding of the cause and progression of these venous diseases. A number of publications have used a candidate gene approach to identify genes implicated in venous disease. Although these studies have opened up important new insights, there has been a general failure to replicate results in an independent cohort of patients. With our limited knowledge of the biological pathways involved in the pathogenesis of venous disease we are not in a strong position to formulate truly erudite a priori candidate gene hypothesis-directed studies. A genome-wide association study should therefore be considered to help further our understanding of the genetic basis of venous disease. Due to the large sample sizes required for discovery and validation, using the new generations of molecular technologies, it will be necessary to form collaborating groups in order to successfully advance the field of venous disease genetics.

  12. Idiopathic venous thromboembolism and thrombophilia

    OpenAIRE

    Sinescu, C; Hostiuc, M; Bartos, D.

    2011-01-01

    During the past decade idiopathic venous thromboembolism has become a separate entity, a chronic illness which has required prolonged anticoagulation and other prevention strategies to avoid recurrences. This article reviews recent developments regarding unprovoked venous thromboembolism and its relation with thrombophilia. In the beginning, the latest definition of idiopathic venous thromboembolism is presented. The article continues with statistics about thrombophilia, related venous thromb...

  13. Bilateral surgical reconstruction for internal jugular veins disease in patients with chronic cerebrospinal venous insufficiency and associated multiple sclerosis.

    Science.gov (United States)

    Spagnolo, Salvatore; Scalise, Filippo; Barbato, Luciano; Grasso, Maria Antonietta; Tesler, Ugo F

    2014-10-01

    Chronic cerebrospinal venous insufficiency (CCSVI) is a vascular condition characterized by morphologic alterations involving efferent cerebral vascular paths. CCSVI has been implicated as a contributing factor to multiple sclerosis (MS) but this theory is highly controversial. We report 3 cases of CCSVI patients with MS who had undergone internal jugular veins (IJVs) angioplasty to restore vessels patency. All patients reported significant symptomatic improvement after angioplasty until symptoms recurred after restenosis of the treated IJVs. Surgical IJVs reconstruction was performed. Patients' symptoms gradually improved and the benefits were maintained at the 1-year follow-up.

  14. Adverse events after endovascular treatment of chronic cerebro-spinal venous insufficiency (CCSVI) in patients with multiple sclerosis.

    Science.gov (United States)

    Ghezzi, A; Annovazzi, P; Amato, M P; Capello, E; Cavalla, P; Cocco, E; Falcini, M; Gallo, A; Patti, F; Perini, P; Rodegher, M E; Rovaris, M; Rottoli, M R; Comi, G

    2013-06-01

    Although it is debated whether chronic cerebro-spinal venous insufficiency (CCSVI) plays a role in multiple sclerosis (MS) development, many patients undergo endovascular treatment (ET) of CCSVI. A study is ongoing in Italy to evaluate the clinical outcome of ET. Severe adverse events (AEs) occurred in 15/462 subjects at a variable interval after ET: jugular thrombosis in seven patients, tetraventricular hydrocephalus, stroke, paroxysmal atrial fibrillation, status epilepticus, aspiration pneumonia, hypertension with tachicardia, or bleeding of bedsore in the remaining seven cases. One patient died because of myocardial infarction 10 weeks after ET. The risk of severe AEs related to ET for CCSVI must be carefully considered.

  15. Phase 3 evaluation of HP802-247 in the treatment of chronic venous leg ulcers.

    Science.gov (United States)

    Kirsner, Robert S; Vanscheidt, Wolfgang; Keast, David H; Lantis, John C; Dove, Cyaandi R; Cazzell, Shawn M; Vartivarian, Mher; Augustin, Matthias; Marston, William A; McCoy Bs, Nicholas D; Cargill PhD, D Innes; Lee Mshs, Tommy D; Dickerson, Jaime E; Slade Md, Herbert B

    2016-09-01

    In 2012 we reported promising results from a phase 2 clinical trial of HP802-247, a novel spray-applied investigational treatment for chronic venous leg ulcers consisting of human, allogeneic fibroblasts and keratinocytes. We now describe phase 3 clinical testing of HP802-247, its failure to detect efficacy, and subsequent investigation into the root causes of the failure. Two randomized, controlled trials enrolled a total of 673 adult outpatients at 96 centers in North America and Europe. The primary endpoint was the proportion of ulcers with confirmed closure at the end of 12 weeks of treatment. An investigation into the root cause for the failure of HP802-247 to show efficacy in these two phase 3 trials was initiated immediately following the initial review of the North American trial results. Four hundred twenty-one patients were enrolled in the North American (HP802-247, 211; Vehicle 210) and 252 in the European (HP802-247, 131; Vehicle 121) trials. No difference in proportion of closed ulcers at week 12 was observed between treatment groups for either the North American (HP802-247, 61.1%; Vehicle 60.0%; p = 0.5896) or the European (HP802-247, 47.0%; Vehicle 50.0%; p = 0.5348) trials. Thorough investigation found no likelihood that design or execution of the trials contributed to the failure. Variability over time during the trials in the clinical response implicated the quality of the cells comprising HP802-247. Concordance between the two separate, randomized, controlled trials with distinct, nonoverlapping investigative sites and independent monitoring teams renders the possibility of a Type II error vanishingly small and provides strong credibility for the unexpected lack of efficacy observed. The most likely causative factors for the efficacy failure in phase 3 was phenotypic change in the cells (primarily keratinocytes) leading to batch to batch variability due to the age of the cell banks.

  16. Immune function of erythrocytes in patients with chronic venous insufficiency of the lower extremities

    Institute of Scientific and Technical Information of China (English)

    ZHANG Lan; ZHANG Bai-gen; ZHANG Ji-wei; ZHANG Hao

    2007-01-01

    Background The influence of inflammatory processes has been one of the hot topics in discussions of the etiology of chronic venous insufficiency(CVI).Erythrocytes are very important in controlling inflammatory immunity and innate immune reactions.The purpose of this study was to analyze the correlation between the development of CVI and the change of CD35,Fy6 on erythrocytes,and interleukin-8(IL-8) levels.Methods A group of 43 patients with CVI were studied in parallel with 8 healthy individuals serving as centrol subjects.Control subjects were those with normal findings on lower extremity duplex examinations.We used an erythrocyte flow cytometer to examine the expression of both CD35 and Fy6 on red blood cells,and an enzyme-linked immunosorbent assay analysis method to measure plasma IL-8 levels.We also analyzed the change of IL-8 levels under the influence of erythrocytes using a modified method of the hemaimmune reaction.Results Compared with normal centrol subjects,CD35 expression increased significantly among patients with CVI classified as C4 without lipodermatosclerosis,but tended to decrease and reach the lowest level among patients classified as C5-C6.Fy6 expression increased significantly among patients in the early stages of CVI,but tended to decrease remarkably among patients classified as C5-C6.The inflammatory response intensified at the C5-C6 classification,where high levels of IL-8 coexisted with a low expression of Fy6.The increase in IL-8 in the CVI group was higher than in the control group in association with the complete blood cells,regardless of the presence of erythrocytes,when inactive tumour cells were added,whereas the level of IL-8 in the CVI group was significantly lower than in the control group.Conclusions Abnormalities of erythrocyte innate immunity represents a fundamental derangement in CVI.These inadequate inflammatory responses may lead to local tissue and microvascular damage of the lower extremity.

  17. Venous Sampling

    Science.gov (United States)

    ... Physician Resources Professions Site Index A-Z Venous sampling Venous sampling is a diagnostic procedure that uses ... the limitations of venous sampling? What is venous sampling? Venous sampling is a diagnostic procedure that involves ...

  18. Femoral and iliofemoral thrombectomy to prevent chronic venous insufficiency. Follow-up of 18 patients.

    Science.gov (United States)

    de Araujo Bessa, J C

    1986-01-01

    Eighteen patients with femoral and iliofemoral venous thrombosis were treated surgically. Five of the patients had a moderate degree of venous congestion and were classified as having phlegmasia alba dolens and 13 patients had phlegmasia cerulea dolens. The mean age was 39 years, range 18-60 years; 6 were men and 12 women. Thrombectomy was performed with a Fogarty venous thrombectomy catheter. In all cases the thrombosis was verified by phlebography. Pre- and postoperative phlebography was used in all cases to show the patency of the femoral and iliofemoral segment. There was no operative pulmonary embolism or mortality. Heparin infusion was continued in the thrombectomized segment for 10 days followed by phenprocumone treatment. The patients were followed from 6 to 8 months, postoperatively. The operation was performed in the acute stage and the late results are as follows: 4 limbs good, 6 limbs fair and 8 limbs poor. The best results were obtained when the latency period was 24 to 72 hours. Postthrombotic sequelae could not be prevented in about 44% of all patients despite venous thrombectomy.

  19. Pathogenesis of chronic venous insufficiency and possible effects of compression and pentoxifylline.

    Science.gov (United States)

    Coleridge Smith, P D

    1993-01-01

    It has been recognized for over 2000 years that ulceration of the leg may be associated with visible varices of the lower limb. More recent physiological investigation has shown that the pressure in the veins of the lower limb remains raised in patients with venous ulceration during ambulation, whereas in normal subjects the pressure in superficial veins falls to a low level. This elevated pressure appears to cause damage to the superficial capillaries in the skin culminating in the production of venous ulceration. Events in the dermal capillaries which result in skin destruction have yet to be fully defined. Pericapillary fibrin cuffs have been demonstrated histologically and suggested as a cause of diminished nutrition to the skin. White blood cells have been shown to accumulate in the lower limb of patients with venous disease and these accumulations are particularly located around the dermal capillaries. Activated white blood cells releasing free radicals and destructive enzymes may precipitate skin destruction. An understanding of these mechanisms may help to explain the efficacy of compression hosiery and bandaging as well as some of the new pharmacological agents which have been shown to influence venous ulcer healing.

  20. May symptoms of chronic cerebrospinal venous insufficiency be improved by venous angioplasty? An independent 4-year follow up on 366 cases

    Directory of Open Access Journals (Sweden)

    Pietro M. Bavera

    2015-10-01

    Full Text Available The aim of the study was to collect results from 366 chronic cerebrospinal venous insufficiency (CCSVI affected patients that were regularly Duplex controlled after having received vein angioplasty following diagnosis for CCSVI. The procedures were all performed in the same Centre and same equipment. The patients were divided into three groups according to the attributed severity of the associated multiple sclerosis: 264 relapse-remitting (RR (72%: 179 females (67.8% and 85 (32.2% males; 62 secondary progressive (17%: 37 (59.7% females and 25 (40.3% males; 40 primary progressive (11%: 22 (55% females and 18 (45% males. A data base revealed eleven most frequent disturbs and symptoms, together with working capacities, and was kept up-todate at every Duplex control aiming to establish a novel rapid CCSVI symptoms questionnaire assessment in 4 years follow up. The symptoms were: diplopia, fatigue, headache, upper limb numbness/mobility, lower limb numbness/mobility, thermic sensibility, bladder control, balance coordination, quality of sleep, vertigo, mind concentration. Results, as follows, appear to be significantly good in the RR group, also the biggest one. Diplopia improved in 262/264 patients (99.2% (P<0.0001; fatigue in 260/264 (98.5% (P<0.0001; headache in 205/208 (98.6% (P<0.0001; balance coordination in 23/26 (88.5% (P<0.0001; quality of sleep in 55/59 (93.2% (P<0.0001; vertigo in 30/33 (90.9% (P<0.0001; mind concentration in 142/144 (98.6% (P<0.0001. Other results regarded: upper limb numbness and mobility in 20/24 (83.3% (P=0.0002; lower limb numbness and mobility 13/15 (86.7% (P=0.0087; thermic sensibility 3/4 (75% [P: not significant (n.s.]; bladder control 2/3 (66.6% (P: n.s.. In contrast in the progressive cases results are quite different where, nevertheless, some useful considerations were collected and statistically significant, too. In addition, venous angioplasty appears to be safe, side effects were observed only in seven

  1. Is vein damage the only cause of clinical signs of lower limb chronic venous insufficiency?

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    Amélia Cristina Seidel

    2014-09-01

    Full Text Available Background:Venous insufficiency is a very prevalent disease. Some decades ago a group of patients was identified that had symptoms of venous insufficiency, but no visible anatomic abnormalities. Studies showed that this subset had reduced venous tone, and their condition became known as hypotonic phlebopathy.Objective:To investigate prevalence, age group and variations in body mass index (BMI among patients with hypotonic phlebopathy.Methodology:A total of 1,960 limbs were examined in 1,017 patients who had been referred for complaints compatible with venous insufficiency. Patients with BMI ≥ 30 were defined as obese. The patients were examined using color Doppler ultrasonography to detect presence or absence of reflux in veins of the lower limbs and were then distributed into two groups as follows: patients with CEAP ≤ 1 and no reflux, diagnosed with hypotonic phlebopathy; or patients with CEAP ≥ 2 and reflux.Results:The study sample comprised 89.7% women and 10.3% men with a mean age of 44.9 years. Hypotonic phlebopathy was more common among the women (p = 0.0001. Obese women were more likely than women who were not obese to have venous symptom etiology involving trunk lesions (p = 0.0017. Among the men, obesity was unrelated to etiology of symptoms (p = 0.5991. Symptomology was more likely to be related to trunk vein damage among older age groups than among younger age groups (p-valor <0.0001.Conclusions:Hypotonic phlebopathy was very prevalent, particularly among young women who were not obese.

  2. Superabsorbent dressings for copiously exuding wounds.

    Science.gov (United States)

    Faucher, Nathalie; Safar, Helene; Baret, Mylène; Philippe, Anne; Farid, Rachida

    Exudate control is important in the management of both acute and chronic wounds. A new category of absorbent dressings that contain superabsorbent particles promises high absorbency. The aim of this multicentre, prospective, non-comparative observational study was to evaluate the clinical efficacy and absorbent capacity of a superabsorbent dressing. Fifteen inpatients and outpatients with highly exuding wounds were included. Most patients (n=8) (53%) had chronic wounds; 20% (n=3) had ulcerating tumours. The superabsorbent dressing was used as a primary or a secondary dressing. Assessment was on day 0 (start), day 3 and day 7 (end of study). The study looked at wound bed and periwound skin condition, exudate production, pain upon dressing removal, reason for dressing removal, and frequency of dressing changes. A clinical visual scoring tool was used, together with digital photographs, which were assessed by the same experienced clinician. All 15 patients completed the study, during which no adverse events were noted. At day 7, maceration had reduced from 46.7% (n=7) at day 0 to 6.7% (n=1). After only 3 days, dressing change frequency was reduced from once daily to twice weekly in 80% (n=12) of patients. The superabsorbent dressing seems to reduce complications associated with exudate production, stimulate wound healing and increase patient comfort; it may also save time and costs for caregivers.

  3. Novel treatment techniques for recanalization of femoral-popliteal deep venous occlusion from chronic thrombosis.

    Science.gov (United States)

    Spencer, Elizabeth Brooke; Stratil, Peter; Mizones, Heidi

    2014-06-01

    Patients with postthrombotic syndrome due to previous femoral-popliteal deep venous thrombosis often experience lifestyle-limiting lower-extremity pain and swelling. Conservative treatment options include compression stockings and lymphedema massage, but in many cases these treatments only temporarily and partially improve symptoms. Ultrasound and venography in patients with postthrombotic syndrome often show only partial recanalization of the femoral vein with significant collateral vein formation. These abnormal veins are insufficient for adequate venous drainage from the lower extremity as evidenced by the patient's continued symptoms. Recanalization of the occluded or partially occluded femoral vein using prolonged venoplasty, with or without chemical thrombolysis, combined with optimizing anticoagulation and conservative treatment measures, results in lasting improvement in symptoms for a high percentage of patients.

  4. Disappearance of diabetic macular hard exudates after hemodialysis introduction.

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    Matsuo,Toshihiko

    2006-06-01

    Full Text Available

    We report herein the disappearance of macular hard exudates after the introduction of hemodialysis in diabetic patients. A 62-year-old woman and a 52-year-old man with diabetes mellitus showed hard exudates in the macula of the left eyes. Both patients had previously undergone panretinal photocoagulation in both eyes. During the follow-up, hemodialysis was introduced for deteriorating chronic renal failure caused by diabetic nephropathy. Half a year later, macular hard exudates in the left eyes disappeared dramatically in both patients, but the visual acuity remained the same. No additional laser treatment was done during the observation period. Hemodialysis is considered to have accelerated the resolution of macular hard exudates in both patients. The deposition of macular hard exudates in diabetic patients is due in part to concurrent poor renal function.

  5. Low level laser therapy (GaAlInP 660 nm) in healing of a chronic venous ulcer: a case study

    Science.gov (United States)

    Botaro, C. A.; Faria, L. A.; Oliveira, R. G.; Bruno, R. X.; Rocha, C. A. Q. C.; Paiva-Oliveira, E. L.

    2015-07-01

    The venous ulcer represents approximately 70% to 90% of inferior member ulcers, and the most common etiological factor is venous insufficiency, triggered by venous hypertension. Currently in Brazil there are several types of lasers used in physiotherapy, which benefit biological potential, emitting low power radiation, with anti-inflammatory, analgesic, healing and circulatory effects. This study aimed at the analysis of low level laser therapy effects (LLLT) on the process of tissue repair in chronic venous ulcers. We conducted a case study of a patient with a venous ulcer in the lateral region of the right inferior member. The patient underwent LLLT, which used a GaAlInP diode laser, with a wavelength of 660 nm and energy density of 4 J cm-2 applied punctually at the edges of the wound, with an average distance of 1 cm between the points with a pen-laser perpendicular wrapped in paper and a plastic wrap, keeping contact with the tissue. After four months of therapy and a total of 21 sessions, an improvement was noticeable in the gross appearance of the wound, but after a month and a half without therapy, the dimensions of the wound increased in length and width. Analyzing the results of this case study allows us to conclude that the LLLT GaAlInP (660 nm) with an energy density of 4 J cm-2, was not successful in the healing of venous ulcers.

  6. Progressive or degressive compression pressure profile in patients with chronic venous disorders of the lower limb

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    Giovanni Mosti

    2014-03-01

    Full Text Available Graduated compression devices are considered the standard care for management of venous and lymphatic disorders. Recently compression devices exerting a pressure over the calf higher than over the ankle have been proved to be more effective than traditional graduated devices in increasing the impaired ejection fraction (EF from the lower leg in patients with venous disease. Aim of this work is presenting an overview of the new concept on progressive compression, its potential benefits and limits. In different series of tests, the EF from the lower leg was assessed in 70 patients with severe reflux in the great saphenous vein (GSV. EF was measured by strain gauge plethysmography, in baseline conditions and after applying graduated compression devices or the new inversely graduated or progressive compression (PC devices. The interface pressure was recorded, simultaneously with the EF, both in the gaiter area (B1 point and at the calf (C point in order to assess the compression pressure profile. EF, severely impaired in patients with GSV reflux, was increased by compression. So called PC devices (both PC elastic stocking and PC inelastic bandages were significantly more effective than graduated compression in increasing the ejection fraction. The higher the pressure on the calf the higher the EF improvement. Maintaining the same strong pressure over the calf by means of two progressive stockings and increasing the pressure only over the calf to restore a graduated compression didn’t improve the EF. To improve venous pumping function in the ambulant patient stronger compression of the calf is more effective than graduated compression. This can be explained by the higher amount of blood volume pooled in the calf veins.

  7. [Phlebosclerosing therapy after operative intervention for chronic venous insufficiency of the lower extremities].

    Science.gov (United States)

    Shamsadinskiĭ, A A; Shamsadinskaia, T A

    2009-02-01

    To the Center of angiology and microsurgery have been submitted 75 patients seeking for the cosmetic result of their treatment improvement, to whom operative interventions for the lower extremities varicosities were performed previously. The sclerosing procedures for the dilated venous tributaries, reticular veins and teleangiectasiae was conducted, complete elimination of a "heavy feet" syndrome was noted together with reduction of the symptoms severity. The phlebosclerosing method permits to achieve good clinical, aesthetic results, to improve the quality of life and social activity of the patients.

  8. Recommendations for multimodal noninvasive and invasive screening for detection of extracranial venous abnormalities indicative of chronic cerebrospinal venous insufficiency: a position statement of the International Society for Neurovascular Disease.

    Science.gov (United States)

    Zivadinov, Robert; Bastianello, Stefano; Dake, Michael D; Ferral, Hector; Haacke, E Mark; Haskal, Ziv J; Hubbard, David; Liasis, Nikolaos; Mandato, Kenneth; Sclafani, Salvatore; Siddiqui, Adnan H; Simka, Marian; Zamboni, Paolo

    2014-11-01

    Under the auspices of the International Society for Neurovascular Disease (ISNVD), four expert panel committees were created from the ISNVD membership between 2011 and 2012 to determine and standardize noninvasive and invasive imaging protocols for detection of extracranial venous abnormalities indicative of chronic cerebrospinal venous insufficiency (CCSVI). The committees created working groups on color Doppler ultrasound (US), magnetic resonance (MR) imaging, catheter venography (CV), and intravascular US. Each group organized a workshop focused on its assigned imaging modality. Non-ISNVD members from other societies were invited to contribute to the various workshops. More than 60 neurology, radiology, vascular surgery, and interventional radiology experts participated in these workshops and contributed to the development of standardized noninvasive and invasive imaging protocols for the detection of extracranial venous abnormalities indicative of CCSVI. This ISNVD position statement presents the MR imaging and intravascular US protocols for the first time and describes refined color Doppler US and CV protocols. It also emphasizes the need for the use of for noninvasive and invasive multimodal imaging to diagnose adequately and monitor extracranial venous abnormalities indicative of CCSVI for open-label or double-blinded, randomized, controlled studies.

  9. Prevention of venous thromboembolism in hospitalized patients with chronic kidney disease

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    Marcora Mandreoli

    2013-04-01

    Full Text Available Despite the high morbidity and mortality associated with venous thromboembolism in hospitalized medical patients with a number of risk factors, and large evidence that prophylaxis is effective, prophylaxis rates remain elusive in medically ill patients. Furthermore, in patients with renal failure, prophylaxis often is omitted or sub-optimal, due to fear of provoking hemorrhage. Patients with end-stage renal disease often have platelet deficits. Low molecular weight heparin (LMWH therapy may also be difficult to manage in these cases because LMWH clearance is largely dependent on the kidneys. Administration of LMWH to patients with some degree of renal failure may lead to bioaccumulation of anti-Xa activity with an increased risk of bleeding. In recent years, LMWH has largely replaced unfractionated heparin (UFH for the treatment and prophylaxis of thromboembolic disease. LMWHs have been shown to be superior to UFH in the prevention of venous thromboembolism. They are also easier to administer and do not require laboratory monitoring. However, several case reports and a metaanalysis indicate that the use of LMWHs at therapeutic doses in patients with advanced renal failure can be associated with major bleeding with serious adverse effects. In this paper, we review recent evidence supporting the safety of LMWHs at prophylactic doses in patients with mild or moderate renal disease. Current evidence suggests that bioaccumulation of enoxaparin (the most widely used LMWH can occur when the drug is used at standard therapeutic doses in patients with severely impaired renal function. This risk can be reduced by empiric dose reduction or monitoring of anti-Xa heparin levels.

  10. Rational therapy of chronic venous insufficiency – chances and limits of the therapeutic use of horse-chestnut seeds extract

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    Greeske Karin

    2001-12-01

    Full Text Available Abstract Background and methods We report two clinical studies, one already published, performed in patients with early and advanced chronic venous insufficiency (CVI. In both, compression therapy and oral therapy with horse-chestnut seeds extracts (HCSE were compared to placebo. Results The published study in early CVI (Grade I showed HCSE and compression to be superior to placebo and to be equivalent to each other in reducing lower leg volume, a measure for oedema. In the study, in advanced CVI (Grade II and IIIa, compression appeared to be superior to placebo, whereas HCSE was not. HCSE fared better in Grade II than in Grade IIIa patients. These results are discussed in the light of data from an in vitro model, where HCSE has been able to close the intercellular gaps in the venular endothelium. Not fully specified factors lead to an opening of these gaps, resulting in oedema as well as in local coagulation and thrombosis. The subsequent inflammation keeps these gaps open and initiates and maintains a chronic disease process, which may be the starting point of CVI. Conclusion Due to its ability to close the venular endothelial gaps, HCSE seems to be a suitable and protecting therapy during the early stages of CVI. In later more severe stages compression therapy is indicated. Taking into account the observed negative impact of compression on quality of life, pharmacological CVI therapy should start early to avoid progress and to spare patients compression therapy.

  11. Forkhead box C2 promoter variant c.-512C>T is associated with increased susceptibility to chronic venous diseases.

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    Sumi Surendran

    Full Text Available Chronic venous disease (CVD is one of the most prevalent yet underrated disorders worldwide. High heritability estimates of CVD indicate prominent genetic components in its etiology and pathology. Mutations in human forkhead box C2 (FoxC2 gene are strongly associated with valve failure in saphenous and deep veins of lower extremities. We explored the association of genetic variants of FoxC2 as well as FoxC2 mRNA and protein expression levels with CVD of lower limbs. We systematically sequenced the single coding exon, 5' and 3' flanking regions of FoxC2 gene in 754 study subjects which includes 382 patients with CVD and 372 healthy subjects. Four novel and three reported polymorphisms were identified in our cohort. Three variants in 5' flanking region and one in 3' flanking region of FoxC2 gene were significantly associated with CVD risk. FoxC2 mRNA in vein tissues from 22 patients was 4±1.42 fold increased compared to saphenous veins from 20 normal subjects (pT (rs34221221: C>T variant which is located in the FoxC2 putative promoter region was further analyzed. Functional analysis of c.-512C>T revealed increased mRNA and protein expression in patients with homozygous TT genotype compared to heterozygous CT and wild CC genotypes. Luciferase assay indicated higher transcriptional activity of mutant compared to wild genotype of this variant. These findings suggested that c.-512C>T variant of FoxC2 was strongly associated with susceptibility to CVD and also that this variant resulted in FoxC2 overexpression. To obtain a mechanistic insight into the role of upregulated FoxC2 in varicosities, we overexpressed FoxC2 in venous endothelial cells and observed elevated expression of arterial markers Dll4 and Hey2 and downregulation of venous marker COUP-TFII. Our study indicates altered FoxC2-Notch signaling in saphenous vein wall remodeling in patients with varicose veins.

  12. Observer agreement of lower limb venous reflux assessed by duplex ultrasound scanning using manual and pneumatic cuff compression in patients with chronic venous disease and controls

    DEFF Research Database (Denmark)

    Broholm, R; Kreiner, S; Bækgaard, Niels;

    2011-01-01

    The study aimed to evaluate observer agreement between two experienced ultrasound operators examining deep venous reflux assessed by duplex ultrasound (DU) using either manual or pneumatic cuff compression. In addition, the two methods were compared with each other with regard to immediate...

  13. Symptoms in patients with skin changes due to chronic venous insufficiency often lead to emergency care service: an Italian observational study.

    Science.gov (United States)

    Ruggiero, Michele; Grande, Raffaele; Naso, Agostino; Butrico, Lucia; Rubino, Paolo; Placida, Girolamo Domenico; Cannistrà, Marco; Serra, Raffaele

    2016-10-01

    Chronic venous insufficiency (CVI) is the most advanced form of chronic venous disease (CVD), and is often associated with skin changes such as hyperpigmentation, eczema, lipodermatosclerosis and venous skin ulceration that cause discomfort, pain, sleep disturbances, absenteeism in the workplace, disability and deteriorated quality of life (QoL). The purpose of this study is to evaluate the prevalence of CVI and skin changes in patients who turn to Continuous Assistance Services due to the presence of disturbing symptoms of their condition. Data were evaluated by consulting the medical records, during a 16-month period, available with three Continuous Assistance Services of the Italian territory. The overall population of the referring centres consisted of 1186 patients [739 females (62·31%) and 447 males (37·69%)]. Seventy-nine patients (6·66%) consulted the emergency unit for venous symptoms related to CVD. Patients with more severe disease (CVI, categories C4-C6) represented the majority accounting for 60·75%, while patients with moderate disease (C3) accounted for 35·44% and patients with mild disease (C1-C2 stages) accounted for 3·79%. The main finding of this study is that despite CVI not being a disease that commonly requires medical emergency/urgency intervention, patients with CVI, especially in advanced stage with skin changes, may turn to Continuous Assistance Service for treating bothersome symptoms related to their condition.

  14. Diagnostic performance of magnetic resonance venography in the detection of recanalization in patients with chronic cerebral venous sinus thrombus

    Institute of Scientific and Technical Information of China (English)

    SUN Ying; ZHENG Dong-you; JI Xun-ming; Peter WEALE; WU Hao; JIANG Li-dan; YANG Li-zhuang

    2009-01-01

    Background In the chronic stage of cerebral venous sinus thrombosis (CVST), recanalization can result in disparate MR appearances. We aimed to prospectively investigate the diagnostic accuracy of magnetic resonance venography (MRV) in the evaluation of the recanalization of CVST.Methods This study prospectively evaluated the diagnostic performance of 2-dimensional time-of-flight (2D-TOF) MRV in thirty-two consecutive patients during a three- to six-month follow-up for CVST. Both 2D-TOF MRV and digital substraction angiography (DSA) were undertaken. Diagnostic accuracy of 2D-TOF MRV in the detection of recanalized thrombus was evaluated using DSA as the reference standard.Results MRV and DSA were completed without complications in all 32 patients. The sensitivity, specificity, positive predictive value, and negative predictive value of 2D-TOF MRV for the detection of recanalization on a segmental basis were 91% (62/68), 93% (37/40), 95% (62/65), and 86% (37/43) respectively.Conclusion 2D-TOF MRV provides high sensitivity and specificity for the diagnosis of recanalized CVST segments.

  15. A Systematic Review of the Efficacy of Centella asiatica for Improvement of the Signs and Symptoms of Chronic Venous Insufficiency

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    Nyuk Jet Chong

    2013-01-01

    Full Text Available We aimed to assess the efficacy of Centella asiatica for improvement of the signs and symptoms of chronic venous insufficiency (CVI. We searched 13 electronic databases including the Cochrane Central Register of Controlled Trials for randomised controlled trials assessing the efficacy of Centella asiatica for CVI. Two review authors independently selected studies, assessed the risks of bias of included studies and extracted data. The treatment effects of similar studies were pooled whenever appropriate. Eight studies met the inclusion criteria. The pooling of data of similar studies showed that Centella asiatica significantly improved microcirculatory parameters such as transcutaneous partial pressure of CO2 and O2, rate of ankle swelling and venoarteriolar response. Three out of the eight studies did not provide quantitative data. However, these studies reported that patients treated with Centella asiatica showed significant improvement in CVI signs such as leg heaviness, pain and oedema. Our results show that Centella asiatica may be beneficial for improving signs and symptoms of CVI but this conclusion needs to be interpreted with caution as most of the studies were characterised by inadequate reporting and thus had unclear risks of bias, which may threaten the validity of the conclusions.

  16. Chronic hypoxia increases TRPC6 expression and basal intracellular Ca2+ concentration in rat distal pulmonary venous smooth muscle.

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    Lei Xu

    Full Text Available Hypoxia causes remodeling and contractile responses in both pulmonary artery (PA and pulmonary vein (PV. Here we explore the effect of hypoxia on PV and pulmonary venous smooth muscle cells (PVSMCs.Chronic hypoxic pulmonary hypertension (CHPH model was established by exposing rats to 10% O2 for 21 days. Rat distal PVSMCs were isolated and cultured for in vitro experiments. The fura-2 based fluorescence calcium imaging was used to measure the basal intracellular Ca2+ concentration ([Ca2+]i and store-operated Ca2+ entry (SOCE. Quantitative RT-PCR and western blotting were performed to measure the expression of mRNA and levels of canonical transient receptor potential (TRPC protein respectively.Hypoxia increased the basal [Ca2+]i and SOCE in both freshly dissociated and serum cultured distal PVSMCs. Moreover, hypoxia increased TRPC6 expression at mRNA and protein levels in both cultured PVSMCs exposed to prolonged hypoxia (4% O2, 60 h and distal PV isolated from CHPH rats. Hypoxia also enhanced proliferation and migration of rat distal PVSMCs.Hypoxia induces elevation of SOCE in distal PVSMCs, leading to enhancement of basal [Ca2+]i in PVSMCs. This enhancement is potentially correlated with the increased expression of TRPC6. Hypoxia triggered intracellular calcium contributes to promoted proliferation and migration of PVSMCs.

  17. Central venous line complications with chronic ambulatory infusion of prostacyclin analogues in pediatric patients with pulmonary arterial hypertension.

    Science.gov (United States)

    Marr, Courtney R; McSweeney, Julia E; Mullen, Mary P; Kulik, Thomas J

    2015-06-01

    Chronic infusion of prostacyclin (PGI2) via a Broviac central venous line (CVL) is attended by risk of CVL-related complications, but we know of only one report regarding CVL-associated bloodstream infection (BSI) with PGI2 in children and none regarding other complications. We conducted a retrospective cohort study involving pediatric patients with pulmonary hypertension treated with chronic intravenous infusion of PGI2 at Boston Children's Hospital and determined the rate (per 1,000 line-days) of various CVL-related complications. We also determined how often complications necessitated line replacement and hospitalization, time to replacement of CVLs, and interpatient variability in the incidence of complications. From 1999 until 2014, 26 patients meeting follow-up criteria had PGI2 infusion, representing 43,855 line-days; mean follow-up was 56 months (range, 1.4-161 months). The CVL complication rates (per 1,000 line-days) were as follows: CVL-BSI, 0.25; superficial line infection, 0.48; impaired integrity, 0.59; occlusion, 0.09; and malposition, 0.32. The total complication rate was 1.73 cases per 1,000 line-days. All CVL-BSI and malposition cases were treated with CVL removal and replacement. Of CVLs with impaired integrity, 23 could be repaired and 3 required replacement. Six of 21 superficial CVL infections required replacement of the CVL. Three of 4 occluded CVLs were replaced. CVL complications occasioned 65 hospitalizations. There was marked interpatient variability in the rate of complications, much but not all of which appeared to be related to duration of CVL placement. We conclude that non-BSI complications are very significant and that efforts to teach and emphasize other aspects of line care are therefore very important.

  18. Proliferation and mitogenic response to PDGF-BB of fibroblasts isolated from chronic venous leg ulcers is ulcer-age dependent

    DEFF Research Database (Denmark)

    Agren, M S; Steenfos, H H; Dabelsteen, S

    1999-01-01

    Several pathophysiologic mechanisms have been proposed to explain slow-healing leg ulcers, but little is known about the growth behavior of cells in these wounds. Platelet-derived growth factor-BB applied topically to chronic wounds has shown beneficial effects, although the effects have been les...... chronic wounds have approached or even reached the end of their lifespan (phase III). This might provide one explanation for the non-healing state and therapy resistance to topical platelet-derived growth factor-BB of some venous leg ulcers.......Several pathophysiologic mechanisms have been proposed to explain slow-healing leg ulcers, but little is known about the growth behavior of cells in these wounds. Platelet-derived growth factor-BB applied topically to chronic wounds has shown beneficial effects, although the effects have been less...... pronounced than would have been expected based on studies on acute wounds. The objective of this study was to compare fibroblasts in culture obtained from chronic wounds (non-healing chronic venous leg ulcers), acute wounds and normal dermis regarding growth, mitogenic response to platelet-derived growth...

  19. 'Chronic cerebrospinal venous insufficiency' in multiple sclerosis. Is multiple sclerosis a disease of the cerebrospinal venous outflow system?; 'Chronische zerebrospinale venoese Insuffizienz' bei Multipler Sklerose. Ist die Multiple Sklerose eine Erkrankung des zerebrospinalen venoesen Abflusssystems?

    Energy Technology Data Exchange (ETDEWEB)

    Wattjes, M.P. [VU Univ. Medical Center, Amsterdam (Netherlands). Dept. of Radiology; Doepp, F. [Universitaetsklinik Charite, Berlin (Germany). Neurologische Klinik; Bendszus, M. [Heidelberg Univ. (Germany). Abt. fuer Neuroradiologie; Fiehler, J. [Universitaetsklinikum Hamburg-Eppendorf (Germany). Klinik fuer Neuroradiologische Diagnostik und Intervention

    2011-06-15

    Chronic impaired venous outflow from the central nervous system has recently been claimed to be associated with multiple sclerosis (MS) pathology. This resulted in the term chronic cerebrospinal venous insufficiency (CCSVI) in MS. The concept of CCSVI is based on sonography studies showing that impaired venous outflow leading to pathological reflux is almost exclusively present in MS patients but not in healthy controls. Based on these findings, a new pathophysiological concept has been introduced suggesting that chronic venous outflow obstruction and venous reflux in the CNS result in pathological iron depositions leading to inflammation and neurodegeneration. The theory of CCSVI in MS has rapidly generated tremendous interest in the media and among patients and the scientific community. In particular, the potential shift in treatment concepts possibly leading to an interventional treatment approach including balloon angioplasty and venous stent placement is currently being debated. However, results from recent studies involving several imaging modalities have raised substantial concerns regarding the CCSVI concept in MS. In this review article, we explain the concept of CCSVI in MS and discuss this hypothesis in the context of MS pathophysiology and imaging studies which have tried to reproduce or refute this theory. In addition, we draw some major conclusions focusing in particular on the crucial question as to whether interventional treatment options are expedient. In conclusion, the present conclusive data confuting the theory of CCSVI in MS should lead to reluctance with respect to the interventional treatment of possible venous anomalies in MS patients. (orig.)

  20. Drug therapy of chronic venous insufficiency of the lower limbs%下肢慢性静脉功能不全的药物治疗

    Institute of Scientific and Technical Information of China (English)

    王深明; 姚陈

    2011-01-01

    Chronic venous insufficiency (CVI) of the lower limbs is a kind of vascular disease with high morbidity. The etiological factors of CVI are venous hypertension and inflammation cascade reaction.The mechanisms are thepharmacological targets of most drugs for CVI. Systemic drugtherapy has been tried for many years in an attempt to reducesymptoms and improve microcirculation. The first aim of drugtherapy is to improve CVI symptoms and avoid adversereaction.%下肢慢性静脉功能不全(chronic venous insufficiency,CVI)是常见的血管外科疾病.病因主要有下肢静脉血流异常所导致的静脉高压以及静脉压升高后导致静脉系统出现的炎症级联反应.目前治疗CVI的药物多是以上述发病机制为靶点,在缓解症状、改善微循环方面具有重要作用.有效改善下肢慢性静脉疾病的症状并且尽量避免不良反应的出现是药物治疗的首要目标.

  1. Inhibitory Effect of Natural Anti-Inflammatory Compounds on Cytokines Released by Chronic Venous Disease Patient-Derived Endothelial Cells

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    Veronica Tisato

    2013-01-01

    Full Text Available Large vein endothelium plays important roles in clinical diseases such as chronic venous disease (CVD and thrombosis; thus to characterize CVD vein endothelial cells (VEC has a strategic role in identifying specific therapeutic targets. On these bases we evaluated the effect of the natural anti-inflammatory compounds α-Lipoic acid and Ginkgoselect phytosome on cytokines/chemokines released by CVD patient-derived VEC. For this purpose, we characterized the levels of a panel of cytokines/chemokines (n=31 in CVD patients’ plasma compared to healthy controls and their release by VEC purified from the same patients, in unstimulated and TNF-α stimulated conditions. Among the cytokines/chemokines released by VEC, which recapitulated the systemic profile (IL-8, TNF-α, GM-CSF, INF-α2, G-CSF, MIP-1β, VEGF, EGF, Eotaxin, MCP-1, CXCL10, PDGF, and RANTES, we identified those targeted by ex vivo treatment with α-Lipoic acid and/or Ginkgoselect phytosome (GM-CSF, G-CSF, CXCL10, PDGF, and RANTES. Finally, by investigating the intracellular pathways involved in promoting the VEC release of cytokines/chemokines, which are targeted by natural anti-inflammatory compounds, we documented that α-Lipoic acid significantly counteracted TNF-α-induced NF-κB and p38/MAPK activation while the effects of Ginkgo biloba appeared to be predominantly mediated by Akt. Our data provide new insights into the molecular mechanisms of CVD pathogenesis, highlighting new potential therapeutic targets.

  2. Minimally Invasive Monitoring of Chronic Central Venous Catheter Patency in Mice Using Digital Subtraction Angiography (DSA.

    Directory of Open Access Journals (Sweden)

    Giovanna Figueiredo

    Full Text Available Repetitive administration of medication or contrast agents is frequently performed in mice. The introduction of vascular access mini-ports (VAMP for mice allows long-term vascular catheterization, hereby eliminating the need for repeated vessel puncture. With catheter occlusion being the most commonly reported complication of chronic jugular vein catheterization, we tested whether digital subtraction angiography (DSA can be utilized to evaluate VAMP patency in mice.Twenty-three mice underwent catheterization of the jugular vein and subcutaneous implantation of a VAMP. The VAMP was flushed every second day with 50 μL of heparinized saline solution (25 IU/ml. DSA was performed during injection of 100 μL of an iodine based contrast agent using an industrial X-ray inspection system intraoperatively, as well as 7±2 and 14±2 days post implantation.DSA allowed localization of catheter tip position, to rule out dislocation, kinking or occlusion of a microcatheter, and to evaluate parent vessel patency. In addition, we observed different ante- and retrograde collateral flow patterns in case of jugular vein occlusion. More exactly, 30% of animals showed parent vessel occlusion after 7±2 days in our setting. At this time point, nevertheless, all VAMPs verified intravascular contrast administration. After 14±2 days, intravascular contrast injection was verified in 70% of the implanted VAMPs, whereas at this point of time 5 animals had died or were sacrificed and in 2 mice parent vessel occlusion hampered intravascular contrast injection. Notably, no occlusion of the catheter itself was observed.From our observations we conclude DSA to be a fast and valuable minimally invasive tool for investigation of catheter and parent vessel patency and for anatomical studies of collateral blood flow in animals as small as mice.

  3. Medical management of venous ulcers.

    Science.gov (United States)

    Pascarella, Luigi; Shortell, Cynthia K

    2015-03-01

    Venous disease is the most common cause of chronic leg ulceration and represents an advanced clinical manifestation of venous insufficiency. Due to their frequency and chronicity, venous ulcers have a high socioeconomic impact, with treatment costs accounting for 1% of the health care budget in Western countries. The evaluation of patients with venous ulcers should include a thorough medical history for prior deep venous thrombosis, assessment for an hypercoagulable state, and a physical examination. Use of the CEAP (clinical, etiology, anatomy, pathophysiology) Classification System and the revised Venous Clinical Severity Scoring System is strongly recommended to characterize disease severity and assess response to treatment. This venous condition requires lifestyle modification, with affected individuals performing daily intervals of leg elevation to control edema; use of elastic compression garments; and moderate physical activity, such as walking wearing below-knee elastic stockings. Meticulous skin care, treatment of dermatitis, and prompt treatment of cellulitis are important aspects of medical management. The pharmacology of chronic venous insufficiency and venous ulcers include essentially two medications: pentoxifylline and phlebotropic agents. The micronized purified flavonoid fraction is an effective adjunct to compression therapy in patients with large, chronic ulceration.

  4. Influence of antioxidant complex on the adhesion of leukocytes in chronic venous insufficiency of lower limbs in rats

    Directory of Open Access Journals (Sweden)

    Mark Plotnikov

    2012-01-01

    Conclusions: Model of CVI of lower limb is accompanied by increased venous pressure and raised adhesion activity of leukocytes. Administration of AOC for 14 days reduces the adhesive activity of leukocytes.

  5. Managing wound exudate using a super-absorbent polymer dressing: a 53-patient clinical evaluation.

    Science.gov (United States)

    Cutting, K F

    2009-05-01

    This real-life, observational evaluation shows that, by absorbing and retaining within its structure the corrosive enzymes found in chronic exudate, this dressing both reduces the likelihood of peri-wound maceration and promotes healing.

  6. Hypoperfusion of brain parenchyma is associated with the severity of chronic cerebrospinal venous insufficiency in patients with multiple sclerosis: a cross-sectional preliminary report

    Directory of Open Access Journals (Sweden)

    Bergsland Niels

    2011-03-01

    Full Text Available Abstract Background Several studies have reported hypoperfusion of the brain parenchyma in multiple sclerosis (MS patients. We hypothesized a possible relationship between abnormal perfusion in MS and hampered venous outflow at the extracranial level, a condition possibly associated with MS and known as chronic cerebrospinal venous insufficiency (CCSVI. Methods We investigated the relationship between CCSVI and cerebral perfusion in 16 CCSVI MS patients and 8 age- and sex-matched healthy controls. Subjects were scanned in a 3-T scanner using dynamic susceptibility, contrast-enhanced, perfusion-weighted imaging. Cerebral blood flow (CBF, cerebral blood volume (CBV and mean transit time (MTT were measured in the gray matter (GM, white matter (WM and the subcortical GM (SGM. The severity of CCSVI was assessed according to the venous hemodynamic insufficiency severity score (VHISS on the basis of the number of venous segments exhibiting flow abnormalities. Results There was a significant association between increased VHISS and decreased CBF in the majority of examined regions of the brain parenchyma in MS patients. The most robust correlations were observed for GM and WM (r = -0.70 to -0.71, P P corrected = 0.022, and for the putamen, thalamus, pulvinar nucleus of thalamus, globus pallidus and hippocampus (r = -0.59 to -0.71, P P corrected Conclusions This pilot study is the first to report a significant relationship between the severity of CCSVI and hypoperfusion in the brain parenchyma. These preliminary findings should be confirmed in a larger cohort of MS patients to ensure that they generalize to the MS population as a whole. Reduced perfusion could contribute to the known mechanisms of virtual hypoxia in degenerated axons.

  7. Chronic Venous Insufficiency

    Science.gov (United States)

    ... restlessness, tiredness, fatigue, pain, throbbing, burning, itching and muscle cramping. In advanced cases, breakdown of the skin may cause bleeding from varicose veins, and large varicosities may develop blood clots, a condition ... muscles may improve calf muscle function T he V ...

  8. Using the MEM-net program to report on mapping the EchoColorDoppler assessment for chronic cerebro spinal venous insufficiency

    Directory of Open Access Journals (Sweden)

    Mandolesi S

    2014-07-01

    Full Text Available Sandro Mandolesi,1 Aldo d’Alessandro,2 Ettore Manconi,3 Tarcisio Niglio,4 Augusto Orsini,5 Dimitri Mandolesi,6 Alessandro d'Alessandro,7 Francesco Fedele1 1Department of Cardiovascular and Respiratory Sciences, Sapienza University Rome, Rome, Italy; 2Department of Angiology, “T Masselli-Mascia” Hospital, San Severo (FG, Foggia, Italy; 3Department of Cardiovascular and Neurological Sciences, University of Cagliari, Cagliari, Italy; 4Istituto Superiore di Sanità, Rome, Italy; 5Department of Vascular Surgery, “Gioia” Hospital, Sora (FR, Sora, Italy; 6Medicina del lavoro Sapienza University Roma, Rome, Italy; 7Faculty of Medicine, Catholic University “Our Lady of Good Counsel,” Tirana, Albania Introduction: Chronic cerebrospinal venous insufficiency (CCSVI is characterized by multiple stenosis/obstructions affecting the principal extracranial outflow pathways of the cerebrospinal venous system. Using EchoColorDoppler (ECD to assess chronic CCSVI is a very difficult and long examination. It takes about an hour even for an expert sonographer. Methods: Hemodynamic morphological map (MEM-Net is a program that works on the Internet. All the morphological and hemodynamic data of the patient can be entered into the program’s anatomical scheme to create a map of the ECD report. The program also allows us to collect all the data during the ECD assessment and, using its algorithm, make the report uniform. Conclusion: Reporting on the map by using MEM-net shortens the time of ECD written reporting that is done automatically. The program also makes a blind control of the report and enables the use of it for scientific research. We hope that in the future everyone will use this data collection tool for all scientific work on this topic. Keywords: CCSVI, ECD, Map, cerebral venous system, sonography

  9. Efficacy and cost-effectiveness of octenidine wound gel in the treatment of chronic venous leg ulcers in comparison to modern wound dressings.

    Science.gov (United States)

    Hämmerle, Gilbert; Strohal, Robert

    2016-04-01

    The aim of this study was to determine the efficacy, safety and cost-effectiveness of an octenidine-based wound gel in the treatment of chronic venous leg ulcers. For this purpose, 49 wounds were treated with either modern wound-phase-adapted dressings alone (treatment arm 1; n = 17), octenidine wound gel plus modern wound-phase-adapted dressings (treatment arm 2; n = 17) or octenidine wound gel alone (treatment arm 3; n = 15). During the study period of 42 days with dressing changes every 3-5 days, wound healing characteristics and treatment costs of different dressings were analysed. Wound size reduction was significantly better (P = 0·028) in both octenidine wound gel treatment arms compared to modern dressings alone with total reductions of 14·6%, 64·1% and 96·2% in treatment arms 1-3. Early wound healing was merely observed under octenidine wound gel treatment (n = 9), whereby lowest treatment costs were generated by octenidine wound gel alone (€20·34/dressing change). As a result, the octenidine wound gel is cost-effective and well suitable for the treatment of chronic venous leg ulcers, considering both safety and promotion of wound healing.

  10. Evaluating safety of tunneled small bore central venous catheters in chronic kidney disease population: A quality improvement initiative.

    Science.gov (United States)

    Bhutani, Gauri; El Ters, Mireille; Kremers, Walter K; Klunder, Joe L; Taler, Sandra J; Williams, Amy W; Stockland, Andrew H; Hogan, Marie C

    2016-09-20

    Introduction Peripherally inserted central venous catheters (PICCs) may adversely impact future successful arteriovenous fistulae (AVF). As part of a quality improvement project, the performance of tunneled small bore tunneled central venous catheters (TSB-CVCs), as alternatives to PICCs, was evaluated. Methods A retrospective observational study, involving individuals ≥18 years of age who underwent TSB-CVC placement by Interventional Radiology at Mayo Clinic, Rochester, MN between 1/1/2010 and 8/30/2013. Findings The study cohort included 92 patients with a median age of 55 (46-67) years, who underwent 108 TSB-CVC placements. Baseline renal disease was present in 71% (77/108). Most TSB-CVCs were placed in hospitalized patients (94%; 102/108); five French in diameter (61%; 66/108) and located in an internal jugular vein (84%; 91/108). Median catheter indwelling time was 20 (11-43) days (n = 84). TSB-CVC-related bloodstream infection, deep venous thrombosis (DVT), and superficial venous thrombosis (SpVT) rates per line were 0.009 (1/108), 0.018 (2/108), and 0.009 (1/108), respectively. Venous outcomes in a subgroup of 54 patients, who had documented PICC placements (n = 161) in addition to TSB-CVC (n = 58) were compared. TSB-CVC-DVT rate was lower than the PICC-DVT rate (0.017 [1/58] vs. 0.106 per line [17/161]; P = 0.04). The TSB-CVC-SpVT rate was not different from the PICC-SpVT rate (0 [0/58] vs. 0.037 [6/161] per line; P = 0.14). Discussion TSB-CVCs demonstrated an excellent safety profile in our study. These catheters should be preferentially utilized for arm vein preservation in advanced kidney disease. Their impact on future AVF success needs further evaluation.

  11. Determination of Oxidative Stress in Patients With Chronic Venous Ulcer%慢性静脉性溃疡组织中氧化应激产物的测定

    Institute of Scientific and Technical Information of China (English)

    杨帆; 邓璐

    2016-01-01

    ABSTRACT:ObjectiveTo clarify whether there is oxidative stress in chronic venous ulcer, and to lay a theoretical foundation for the further study of the pathogenesis of chronic venous ulcer. Methods 36 cases were diagnosed from January 2015 to October 2015 were treated for chronic venous insufficiency of lower extremity ulcers in patients with ulcer specimens, determination of malondialdehyde (MDA), reduced glutathione (GSH), superoxide dismutase (SOD) content and compared with the burn ulcer tissue and normal skin tissue.Results With the control group (normal skin, burn ulcer group),duration of ulcer2 weeks and> 1 month group, venous ulceration of the concentration of MDA significantly increased (P2weeks and >1 month group, the SOD、GSH of venous ulcer group significantly reduced (P2周和>1月组,静脉性溃疡MDA浓度显著增加(P2周和>1月组中,静脉性溃疡组SOD、GSH明显减少(P<0.05)。结论静脉性溃疡创面氧化应激反应增强,抗氧化能力减弱,并产生了大量的氧化应激产物。

  12. The impact of obesity on venous insufficiency.

    Science.gov (United States)

    Seidel, A C; Belczak, C E Q; Campos, M B; Campos, R B; Harada, D S

    2015-08-01

    Association between chronic venous disease and obesity has recently been studied, with indications that it may worsen in obese patients. The aim of study was to correlate clinical classes of chronic venous disease according to Clinical Etiology Anatomy Pathophysiology (CEAP) classification and body mass index, as well as to compare the severity of chronic venous disease in obese and nonobese patients. This retrospective cross-sectional prevalence study was conducted at the Maringá State University and Belczak Vascular Center along a period of 2 years, consisting of a random sample of 482 patients with complaints compatible with chronic venous disease. Data obtained from patient's files included gender, age, weight and height (for calculating body mass index), and clinical class (C) of chronic venous disease according to CEAP classification. Statistical analysis included Spearman's correlation coefficient, Chi-square test (for comparing frequencies), and Student's t-test (for comparing means). Significant positive correlation between body mass index and clinical classes was established for women (0.43), but not for men (0.07). Obesity (body mass index  : ≥  : 30.0) was significantly more frequent in patients with chronic venous disease in clinical classes 3 (p venous disease in clinical class 1 (p venous disease in women, but not in men. It also corroborated the negative impact of obesity on the clinical severity of chronic venous disease.

  13. Endovascular treatment of chronic cerebro spinal venous insufficiency in patients with multiple sclerosis modifies circulating markers of endothelial dysfunction and coagulation activation: a prospective study.

    Science.gov (United States)

    Napolitano, Mariasanta; Bruno, Aldo; Mastrangelo, Diego; De Vizia, Marcella; Bernardo, Benedetto; Rosa, Buonagura; De Lucia, Domenico

    2014-10-01

    We performed a monocentric observational prospective study to evaluate coagulation activation and endothelial dysfunction parameters in patients with multiple sclerosis undergoing endovascular treatment for cerebro-spinal-venous insufficiency. Between February 2011 and July 2012, 144 endovascular procedures in 110 patients with multiple sclerosis and chronical cerebro-spinal venous insufficiency were performed and they were prospectively analyzed. Each patient was included in the study according to previously published criteria, assessed by the investigators before enrollment. Endothelial dysfunction and coagulation activation parameters were determined before the procedure and during follow-up at 1, 3, 6, 9, 12, 15 and 18 months after treatment, respectively. After the endovascular procedure, patients were treated with standard therapies, with the addition of mesoglycan. Fifty-five percent of patients experienced a favorable outcome of multiple sclerosis within 1 month after treatment, 25% regressed in the following 3 months, 24.9% did not experience any benefit. In only 0.1% patients, acute recurrence was observed and it was treated with high-dose immunosuppressive therapy. No major complications were observed. Coagulation activation and endothelial dysfunction parameters were shown to be reduced at 1 month and stable up to 12-month follow-up, and they were furthermore associated with a good clinical outcome. Endovascular procedures performed by a qualified staff are well tolerated; they can be associated with other currently adopted treatments. Correlations between inflammation, coagulation activation and neurodegenerative disorders are here supported by the observed variations in plasma levels of markers of coagulation activation and endothelial dysfunction.

  14. [Use of laser technologies in treatment of chronic venous insufficiency in patients with a wide ostial segment of the main trunks of subcutaneous veins].

    Science.gov (United States)

    Luk'ianenko, M Iu; Starodubtsev, V B; Karpenko, A A; Sergeevichev, D S

    2014-01-01

    Presented herein is the authors' experience in endovascular laser obliteration of the major trunks of the grate saphenous vein (GSV) with a wide ostial segment (measuring from 15 to 34 mm) in patients presenting with chronic venous insufficiency. Group One patients (n=32) underwent crossectomy followed by endovasal laser obliteration (EVLO) of the GSV's trunk on the femur. Group Two patients (n=46) were not subjected to crossectomy, whereas obliteration of the GSV's trunk was carried out immediately from the ostium. In Group One we managed to achieve obliteration of the GSV's trunk in 32 patients (100%) with no additional interventions, and in Group Two this was achieved in 42 (91.3%) patients. Four patients (8.7%) required performing a secondary procedure of EVLO after which obliteration of the trunk was achieved in all patients of Group Two. There was no evidence of deep-vein thrombosis.

  15. Etiology and pathogensis of chronic venous ulcer of lower extremities%下肢静脉性溃疡相关病因及其发生机制的研究

    Institute of Scientific and Technical Information of China (English)

    查斌山; 朱化刚

    2010-01-01

    Venous leg ulceration is a common, debilitating chronic condition, which is the most severe complications of chronic venous insufficiency. The persistent venous hypertension is the primary cause of ve-nous ulcer, and leukocyte activation plays a key role in the formation of venous ulcers,and other related fac-tors such as heart disease also play an important role in the development of varicose to ulceration.%慢性静脉性溃疡是下肢慢性静脉功能不全中最严重的最难治的并发症.持续性的静脉高压是引起静脉性溃疡的主要原因;白细胞激活在静脉性溃疡的形成中起关键作用;心脏病等相关因素在静脉曲张向溃疡发展的过程中亦发挥着重要作用.

  16. Comparison of arterial and venous blood gases and the effects of analysis delay and air contamination on arterial samples in patients with chronic obstructive pulmonary disease and healthy controls.

    LENUS (Irish Health Repository)

    O'Connor, T M

    2012-01-31

    BACKGROUND: Arterial blood gases (ABGs) are often sampled incorrectly, leading to a \\'mixed\\' or venous sample. Delays in analysis and air contamination are common. OBJECTIVES: We measured the effects of these errors in patients with chronic obstructive pulmonary disease (COPD) exacerbations and controls. METHODS: Arterial and venous samples were analyzed from 30 patients with COPD exacerbation and 30 controls. Venous samples were analysed immediately and arterial samples separated into non-air-contaminated and air-contaminated specimens and analysed at 0, 30, 60, 90 and 180 min. RESULTS: Mean venous pH was 7.371 and arterial pH was 7.407 (p < 0.0001). There was a correlation between venous and arterial pH (r = 0.5347, p < 0.0001). The regression equation to predict arterial pH was: arterial pH = 4.2289 + 0.43113 . venous pH. There were no clinically significant differences in arterial PO associated with analysis delay. A statistically significant decline in pH was detected at 30 min in patients with COPD exacerbation (p = 0.0042) and 90 min in controls (p < 0.0001). A clinically significant decline in pH emerged at 73 min in patients with COPD exacerbation and 87 min in controls. Air contamination was associated with a clinically significant increase in PO in all samples, including those that were immediately analyzed. CONCLUSIONS: Arterial and venous pH differ significantly. Venous pH cannot accurately replace arterial pH. Temporal delays in ABG analysis result in a significant decline in measured pH. ABGs should be analysed within 30 min. Air contamination leads to an immediate increase in measured PO, indicating that air-contaminated ABGs should be discarded.

  17. Dutch Venous Ulcer guideline update.

    Science.gov (United States)

    Maessen-Visch, M Birgitte; de Roos, Kees-Peter

    2014-05-01

    The revised guideline of 2013 is an update of the 2005 guideline "venous leg ulcer". In this special project four separate guidelines (venous leg ulcer, varicose veins, compression therapy and deep venous disorders) were revised and developed simultaneously. A meeting was held including representatives of any organisation involved in venous disease management including patient organizations and health insurance companies. Eighteen clinical questions where defined, and a new strategy was used to accelerate the process. This resulted in two new and two revised guidelines within one year. The guideline committee advises use of the C of the CEAP classification as well as the Venous Clinical Severity Score (VCSS) and a Quality of life (QoL) score in the assessment of clinical signs. These can provide insight into the burden of disease and the effects of treatment as experienced by the patient. A duplex ultrasound should be performed in every patient to establish the underlying aetiology and to evaluate the need for treatment (which is discussed in a separate guideline). The use of the TIME model for describing venous ulcers is recommended. There is no evidence for antiseptic or antibiotic wound care products except for a Cochrane review in which some evidence is presented for cadexomer iodine. Signs of infection are the main reason for the use of oral antibiotics. When the ulcer fails to heal the use of oral aspirin and pentoxifylline can be considered as an adjunct. For the individual patient, the following aspects should be considered: the appearance of the ulcer (amount of exudate) according to the TIME model, the influence of wound care products on moisturising the wound, frequency of changing compression bandages, pain and allergies. The cost of the dressings should also be considered. Education and training of patients t improves compliance with compression therapy but does not influence wound healing rates.

  18. Effectiveness of papain gel in venous ulcer treatment: randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Ana Luiza Soares Rodrigues

    2015-06-01

    Full Text Available OBJECTIVE: to assess the effectiveness of 2% papain gel compared to 2% carboxymethyl cellulose in the treatment of chronic venous ulcer patients.METHOD: randomized controlled clinical trial with 12-week follow-up. The sample consisted of 18 volunteers and 28 venous ulcers. In the trial group, 2% papain gel was used and, in the control group, 2% carboxymethyl cellulose gel.RESULTS: the trial group showed a significant reduction in the lesion area, especially between the fifth and twelfth week of treatment, with two healed ulcers and a considerable increase in the amount of epithelial tissue in the wound bed.CONCLUSION: 2% papain gel demonstrated greater effectiveness in the reduction of the lesion area, but was similar to 2% carboxymethyl cellulose gel regarding the reduction in the amount of exudate and devitalized tissue. Multicenter research is suggested to evidence the effectiveness of 2% papain gel in the healing of venous ulcers. UTN number: U1111-1157-2998

  19. Associations of anterior accessory or thigh posterior tributary and great saphenous reflux patterns in early stages of chronic venous valvular insufficiency

    Directory of Open Access Journals (Sweden)

    Carlos Alberto Engelhorn

    2014-07-01

    Full Text Available Varicose veins are a common disorder. Extensive ultrasound (US mapping of lower extremity chronic venous valvular insufficiency includes the great saphenous vein (GSV, anterior accessory saphenous vein (AASV and thigh posterior tributary to GSV such as the posterior accessory saphenous vein (PTSV, PASV. The aim of this study was to determine associations between GSV-AASV-PTSV (including PASV reflux in a specific sample population of Southern Brazilian women, mostly euro descendents, with telangiectasias, reticular veins, varices and/or intermittent edema. US performed in 1016 extremities of 513 women, 43±18 (18-81 years old were included. Women with previous venous thrombosis, surgery, suspicion of pelvic congestion syndrome, and men were excluded. Small saphenous vein and related thigh veins were excluded from analysis. GSV-AASV-PTSV reflux patterns were analyzed; prevalence was compared using χ2 statistics. Reflux prevalence in AASV and/or thigh PTSV was 5.8% (59/1016: 1.3% at PTSV (n=13 and 4.5% at AASV (n=46, significantly lower than GSV reflux: 72% (n=727 (P<0.001. AASV and/or PTSV reflux was associated with GSV reflux (81%, n=48/59; common pattern was diffuse reflux, starting at AASV/PTSV saphenous junctions (56%, n=33/59; otherwise, short, non-diffuse reflux was noted in part of the AASV/PTSV evaluated. Isolated AASV or PTSV reflux was rare (1%, n=11/1016: 9 at the AASV, and 2 at the PTSV. US mapping of AASV/PTSV in early stages of disease, in women without pelvic congestion syndrome, increased reflux detection by 1%, and improved definition of reflux patterns in about 6% of the extremities.

  20. Venous Ultrasound (Extremities)

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Ultrasound - Venous (Extremities) Venous ultrasound uses sound waves to ... limitations of Venous Ultrasound Imaging? What is Venous Ultrasound Imaging? Ultrasound is safe and painless, and produces ...

  1. Chronic Cranial Venous Sinus Thrombosis Retrospective Analysis from Our Hospital in Recent 5 Years%我院近5年慢性颅静脉窦血栓形成的回顾性分析

    Institute of Scientific and Technical Information of China (English)

    王艳; 赵新利; 任玉琴; 吴新艳; 谭军

    2013-01-01

    目的:探讨我院近5年慢性颅静脉窦血栓形成患者的临床特点以及诊断与治疗方法。方法对我院神经内科近5年收治的慢性颅静脉窦血栓形成患者的临床资料进行回顾性分析。结果分别从发病率与危险因素、临床表现、眼底检查与腰椎穿刺、影像学检查以及治疗等5个方面进行总结。结论加深对慢性颅静脉窦血栓形成的了解程度有助于提升其临床诊断水平。%Objective To investigate the hospital nearly five years of chronic cranial venous sinus thrombosis in patients with clinical features and diagnostic and treatment methods. Methods The clinical neurology nearly 5 years admit ed with chronic cranial venous sinus thrombosis in patients with clinical data were retrospectively analyzed. The Results are from morbidity and risk factors, clinical manifestations, fundus examination and lumbar puncture, imaging and therapy five aspects summary. Conclusion deepen the chronic cranial venous sinus thrombosis help to improve the level of understanding of the clinical diagnosis.

  2. 腓肠肌泵与下肢慢性静脉功能不全%Calf Muscle Pump and Chronic Venous Insufficiency in Lower Extremities

    Institute of Scientific and Technical Information of China (English)

    王昆; 乔正荣; 时德

    2002-01-01

    目的探讨腓肠肌泵功能与下肢慢性静脉功能不全(chronic venous insufficiency,CVI)的关系. 方法复习相关文献,并作综述性报道.结果腓肠肌泵功能的研究方法有空气体积描记法、应变容积描记法、肌肉内压力测定、腓肠肌泵功率测定、足水银应变容积描记法、同位素体积描记法及数字光电容积描记法,测得CVI患者的腓肠肌泵功能明显下降,通过治疗后,腓肠肌泵功能明显改善. 结论腓肠肌泵功能与CVI有密切关系.

  3. The recalcitrant venous leg ulcer - A never ending story?

    NARCIS (Netherlands)

    S.W.I. Reeder (Suzan); M.B. Maessen-Visch (Birgitte); S.I. Langendoen; K.P. de Roos; H.A.M. Neumann (Martino)

    2013-01-01

    textabstractIntroduction: In general, four particular causes of recalcitrant venous leg ulcers may be distinguished. These are foot pump insufficiency, chronic venous compartment syndrome and non-re-canalized popliteal vein thrombosis. The fourth cause of recalcitrant venous leg ulcers is lipodermat

  4. Study on β-aescin's Treatment for Chronic Venous Dysfunction%β-七叶皂苷钠治疗慢性静脉功能不全的研究

    Institute of Scientific and Technical Information of China (English)

    余志红; 苏萍; 王奕

    2011-01-01

    Objective: To explore the mechanism of the domestic β-aescin treating chronic venous insufficiency through observing its actions on the isolated canine saphenous venous tension,venous pressure, venous return and lymphatic drainage. Method :The isolated canine spiral saphenous uenous tension test was performed to detect the activity of the β-aescin. Furthermore,in the comdition of constant canine femoral artery perfusion kept in the extracorporeal circulation ,we measured the changes in the canine femoral artery pressure, femoral artery artery flow and the lymphatic drainage flow after intravenous injection of the drug. Result: When β-aescin was administrated at the dose between 5.0 × 10-5-5.25 × 10-6g·mL-1 ,it could obviously increase the contractile tension of the venous to norepinephrine in a dose-dependent manner. With canine femoral artery perfusion kept constant,β-aescin,whose doses were 50 mg and 100 mg,could reinforce intently the canine femoral venous tension,accelerate the rise of the venous return and lymphatic drainage. Conclusion: The domestic β-aescin extracted from shorea has some therapeutical effect on chronic venous insufficiency by strengthening the venous tension, increasing the venous pressure and promoting venous return and lymphatic drainage.%目的:观察国产β-七叶皂苷钠对犬离体隐静脉张力和对犬静脉压、静脉回流和淋巴同流的作用,从而探讨其治疗慢性静脉功能不全的机制.方法:采用犬离体螺旋隐静脉条张力试验观察β-七叶皂苷钠对犬离体隐静脉收缩张力的影响;另在体外循环保持犬股动脉灌流恒定的条件下,经静脉全身给药后测定犬股静脉压、股静脉流量和淋巴回流量的变化.结果:β-七叶皂苷钠5.0 ×10-5 ~ 5.25×10-6 g·mL-1剂量能明显增加犬离体隐静脉条收缩张力,使其对去甲肾上腺素的反应性增加,且呈剂量依赖性.犬股动脉灌流恒定时,50,100 mg β-七叶皂苷钠能明显加强犬

  5. 下肢慢性静脉功能不全动脉铸型的三维重建及意义%Three-dimensional reconstruction and significance of arterial cast on chronic venous insufficiency of low extremity

    Institute of Scientific and Technical Information of China (English)

    黄海龙; 符伟平; 黄绍贤; 龚达聪

    2015-01-01

    Objective To evaluate the three-dimensional reconstruction and significance of arterial cast on chronic venous insufficiency of low extremity. Methods A set of specimen on chronic venous insufficiency of left lower extremity amputation residues was infused with epoxy resin-lead oxide through the femoral artery,and then casted. The CT data of the cast specimen was used to reconstruct 3D modal of ar-tery on chronic venous insufficiency of left lower extremity,using the volume rendering(VR) and maximum intensity projection(MIP). Re-sults The cast specimen and 3D reconstruction of chronic venous insufficiency of left lower extremity amputation residues could clearly dis-play distribution and run of lower extremity arteries,blood supply of lesion and local region embolism of small artery ( arteriole) . Conclusion The 3D modal of artery on chronic venous insufficiency of left lower extremity should provide morphological basis of exact etiology and perfect pathogenesis,also has a certain guiding significance of clinical diagnosis and treatment.%目的:探讨下肢慢性静脉功能不全动脉铸型的三维重建及意义。方法采用改良环氧树脂混合液-氧化铅填充剂对1例左侧下肢截肢残体慢性静脉功能不全( CVI)标本进行灌注并铸型,并在铸型基础上行64层螺旋CT薄层扫描,以容积再现法( VR)和最大密度投影法( MIP)重建三维数字化模型。结果血管铸型和CT三维重建的左侧下肢截肢残体CVI动脉模型均清晰地显示下肢动脉的分布及走行、内侧踝关节溃疡灶内踝网血供情况及局部区域性小动脉(微动脉)栓塞情况。结论下肢CVI动脉模型可为CVI确切病因和完善病理机制提供形态学基础,对临床诊断和治疗具有一定指导意义。

  6. Subretinal lipid exudation associated with untreated choroidal melanoma

    Directory of Open Access Journals (Sweden)

    C K Minija

    2011-01-01

    Full Text Available Subretinal lipid exudation in an untreated choroidal melanoma is very rare. It is seen following plaque radiotherapy in choroidal melanoma. There is only one case report of untreated choroidal melanoma with massive lipid exudation in a patient with metastatic hypernephroma. We report here a rare case of untreated choroidal melanoma with lipid exudation. Subretinal exudation that is rarely seen following plaque brachytherapy was noted at the borders of this untreated tumor. Lipid exudation partially resolved following brachytherapy.

  7. Probabilidade de refluxo nas veias safenas de mulheres com diferentes graus de insuficiência venosa crônica Reflux probability in saphenous veins of women with different degrees of chronic venous insufficiency

    Directory of Open Access Journals (Sweden)

    Maria Fernanda Cassou

    2007-09-01

    Full Text Available CONTEXTO: A presença de refluxo nas junções safeno-femoral e safeno-poplítea é um dado importante para programação da cirurgia de varizes. Estudos mostraram que, na maioria dos pacientes com insuficiência venosa crônica, as junções estão competentes, e o refluxo está presente ao longo do trajeto das veias safenas. OBJETIVOS: Identificar probabilidade de diferentes padrões de refluxo nas veias safenas de mulheres com vários graus de insuficiência venosa crônica e avaliar se o comprometimento das junções das safenas está associado com gravidade da insuficiência venosa. MÉTODOS: Um total de 1.184 membros inferiores de 672 mulheres foram estudados pela ultra-sonografia vascular com Doppler colorido e avaliados pela classificação clínica, etiológica, anatômica e patológica (CEAP. As extremidades foram agrupadas de acordo com a gravidade da insuficiência venosa em graus leve (CEAP C1-C2, moderado (CEAP C3 e grave (CEAP C4-C6. Para avaliar a classificação clínica CEAP na predição do padrão de refluxo, utilizou-se o Teorema de Bayers. Para avaliar associação entre classificação clínica CEAP e padrões de refluxo com ou sem comprometimento das junções das safenas, utilizou-se o teste qui-quadrado (p BACKGROUND: Presence of reflux in saphenofemoral and saphenopopliteal junctions represents important data for indication of varicose vein surgery. Studies demonstrated that in most patients with chronic venous insufficiency junctions are competent and reflux is present in segments in the course of saphenous veins. OBJECTIVES: To identify the probability of different reflux patterns in the saphenous veins of women with various degrees of chronic venous insufficiency and to evaluate whether junction impairment is associated with severity of venous insufficiency. METHODS: A total of 1,184 lower limbs of 672 women were evaluated by color-flow Doppler ultrasonography and classified according to clinical, etiologic

  8. Comprehensive treatment of chronic venous leg ulcers%下肢慢性静脉溃疡的综合治疗

    Institute of Scientific and Technical Information of China (English)

    黄楷; 梁思华; 黄明清; 朱晓彤; 吴文洁; 黎洪浩

    2013-01-01

    Objective To discuss comprehensive surgery strategy of chronic venous ulcerations (CVU). Methods From July 2012 to January 2013,the clinical date of ten patients (10 limbs) with CVU treated in our hospital were reviewed. All cases received great saphenous vein high ligation and stripping, transilluminated powered phlebectomy (TIPP), subfascial endoscopic perforators surgery (SEPS) and foam sclerotherapy. Venous Clinical Severity Score (VCSS) was assessed preoperation and three months after surgery. Results Comprehensive surgery was performed successfully in all patients. VCSS was improved from preoperation(12.3 ± 2.06)to postoperation(9.6 ± 1.71). After (6.70±1.45) months follow-up, for all cases, pain relieved and no recurrence of varicose superficial veins presented. Moreover, ulceration healing happened in 8 cases, while, residual ulcerations presented in only 2 cases(diameter<2cm). No recurrence presented in healing ulcerations. Conclusion The comprehensive surgery strategy treating CVU is feasible and safe, with favourable short-term outcomes.%目的探讨下肢慢性静脉溃疡的综合治疗方法。方法回顾性分析2012年7月~2013年1月我科收治的10例下肢慢性静脉溃疡患者(10条患肢)的临床资料,均采用大隐静脉高位结扎加抽剥并联合应用透光曲张静脉刨吸术、泡沫硬化剂注射、腔镜深筋膜下交通静脉结扎术等方法处理小腿病灶。分别在术前及术后3个月对临床症状的改善情况采集数据,按临床严重程度评分(VCSS)方法进行评估。结果患者均成功实施联合手术治疗方案,在术后的VCSS评分项目中得到改善[(12.3±2.06)v s (9.6±1.71)]。随访(6.70±1.45)个月,疼痛较前均有缓解,未发现患肢有曲张浅静脉残余或复发,8例溃疡基本愈合,仅有2例还有残余溃疡,但都控制在2 cm内,已愈合的溃疡未见复发。结论下肢慢性静脉溃疡经正确选择联合治疗方案进

  9. Hemodynamic evaluation of primary chronic venous insufficiency%原发性下肢慢性静脉功能不全的血流动力学评价

    Institute of Scientific and Technical Information of China (English)

    刘明; 周黎丽; 宋福臣; 侯玉芬

    2008-01-01

    原发性下肢慢性静脉功能不全(chronic venous insufficiency,CVI)是血管外科的常见病,严重危害人们的健康。本研究以75例具有临床症状的原发性CVI患者的104条患肢为对象,采用彩色多普勒超声对患肢血流动力学改变进行评价,为临床治疗提供依据。

  10. 下肢慢性静脉功能不全的病因学研究进展%Progress in Etiopathogenesis Study of Chronic Venous Insufficiency of the Lower Limb

    Institute of Scientific and Technical Information of China (English)

    张宏伟; 牟艳; 刘洋; 何春水

    2007-01-01

    下肢慢性静脉功能不全(chronic venous insufficiency,CVI)是临床上常见的周围血管外科疾病,其发病机制复杂.本文主要从三个方面综述其病因学的研究进展,其中着重介绍了白细胞激活及其诱导的炎症反应在CVI病因学中的重要作用.

  11. 血液成分改变在下肢慢性静脉功能不全中的作用%Changes of blood components in chronic venous insufficiency of lower limbs

    Institute of Scientific and Technical Information of China (English)

    叶开创; 陆信武

    2009-01-01

    静脉高压是下肢慢性静脉功能不全(chronic venous insufficiency,CVI)最主要的病理生理学基础,但CVI的发病机制较复杂,至今仍未完全明确。随着“白细胞捕获”假说的提出,静脉血液成分及相关因子的变化引起了学者们的重视,本文就此作一介绍。

  12. 静脉高压对慢性静脉功能不全患者血小板活性的影响%Effect of venous hypertension on platelet reactivity in patients with chronic venous insufficiency

    Institute of Scientific and Technical Information of China (English)

    叶开创; 陆信武; 李维敏; 刘晓兵; 殷敏毅; 施慧华; 蒋米尔

    2010-01-01

    目的 观察体位变化和压力对下肢慢性静脉功能不全(CVI)患者血小板活性的影响.方法 根据纳入和排除标准,选择24例CVI患者作为实验组和20例正常人作为对照组,采用酶联免疫吸附法(ELISA)测定两组人群在不同体位时下肢静脉血液、肘部静脉血液及在外在压力持续作用60 min后血小板P-选择素表达水平.结果 晨起平卧位及站立30 min后两组下肢静脉血液血小板P-选择素表达水平差异无统计学意义(P>0.05);在90~100mm Hg(1 mmHg=0.133 kPa)压力作用60 min后,CVI患者的下肢静脉血液和肘部静脉血液血小板P-选择素均明显高于对照组(P 0. 05 ). After 60 min of simulated venous hypertension in vitro, whatever anticoagulated blood samples from superficial venous blood at the level of dorsum of foot or elbow, P-selectin from washed platelet plasma was significantly increased in patients with CVI as compared with normal control subjects (P < 0. 01 ). Conclusion Platelet hyper-reactivity in patients with CVI, resulted from venous hypertension, may play a major role in the pathogenesis of CVI.

  13. Nursing for patients with acute or chronic pulmonary deep venous thrombosis%急、慢性肺血栓栓塞症患者的护理

    Institute of Scientific and Technical Information of China (English)

    张平; 姜波; 季颖群; 赵广东; 张中和

    2007-01-01

    @@ 静脉血栓栓塞症(venous thromboembolism,VTE)是把深静脉血栓栓塞症(deep venous thrombosis,DVT)和肺栓塞(pulmonary embolism,PE)作为整体理解,肺栓塞是来自全身静脉系统或右心的栓子游离后阻塞肺动脉或其分支引起的肺循环和呼吸功能障碍的临床综合征.

  14. Staphylococcus hyicus virulence in relation to exudative epidermitis in pigs

    DEFF Research Database (Denmark)

    Wegener, Henrik Caspar; Andresen, Lars Ole; Bille-Hansen, Vivi

    1993-01-01

    Staphylococcus hyicus strains with different phage types, plasmid profiles, and antibiotic resistance patterns were isolated from piglets with exudative epidermitis. The strains could be divided into virulent strains, producing exudative epidermitis, and avirulent strains, producing no dermal...

  15. Artificial Root Exudate System (ARES): a field approach to simulate tree root exudation in soils

    Science.gov (United States)

    Lopez-Sangil, Luis; Estradera-Gumbau, Eduard; George, Charles; Sayer, Emma

    2016-04-01

    The exudation of labile solutes by fine roots represents an important strategy for plants to promote soil nutrient availability in terrestrial ecosystems. Compounds exuded by roots (mainly sugars, carboxylic and amino acids) provide energy to soil microbes, thus priming the mineralization of soil organic matter (SOM) and the consequent release of inorganic nutrients into the rhizosphere. Studies in several forest ecosystems suggest that tree root exudates represent 1 to 10% of the total photoassimilated C, with exudation rates increasing markedly under elevated CO2 scenarios. Despite their importance in ecosystem functioning, we know little about how tree root exudation affect soil carbon dynamics in situ. This is mainly because there has been no viable method to experimentally control inputs of root exudates at field scale. Here, I present a method to apply artificial root exudates below the soil surface in small field plots. The artificial root exudate system (ARES) consists of a water container with a mixture of labile carbon solutes (mimicking tree root exudate rates and composition), which feeds a system of drip-tips covering an area of 1 m2. The tips are evenly distributed every 20 cm and inserted 4-cm into the soil with minimal disturbance. The system is regulated by a mechanical timer, such that artificial root exudate solution can be applied at frequent, regular daily intervals. We tested ARES from April to September 2015 (growing season) within a leaf-litter manipulation experiment ongoing in temperate deciduous woodland in the UK. Soil respiration was measured monthly, and soil samples were taken at the end of the growing season for PLFA, enzymatic activity and nutrient analyses. First results show a very rapid mineralization of the root exudate compounds and, interestingly, long-term increases in SOM respiration, with negligible effects on soil moisture levels. Large positive priming effects (2.5-fold increase in soil respiration during the growing

  16. 静脉压迫综合征诊治在下肢慢性静脉功能不全中的意义%Diagnosis and Treatment of Iliac Vein Compression Syndrome in Chronic Venous Insufficiency of the Significance

    Institute of Scientific and Technical Information of China (English)

    崔健

    2014-01-01

    目的:探讨髂静脉压迫综合征在下肢慢性静脉功能不全中的临床诊治意义。方法回顾性分析2007年1月至2010年12月亳州市人民医院收治的80例髂静脉压迫综合征伴下肢慢性静脉功能不全患者的临床资料,分析患者的临床治疗和并发症等情况。结果经治疗,下肢功能损害评价优56例,良21例、中2例、差1例;下肢深静脉瓣膜功能损害程度评价优40例,良27例、中10例、差3例。术后随访12~30个月,4例患者发生深静脉血栓,4例发生髂静脉穿孔,并发症发生率为10.0%。结论临床中纠正髂静脉压迫综合征或者联合静脉手术治疗能够有效地改善下肢慢性静脉功能不全的临床症状,并且提示髂静脉压迫综合征可能是下肢慢性静脉功能不全的基础性病变。%Objective To investigate the iliac vein compression syndrome in chronic venous insufficien-cy of the clinical diagnosis and treatment significance. Methods Retrospective analysis of Bozhou City,An-hui Province People′s Hospital,January 2007 to December 2010 were treated 80 cases of iliac vein compres-sion syndrome associated with chronic venous insufficiency in patients with clinical data,analysis of the pa-tient′s clinical treatment and complications and so on. Results After treatment, the evaluation of lower ex-tremity dysfunction excellent 56 cases,good in 21 cases,in two cases,and poor in 1 case;deep venous func-tion evaluated the extent of damage excellent in 40 cases,good in 27 cases,10 cases and poor in 3 cases. Pa-tients were followed up 12-30 months,four patients developed deep vein thrombosis,iliac vein perforation oc-curred in 4 cases,the complication rate was 10. 0%. Conclusion Clinical corrected iliac vein compression syndrome or combined with intravenous surgery can effectively improve chronic venous insufficiency of the clinical symptoms and prompt iliac vein compression syndrome may be chronic venous insufficiency based le-sions.

  17. Normal venous anatomy and physiology of the lower extremity.

    Science.gov (United States)

    Notowitz, L B

    1993-06-01

    Venous disease of the lower extremities is common but is often misunderstood. It seems that the focus is on the exciting world of arterial anatomy and pathology, while the topic of venous anatomy and pathology comes in second place. However, venous diseases such as chronic venous insufficiency, leg ulcers, and varicose veins affect much of the population and may lead to disability and death. Nurses are often required to answer complex questions from the patients and his or her family about the patient's disease. Patients depend on nurses to provide accurate information in terms they can understand. Therefore it is important to have an understanding of the normal venous system of the legs before one can understand the complexities of venous diseases and treatments. This presents an overview of normal venous anatomy and physiology.

  18. A diferença na qualidade de vida de pacientes com doença venosa crônica leve e grave Differences in the quality of life of patients with mild and severe chronic venous disease

    Directory of Open Access Journals (Sweden)

    Raymundo Fagner Farias Novais dos Santos

    2009-06-01

    Full Text Available CONTEXTO: A doença venosa crônica atinge os indivíduos em sua fase mais produtiva da vida, acarretando dor, perda de mobilidade e afastamento de atividades, podendo interferir diretamente na qualidade de vida. Seus sintomas clínicos decorrem de um estado de hipertensão venosa, causada por refluxo e/ou obstrução venosa. OBJETIVO: Determinar a diferença na qualidade de vida de pacientes com doença venosa crônica leve e grave. MÉTODOS: Foi realizado estudo transversal analítico comparativo na unidade de saúde durante 8 meses. A amostra foi calculada em 88 pacientes e dividida em dois grupos: Grupo A (CEAP clínico 1, 2 e 3 e Grupo B (CEAP clínico 4, 5 e 6. Foi usado o questionário genérico Medical Outcomes Study - 36-Item Short-Form Health Survey (SF-36. A análise estatística para verificar se havia diferença foi através do teste t de Student, com intervalo de confiança de 95% e p BACKGROUND: Chronic venous disease afflicts individuals in their most productive years, resulting in pain and loss of mobility and independence in performing routine daily activities, which may directly interfere with the patient's quality of life. Clinical symptoms result from venous hypertension caused by reflux and/or venous blockage. OBJECTIVE: To determine differences in the quality of life of patients with mild and severe chronic venous disease. METHODS: A cross-sectional comparative study was conducted in a health care facility during an 8-month period. The sample was composed of 88 patients divided into two groups: group A (clinical CEAP class 1, 2 and 3 and group B (clinical CEAP class 4, 5 and 6. The Medical Outcomes Study - 36-Item Short-Form Health Survey (SF-36 questionnaire was used. Statistical analysis was conducted using the Student t test, with a 95% confidence interval and a level of significance set at p < 0.05. RESULTS: We analyzed 88 subjects, 47 in group A and 41 in group B. Of the total, 87.5% (77 were women and 34% (30 were

  19. 外科手术在治疗慢性静脉功能不全中的作用%Evaluation of surgical management for treatment of chronic venous insufficiency in lower extremity

    Institute of Scientific and Technical Information of China (English)

    陆民

    2008-01-01

    下肢慢性静脉功能不全(chronic venous insufficiency,CVI)是外科临床的常见病和多发病,我国的发病率约为8%-13%。按1995年American Venous Forum所认同的概念及诊断和分类标准,多种血管疾病均可导致CVI的发生。按病因可分为原发性、继发性和先天性;按血流动力学可分为血液反流性病变和血液回流障碍性病变;按解剖学可涉及浅静脉、深静脉和交通静脉三个系统。外科手术主要针对原发性、血液反流性疾病,范围可涵盖浅静脉、深静脉和交通静脉。

  20. 下肢慢性静脉功能不全与CEAP分类系统%Chronic venous insufficiency of the lower extremities and the CEAP system of classification

    Institute of Scientific and Technical Information of China (English)

    张柏根

    2005-01-01

    下肢慢性静脉功能不全(chronic venous insufficiency,CVI)是最常见的周围血管疾病.人群患病率高达27%,年新发病率0.5%~3.0%.其中静脉性溃疡约占1.5%。CVI的临床表现包括下肢浅静脉扩张或曲张、腿部乏力、沉重、胀痛,水肿、皮肤营养性改变、静脉性溃疡;涉及静脉病变范围.可局限于浅静脉、交通静脉、深静脉或累及整个下肢静脉系统;

  1. The efficacy evaluation way and clinical application for chronic venous insufficiency of the lower limbs%下肢慢性静脉功能不全的评价方式及临床应用

    Institute of Scientific and Technical Information of China (English)

    张福先; 赵辉

    2015-01-01

    下肢慢性静脉疾病(chronic venous diseases,CVD)病人逐年增加,规范CVD疾病的诊断和治疗并进行推广成为血管外科专家们关注的焦点,CEAP分级、VCSS评分及CIVIQ问卷是目前国际上广泛应用的3个评分量表,其评价CVD疾病病情及疗效各有侧重及优缺点,临床常将3个评分量表组合应用,以提高对病情评估的准确性、完整性和有效性.随着对CVD疾病认识的加深,其评估量表必会更加完善、更加稳定有效.%The number of patients suffering from chronic venous diseases (CVD) of the lower limbs keeps increasing year by year. How to standardize the diagnosis and treatment of CVD and make it popularized becomes the focus of the attentions of the vascular surgery experts. Three scales used widely all over the world were known as CEAP classification, VCSS score and CIVIQ questionnaire. These scales have their own merits and demerits, therefore, composite applications were frequently used to elevate the accuracy, integrity and effectiveness of the disease assessment. The scales for CVD evaluation would be more completed, stable and effective in the future accompanying with the growing awareness of CVD.

  2. 下肢慢性静脉功能不全伴脂质硬皮症的手术治疗%Efficacy of Surgery Treatment in Chronic Venous Insufficiency with Lipodermatosclerosis

    Institute of Scientific and Technical Information of China (English)

    李岩; 周海华; 宁勇; 万伯顺; 朱玉敏

    2013-01-01

    目的:探讨手术治疗下肢慢性静脉功能不全(chronic venous insufficiency,CVI)伴脂质硬皮症(lipodermatosclerosis,LDS)的疗效.方法:对36例CVI伴LDS患者行大、小隐静脉高位结扎术联合点式浅静脉分段抽剥术和交通静脉结扎术.采用临床严重程度评分(venous clinical severity score,VCSS)、生活质量量表(chronic venous insufficiency questionnaire,CIVIQ)对其进行术前评估和术后随访,并测量LDS皮下硬结厚度.采用配对t检验比较患者手术前后VCSS、CIVIQ评分和LDS皮下硬结厚度.结果:36例患者均得到随访,随访率100%;随访期为6~12个月,平均8.2个月.36例患者术后CEAP分级均明显改善;VCSS评分均值术前为8.14分,术后为0.56分,手术前后差异有统计学意义(P<0.01);CIVIQ评分均值术前为84.0分,术后为98.2分,手术前后差异有统计学意义(P<0.01);LDS皮下硬结厚度均值术前为1.27 cm,术后为0.03 cm,手术前后差异有统计学意义(P<0.01).结论:采用大、小隐静脉高位结扎术联合点式浅静脉分段抽剥术和交通静脉结扎术治疗CVI伴LDS的患者,可明显改善LDS,促进溃疡愈合,提高患者的生活质量.

  3. Deep venous thrombosis and postthrombotic syndrome: invasive management.

    Science.gov (United States)

    Comerota, A J

    2015-03-01

    Invasive management of postthrombotic syndrome encompasses the two ends of the deep vein thrombosis spectrum, patients with acute iliofemoral deep vein thrombosis and those with chronic postthrombotic iliofemoral venous obstruction. Of all patients with acute deep vein thrombosis, those with involvement of the iliofemoral segments have the most severe chronic postthrombotic morbidity. Catheter-based techniques now permit percutaneous treatment to eliminate thrombus, restore patency, potentially maintain valvular function, and improve quality of life. Randomized trial data support an initial treatment strategy of thrombus removal. Failure to eliminate acute thrombus from the iliofemoral system leads to chronic postthrombotic obstruction of venous outflow. Debilitating chronic postthrombotic symptoms of the long-standing obstruction of venous outflow can be reduced by restoring unobstructed venous drainage from the profunda femoris vein to the vena cava.

  4. Automated detection of exudates for diabetic retinopathy screening

    Energy Technology Data Exchange (ETDEWEB)

    Fleming, Alan D [Biomedical Physics, University of Aberdeen, Aberdeen, AB25 2ZD (United Kingdom); Philip, Sam [Diabetes Retinal Screening Service, David Anderson Building, Foresterhill Road, Aberdeen, AB25 2ZP (United Kingdom); Goatman, Keith A [Biomedical Physics, University of Aberdeen, Aberdeen, AB25 2ZD (United Kingdom); Williams, Graeme J [Diabetes Retinal Screening Service, David Anderson Building, Foresterhill Road, Aberdeen, AB25 2ZP (United Kingdom); Olson, John A [Diabetes Retinal Screening Service, David Anderson Building, Foresterhill Road, Aberdeen, AB25 2ZP (United Kingdom); Sharp, Peter F [Biomedical Physics, University of Aberdeen, Aberdeen, AB25 2ZD (United Kingdom)

    2007-12-21

    Automated image analysis is being widely sought to reduce the workload required for grading images resulting from diabetic retinopathy screening programmes. The recognition of exudates in retinal images is an important goal for automated analysis since these are one of the indicators that the disease has progressed to a stage requiring referral to an ophthalmologist. Candidate exudates were detected using a multi-scale morphological process. Based on local properties, the likelihoods of a candidate being a member of classes exudate, drusen or background were determined. This leads to a likelihood of the image containing exudates which can be thresholded to create a binary decision. Compared to a clinical reference standard, images containing exudates were detected with sensitivity 95.0% and specificity 84.6% in a test set of 13 219 images of which 300 contained exudates. Depending on requirements, this method could form part of an automated system to detect images showing either any diabetic retinopathy or referable diabetic retinopathy.

  5. Clinical unity and community empowerment: the use of smartphone technology to empower community management of chronic venous ulcers through the support of a tertiary unit.

    LENUS (Irish Health Repository)

    Quinn, Edel Marie

    2013-01-01

    Chronic ulcers affect roughly 60,000 Irish people, at a total cost of €600,000,000, or €10,000 per patient annually. By virtue of their chronicity, these ulcers also contribute a significant burden to tertiary outpatient vascular clinics.

  6. Venous ulcers of the lower limb: Where do we stand?

    Directory of Open Access Journals (Sweden)

    Chatterjee S Sasanka

    2012-01-01

    Full Text Available Venous ulcers are the most common ulcers of the lower limb. It has a high morbidity and results in economic strain both at a personal and at a state level. Chronic venous hypertension either due to primary or secondary venous disease with perforator paucity, destruction or incompetence resulting in reflux is the underlying pathology, but inflammatory reactions mediated through leucocytes, platelet adhesion, formation of pericapillary fibrin cuff, growth factors and macromolecules trapped in tissue result in tissue hypoxia, cell death and ulceration. Duplex scan with colour flow is the most useful investigation for venous disease supplying information about patency, reflux, effects of proximal and distal compression, Valsalva maneuver and effects of muscle contraction. Most venous disease can be managed conservatively by leg elevation and compression bandaging. Drugs of proven benefit in venous disease are pentoxifylline and aspirin, but they work best in conjunction with compression therapy. Once ulceration is chronic or the patient does not respond to or cannot maintain conservative regime, surgical intervention treating the underlying venous hypertension and cover for the ulcer is necessary. The different modalities like sclerotherapy, ligation and stripping of superficial varicose veins, endoscopic subfascial perforator ligation, endovenous laser or radiofrequency ablation have similar long-term results, although short-term recovery is best with radiofrequency and foam sclerotherapy. For deep venous reflux, surgical modalities include repair of incompetent venous valves or transplant or transposition of a competent vein segment with normal valves to replace a post-thrombotic destroyed portion of the deep vein.

  7. Venous ulcers of the lower limb: Where do we stand?

    Science.gov (United States)

    Chatterjee, Sasanka S

    2012-05-01

    Venous ulcers are the most common ulcers of the lower limb. It has a high morbidity and results in economic strain both at a personal and at a state level. Chronic venous hypertension either due to primary or secondary venous disease with perforator paucity, destruction or incompetence resulting in reflux is the underlying pathology, but inflammatory reactions mediated through leucocytes, platelet adhesion, formation of pericapillary fibrin cuff, growth factors and macromolecules trapped in tissue result in tissue hypoxia, cell death and ulceration. Duplex scan with colour flow is the most useful investigation for venous disease supplying information about patency, reflux, effects of proximal and distal compression, Valsalva maneuver and effects of muscle contraction. Most venous disease can be managed conservatively by leg elevation and compression bandaging. Drugs of proven benefit in venous disease are pentoxifylline and aspirin, but they work best in conjunction with compression therapy. Once ulceration is chronic or the patient does not respond to or cannot maintain conservative regime, surgical intervention treating the underlying venous hypertension and cover for the ulcer is necessary. The different modalities like sclerotherapy, ligation and stripping of superficial varicose veins, endoscopic subfascial perforator ligation, endovenous laser or radiofrequency ablation have similar long-term results, although short-term recovery is best with radiofrequency and foam sclerotherapy. For deep venous reflux, surgical modalities include repair of incompetent venous valves or transplant or transposition of a competent vein segment with normal valves to replace a post-thrombotic destroyed portion of the deep vein.

  8. The origin and composition of cucurbit "phloem" exudate.

    Science.gov (United States)

    Zhang, Cankui; Yu, Xiyan; Ayre, Brian G; Turgeon, Robert

    2012-04-01

    Cucurbits exude profusely when stems or petioles are cut. We conducted studies on pumpkin (Cucurbita maxima) and cucumber (Cucumis sativus) to determine the origin and composition of the exudate. Morphometric analysis indicated that the exudate is too voluminous to derive exclusively from the phloem. Cold, which inhibits phloem transport, did not interfere with exudation. However, ice water applied to the roots, which reduces root pressure, rapidly diminished exudation rate. Sap was seen by microscopic examination to flow primarily from the fascicular phloem in cucumber, and several other cucurbit species, but primarily from the extrafascicular phloem in pumpkin. Following exposure of leaves to 14CO2, radiolabeled stachyose and other sugars were detected in the exudate in proportions expected of authentic phloem sap. Most of this radiolabel was released during the first 20 s. Sugars in exudate were dilute. The sugar composition of exudate from extrafascicular phloem near the edge of the stem differed from that of other sources in that it was high in hexose and low in stachyose. We conclude that sap is released from cucurbit phloem upon wounding but contributes negligibly to total exudate volume. The sap is diluted by water from cut cells, the apoplast, and the xylem. Small amounts of dilute, mobile sap from sieve elements can be obtained, although there is evidence that it is contaminated by the contents of other cell types. The function of P-proteins may be to prevent water loss from the xylem as well as nutrient loss from the phloem.

  9. Microcirculation and venous ulcers: a review.

    Science.gov (United States)

    Pascarella, Luigi; Schönbein, Geert W Schmid; Bergan, John J

    2005-11-01

    Recent histological and immunocytochemical analyses of venous leg ulcers suggest that lesions observed in the different stages of chronic venous insufficiency (CVI) may be related to an inflammatory process. This inflammatory process leads to fibrosclerotic remodeling of the skin and then to ulceration. The vascular network of the most superficial layers of the skin appears to be the target of the inflammatory reaction. Hemodynamic forces such as venous hypertension, circulatory stasis, and modified conditions of shear stress appear to play an important role in an inflammatory reaction accompanied by leukocyte activation which clinically leads to CVI: venous dermatitis and venous ulceration. The leukocyte activation is accompanied by the expression of integrins and by synthesis and release of many inflammatory molecules, including proteolytic enzymes, leukotrienes, prostaglandin, bradykinin, free oxygen radicals, cytokines, and possibly other classes of inflammatory mediators. The inflammatory reaction perpetuates itself, leading to liposclerotic skin and subcutaneous tissue remodeling. In light of the mechanisms of venous ulcer formation cited above, therapy in the future might be directed against leukocyte activation in order to diminish the magnitude of the inflammatory response. With this in mind, the attention of many investigators has been drawn to two different drugs with an anti-inflammatory effect: pentoxifylline and flavonoids.

  10. Avaliação da circulação arterial pela medida do índice tornozelo/braço em doentes de úlcera venosa crônica Evaluation of arterial circulation using the ankle/brachial blood pressure index in patients with chronic venous ulcers

    Directory of Open Access Journals (Sweden)

    Fabiane Noronha Bergonse

    2006-03-01

    Full Text Available FUNDAMENTOS: As úlceras venosas dos membros inferiores são freqüentes e têm grande impacto na qualidade de vida e produtividade do indivíduo, além de alto custo para a saúde pública. OBJETIVOS: Detecção de alterações arteriais em pacientes de úlcera venosa crônica dos membros inferiores com emprego de método não invasivo, de modo a discriminar aqueles em que estaria contra-indicado o tratamento compressivo. MÉTODOS: Foram estudados 40 doentes portadores de úlcera venosa crônica, com o intuito de se avaliar a presença de doença arterial periférica pela medida do índice tornozelo/braço por doppler-ultra-som. RESULTADOS: O índice tornozelo/braço mostrou-se alterado (menor que 1 em 9/22 (40,9% doentes com úlcera venosa crônica e hipertensão arterial concomitante, e apenas em 1/13 (7,7% doentes de úlcera venosa crônica sem hipertensão arterial. CONCLUSÕES: Doentes de úlcera venosa crônica e hipertensão arterial concomitantes devem ser submetidos rotineiramente à medida do índice tornozelo/braço para detecção de possível insuficiência arterial periférica associada.BACKGROUND: Chronic venous ulcers are extremely frequent and have a significant impact on quality of life and work productivity of individuals, in addition to high costs to public health. OBJECTIVES: Detection of arterial circulation alterations in chronic venous ulcer legs using a non-invasive method to discriminate patients not indicated to have compressive treatment. METHODS: Forty patients with chronic venous ulcers were investigated for the presence of peripheral arterial disease with measurement of the ankle/brachial index by Doppler ultrasound. RESULTS: The resting ankle/brachial pressure index was abnormal (lower than 1 in 9/22 (40.9% patients with concomitant chronic venous ulcers and hypertension and only in one out of 13 (7.7% patients with chronic venous ulcers and no hypertension. CONCLUSIONS: Patients with concomitant chronic venous

  11. THE SYSTEMATIC AND EVOLUTIONARY SIGNIFICANCE OF EXUDATE FLAVONOIDS IN AEONIUM

    NARCIS (Netherlands)

    STEVENS, JF; HART, HT; WOLLENWEBER, E

    1995-01-01

    Leaf exudates of 32 species of Aeonium were examined for the presence of flavonoids. Thirty two flavonoids were detected in exudates of half of the species. The flavonoids were identified as methyl ethers of kaempferol, 6-hydroxykaempferol, quercetin, myricetin and scutellarein. The distribution of

  12. Cerebral tubercular thrombophlebitis presenting as venous infarct: Magnetic resonance imaging and pathologic correlation

    Directory of Open Access Journals (Sweden)

    Sandhya Mangalore

    2014-01-01

    Full Text Available Central nervous system involvement by tuberculosis to produce basal meningitis, hydrocephalus, arteritis and infarcts is well-known, the brunt of the pathology being borne by the arterial vasculature to produce neurological sequelae. However, tuberculous thrombophlebitis causing venous infarction is exceedingly rare. We present imaging and pathological features of two autopsy proven cases of tuberculous thrombophlebitis with venous infarcts involving superficial venous system in one and deep venous system in the other. This is the first study presenting radiopathologic correlation of this rare complication. Tuberculous thrombophlebitis should be suspected if basal exudates and multiple white matter T2 hyperintensities are seen on neuroimaging and the imaging protocol should include both magnetic resonance arteriogram and venogram.

  13. Lifestyle and venous thrombosis

    NARCIS (Netherlands)

    Pomp, Elisabeth Rebekka

    2008-01-01

    In the Multiple Environmental and Genetic Assessment of risk factors for venous thrombosis (MEGA study), a large population-based case-control study, we investigated lifestyle factors as risk factors for venous thrombosis. Overweight, smoking and alcohol consumption were addressed and pregnancy and

  14. Duration of wound fluid secretion from chronic venous leg ulcers is critical for interleukin-1α, interleukin-1β, interleukin-8 levels and fibroblast activation

    DEFF Research Database (Denmark)

    Zillmer, Rikke; Trøstrup, Hannah; Karlsmark, Tonny

    2011-01-01

    Wound fluid collected from chronic wounds may be used as a simple gauge of the processes taking place in the tissue. There is lack of information on the optimal conditions for wound fluid procurement. We have studied possible diurnal variations and duration of wound fluid accumulation using reten...

  15. The Clinical Signiifcance of Colour Duplex Ultrasonography in the the Diagnosis of Chronic Venous Insufifciency of Lower Limbs%双功多普勒彩超诊断慢性下肢静脉功能不全的临床意义分析

    Institute of Scientific and Technical Information of China (English)

    张微

    2015-01-01

    Objective To analyse the clinical significance of colour duplex ultrasonography in patients with chronic venous insufficiency in lower limbs. Methods 94 patients in our hospital with chronic venous insufficiency were taken as research subjects, used venous antegrade implementation angiography and duplex doppler ultrasonography. Compared the test results of two methods, and analysed advantage by using duplex doppler ultrasound diagnosis of lower extremity venous insufifciency. Results Duplex doppler ultrasonography of lower extremity venous trafifc detection rate was signiifcantly higher than venous antegrade contrast, the misdiagnosis rate was signiifcantly lower than veins antegrade venous angiography. Conclusion The duplex doppler ultrasound in the diagnosis of deep venous insufficiency is convenient, safe and can effectively improve the accuracy of clinical diagnosis.%目的:探讨双功多普勒彩超在慢性下肢静脉功能不全患者临床诊断中的应用价值。方法选取我院收治的94例慢性下肢静脉功能不全患者作为研究对象,对该组患者实施下肢静脉顺行造影和双功多普勒彩超检查。对比两种检测方法的检测结果,分析采用双功多普勒彩超诊断下肢静脉功能不全的优势。结果双功多普勒彩超检查下肢交通静脉的检出率高于下肢静脉顺行造影,对交通静脉的漏诊率低于下肢静脉顺行造影。结论应用双功多普勒彩超诊断下肢深静脉功能不全患者进行,便捷、安全,可有效提高临床诊断准确率。

  16. [Equine exudative canker: an (auto-)immune disease?].

    Science.gov (United States)

    Jongbloets, A M C; Sloet van Oldruitenborgh-Oosterbaan, M M; Meeus, P J H M; Back, W

    2005-02-15

    Equine canker is a chronic, hyperplastic, exudative pododermatitis affecting one or more feet. Although many causes and treatments have been suggested, the cause of the disease is still unknown and most probably multifactorial. Local treatments include radical surgical debridement of the diseased hoof tissue and application of caustic substances, antibiotics, and pressure bandaging. Nevertheless, the number of recurrences is high (45%). This article presents a 3-year-old New Forest pony-cross mare in which all horny structures (frogs, coronets, spurs, chestnuts) of all feet were affected. Bacteriological and fungal cultures of the frogs were found negative for the pathogens tested. Papilloma virus was not found. Clinical findings raised the hypothesis that the non-specific hyperplastic inflammation of these horn-like structures might have been caused by an (auto-)immune reaction. On the basis of the clinical findings, the pony was treated with surgical debridement of the frogs of a diagonal pair of feet and oral administration of prednisolone (1 mg/kg sid). The frogs, coronets, spurs, and chestnuts of all four feet healed completely within 8 weeks, thus making an (auto-)immune reaction more likely. In conclusion, this case report raised the hypothesis that an aspecific, hyperplastic inflammation of all four feet ('equine canker') and other horny structures may be caused by an (auto-)immune reaction, and that corticosteroids (prednisolone 1 mg/kg sid per os) are effective as treatment.

  17. Use of a portable, single-use negative pressure wound therapy device in home care patients with low to moderately exuding wounds: a case series.

    Science.gov (United States)

    Hurd, Theresa; Trueman, Paul; Rossington, Alan

    2014-03-01

    Negative pressure wound therapy (NPWT) is widely used in the management of acute and chronic wounds. The purpose of this 8-week study was to evaluate outcomes of using a new canisterless, portable, single-use NPWT system in patients with wounds treated in a Canadian community healthcare setting. The device is designed to provide negative pressure at 80±20 mm Hg, 24 hours a day of continuous usage, for a maximum wear time of 7 days. Data on wound outcomes, including exudate levels, wound appearance, and wound area, were collected weekly by a Registered Nurse as part of routine practice. When treatment was discontinued, patients and nurses were asked to rate their satisfaction with the device. Data from patients who had used a conventional NPWT device to manage their wounds were retrospectively abstracted from their medical records. In the prospective study, conducted between October 2011 and July 2012, 326 patients (median age=61 years; range 17-91 years) with wounds of mixed etiology (53 pressure ulcers, 21 venous leg ulcers, 16 diabetic foot ulcers, and 15 traumatic and 221 surgical wounds) were treated for a maximum of 8 weeks with the portable NPWT device. The majority of patients (228 out of 326; 68%) achieved complete wound closure within 8 weeks of treatment. The Kaplan-Meier estimate of median time to healing of all wounds was 9 weeks. The majority of patients (318 patients, 97%) reported they were pleased or satisfied with the dressing performance. Nurses indicated satisfaction with the dressing performance for all but two patients (99%). The majority (89%) of patients managed with conventional NPWT (n=539) had an open surgical wound with moderate or high levels of exudate. Healing rates in the portable and conventional NPWT group were similar (10% to 11% per week). Portable, single-use NPWT has the potential to deliver good wound outcomes in community care settings and simplify the use of negative pressure for nurses and patients. Additional research is

  18. Subfascial endoscopic perforating surgery to treat chronic lower limb venous insufficiency%内镜筋膜下交通静脉结扎术治疗静脉性溃疡

    Institute of Scientific and Technical Information of China (English)

    王深明; 胡作军

    2005-01-01

    下肢交通静脉功能不全在慢性静脉功能不全(chronic venous insufficiency,CVI)肢体皮肤改变,特别是静脉性溃疡发病中的作用早已为人们所注意,早在19世纪60年代,Gay就认识到下肢静脉性溃疡中存在交通静脉功能不全现象。目前虽尚存在一些争沦,但大多数学者仍持认可态度。功能正常的交通静脉由于瓣膜的作用,可保证由下肢浅静脉系统向深静脉系统的单向回流;而当其功能不全时,下肢深静脉的血流就会通过功能不全的交通静脉逆流入浅静脉,引起小腿浅静脉淤血、

  19. Recognition on Surgical Treatment of Chronic Venous Insufficiency in Lower Limb at Present%下肢慢性静脉功能不全治疗的再认识

    Institute of Scientific and Technical Information of China (English)

    时德; 赵渝

    2009-01-01

    周围静脉疾病是临床上的常见病和多发病,其发病率为20%~40%,皮肤营养障碍占2%~5%,发病率比动脉疾病约高10倍,发病机理比动脉疾病复杂,分类方法亦不一致,至今存在着争论。下肢慢性静脉功能不全(chronic venous insufficiency,CVI)按其病因可分为原发性、继发性及先天性;按解剖范围可分为浅、深和交通静脉3个系统,亦即包括浅静脉曲张、深静脉瓣膜功能不全、深静脉血栓形成后遗症、交通静脉瓣膜功能不全等。

  20. Retinoid-like activity and teratogenic effects of cyanobacterial exudates.

    Science.gov (United States)

    Jonas, Adam; Buranova, Veronika; Scholz, Stefan; Fetter, Eva; Novakova, Katerina; Kohoutek, Jiri; Hilscherova, Klara

    2014-10-01

    Retinoic acids and their derivatives have been recently identified by chemical analyses in cyanobacteria and algae. Given the essential role of retinoids for vertebrate development this has raised concerns about a potential risk for vertebrates exposed to retinoids during cyanobacterial blooms. Our study focuses on extracellular compounds produced by phytoplankton cells (exudates). In order to address the capacity for the production of retinoids or compounds with retinoid-like activity we compared the exudates of ten cyanobacteria and algae using in vitro reporter gene assay. Exudates of three cyanobacterial species showed retinoid-like activity in the range of 269-2,265 ng retinoid equivalents (REQ)/L, while there was no detectable activity in exudates of the investigated algal species. The exudates of one green alga (Desmodesmus quadricaudus) and the two cyanobacterial species with greatest REQ levels, Microcystis aeruginosa and Cylindrospermopsis raciborskii, were selected for testing of the potential relation of retinoid-like activity to developmental toxicity in zebrafish embryos. The exudates of both cyanobacteria were indeed provoking diverse teratogenic effects (e.g. tail, spine and mouth deformation) and interference with growth in zebrafish embryos, while such effects were not observed for the alga. Fish embryos were also exposed to all-trans retinoic acid (ATRA) in a range equivalent to the REQ concentrations detected in exudates by in vitro bioassays. Both the phenotypes and effective concentrations of exudates corresponded to ATRA equivalents, supporting the hypothesis that the teratogenic effects of cyanobacterial exudates are likely to be associated with retinoid-like activity. The study documents that some cyanobacteria are able to produce and release retinoid-like compounds into the environment at concentrations equivalent to those causing teratogenicity in zebrafish. Hence, the characterization of retinoid-like and teratogenic potency should be

  1. Unilateral Loss of Spontaneous Venous Pulsations in an Astronaut

    Science.gov (United States)

    Mader, Thomas H.; Gibson, C. Robert; Lee, Andrew G.; Patel, Nimesh; Hart, Steven; Pettit, Donald R.

    2014-01-01

    Spontaneous venous pulsations seen on the optic nerve head (optic disc) are presumed to be caused by fluctuations in the pressure gradient between the intraocular and retrolaminar venous systems. The disappearance of previously documented spontaneous venous pulsations is a well-recognized clinical sign usually associated with a rise in intracranial pressure and a concomitant bilateral elevation of pressure in the subarachnoid space surrounding the optic nerves. In this correspondence we report the unilateral loss of spontaneous venous pulsations in an astronaut 5 months into a long duration space flight. We documented a normal lumbar puncture opening pressure 8 days post mission. The spontaneous venous pulsations were also documented to be absent 21 months following return to Earth.. We hypothesize that these changes may have resulted from a chronic unilateral rise in optic nerve sheath pressure caused by a microgravity-induced optic nerve sheath compartment syndrome.

  2. Venous thrombosis: an overview

    Energy Technology Data Exchange (ETDEWEB)

    Peterson, C.W.

    1986-07-01

    Venous thromboembolic disease contributes to morbidity and mortality in certain groups of hospitalized patients, particularly those who have undergone surgery. Although principles of treatment have changed relatively little during the past 20 years, significant advances have been made in the diagnosis of deep vein thrombosis (DVT). Venography, once the only reliable diagnostic technique, has been largely replaced by noninvasive tests: impedance plethysmography, venous Doppler, /sup 125/I-radiofibrinogen-uptake test, and phleborheography. Virchow's triad of stasis, vessel injury, and hypercoagulability remains a valid explanation of the pathogenesis of thrombus formation, but laboratory and clinical data have refined our knowledge of how these factors interact to result in clinically significant disease. Knowledge of the natural history of venous thrombosis, plus heightened awareness of the long-term morbidity and expense associated with the postphlebitic syndrome, have led to increased interest in preventing DVT. Clinically and economically, venous thrombosis is best managed by prevention. 61 references.

  3. Cerebral venous sinus thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Renowden, Shelley [Frenchay Hospital, Bristol BS16 1LE (United Kingdom)

    2004-02-01

    A comprehensive synopsis on cerebral venous thrombosis is presented. It emphasizes the various aetiologies, the wide clinical spectrum and the unpredictable outcome. Imaging techniques and pitfalls are reported and the therapeutic options are discussed. (orig.)

  4. Central venous catheter - flushing

    Science.gov (United States)

    ... during cancer treatment Bone marrow transplant - discharge Central venous catheter - dressing change Peripherally inserted central catheter - flushing Sterile technique Surgical wound care - open Review Date 9/22/2016 Updated by: ...

  5. Imaging of the complications of peripherally inserted central venous catheters

    Energy Technology Data Exchange (ETDEWEB)

    Amerasekera, S.S.H. [Department of Radiology, Good Hope Hospital, Sutton Coldfield, Birmingham (United Kingdom)], E-mail: steve.amerasekera@nhs.net; Jones, C.M.; Patel, R.; Cleasby, M.J. [Department of Radiology, Good Hope Hospital, Sutton Coldfield, Birmingham (United Kingdom)

    2009-08-15

    Peripherally inserted central catheters (PICC) are widely used to provide central venous access, often in chronically ill patients with long-term intravenous access requirements. There are a number of significant complications related to both insertion and maintenance of PICC lines, including catheter malposition, migration, venous thrombosis, and line fracture. The incidence of these complications is likely to rise as the number of patients undergoing intravenous outpatient therapy increases, with a corresponding rise in radiologist input. This paper provides an overview of the relevant peripheral and central venous anatomy, including anatomical variations, and outlines the complications of PICC lines. Imaging examples demonstrate the range of radiological findings seen in these complications.

  6. Imaging of the complications of peripherally inserted central venous catheters.

    Science.gov (United States)

    Amerasekera, S S H; Jones, C M; Patel, R; Cleasby, M J

    2009-08-01

    Peripherally inserted central catheters (PICC) are widely used to provide central venous access, often in chronically ill patients with long-term intravenous access requirements. There are a number of significant complications related to both insertion and maintenance of PICC lines, including catheter malposition, migration, venous thrombosis, and line fracture. The incidence of these complications is likely to rise as the number of patients undergoing intravenous outpatient therapy increases, with a corresponding rise in radiologist input. This paper provides an overview of the relevant peripheral and central venous anatomy, including anatomical variations, and outlines the complications of PICC lines. Imaging examples demonstrate the range of radiological findings seen in these complications.

  7. A re-appraisal of volume status and renal function impairment in chronic heart failure: combined effects of pre-renal failure and venous congestion on renal function.

    Science.gov (United States)

    Sinkeler, Steef J; Damman, Kevin; van Veldhuisen, Dirk J; Hillege, Hans; Navis, Gerjan

    2012-03-01

    The association between cardiac failure and renal function impairment has gained wide recognition over the last decade. Both structural damage in the form of systemic atherosclerosis and (patho) physiological hemodynamic changes may explain this association. As regards hemodynamic factors, renal impairment in chronic heart failure is traditionally assumed to be mainly due to a decrease in cardiac output and a subsequent decrease in renal perfusion. This will lead to a decrease in glomerular filtration rate and a compensatory increase in tubular sodium retention. The latter is a physiological renal response aimed at retaining fluids in order to increase cardiac filling pressure and thus renal perfusion. In heart failure, however, larger increases in cardiac filling pressure are needed to restore renal perfusion and thus more volume retention. In this concept, in chronic heart failure, an equilibrium exists where a certain degree of congestion is the price to be paid to maintain adequate renal perfusion and function. Recently, this hypothesis was challenged by new studies, wherein it was found that the association between right-sided cardiac filling pressures and renal function is bimodal, with worse renal function at the highest filling pressures, reflecting a severely congested state. Renal hemodynamic studies suggest that congestion negatively affects renal function in particular in patients in whom renal perfusion is also compromised. Thus, an interplay between cardiac forward failure and backward failure is involved in the renal function impairment in the congestive state, presumably along with other factors. Only few data are available on the impact of intervention in volume status on the cardio-renal interaction. Sparse data in cardiac patients as well as evidence from cohorts with primary renal disease suggest that specific targeting of volume overload may be beneficial for long-term outcome, in spite of a certain further decrease in renal function, at least

  8. A stable-isotope mass spectrometry-based metabolic footprinting approach to analyze exudates from phytoplankton

    DEFF Research Database (Denmark)

    Weber, Ralf J. M.; Selander, Erik; Sommer, Ulf;

    2013-01-01

    Phytoplankton exudates play an important role in pelagic ecology and biogeochemical cycles of elements. Exuded compounds fuel the microbial food web and often encompass bioactive secondary metabolites like sex pheromones, allelochemicals, antibiotics, or feeding attractants that mediate biological...... interactions. Despite this importance, little is known about the bioactive compounds present in phytoplankton exudates. We report a stable-isotope metabolic footprinting method to characterise exudates from aquatic autotrophs. Exudates from 13C-enriched alga were concentrated by solid phase extraction...

  9. 下肢静脉功能不全患者手术疗效评价与术后生活质量调查%Evaluation of surgical effectiveness and quality of life in patients with chronic lower limb venous insufficiency

    Institute of Scientific and Technical Information of China (English)

    张智辉; 林少芒; 胡以则; 姚燕丹; 萧剑彬

    2008-01-01

    目的 评价下肢慢性静脉功能不全(chronic venous insufficiency,CVI)患者的手术疗效和术后生活质量.方法 171例CVI患者(193条患肢)根据术式被分为A、B、C三组.采用临床严重程度计分(venous clinical severity score,VCSS)和生活质量调查表(chronic venous insufficiency questionnaire,CIVIQ)评价3种不同术式组术后的VCSS变化和生活质量状况.结果 3组患者术后VCSS记分较术前均显著降低(P0.05);三组术后CIVIQ均在80分以上,各组间差别无统计学意义(P>0.05).结论 根据患者病情选择合适术式,可以有效治疗CVI;应用VCSS和CIVIQ可以客观评价下肢CVI患者的手术疗效和生活质量.

  10. A anquilose tíbio-társica e sua importância na insuficiência venosa crônica Ankle ankylosis and its importance in chronic venous insufficiency

    Directory of Open Access Journals (Sweden)

    Jorge Ribas Timi

    2009-09-01

    Full Text Available CONTEXTO: O desenvolvimento de anquilose em pacientes com insuficiência venosa crônica (IVC pode ser evidenciado em diversos estágios da patologia através de medidas da amplitude de movimento da articulação do tornozelo tomadas com a utilização de um goniômetro. OBJETIVO: Relacionar a diminuição da amplitude de movimento da articulação tíbio-társica na IVC dos membros inferiores (MMII medida por goniometria com a gravidade da IVC, utilizando-se a classificação CEAP. MÉTODOS: No período de março de 2003 a agosto de 2004, 86 pacientes (67 mulheres e 19 homens com média de idade de 50,6 anos foram submetidos à goniometria do tornozelo. Os indivíduos foram divididos conforme a gravidade da IVC de seus MMII (121 avaliados de acordo com a classificação CEAP. Quarenta membros foram caracterizados como C0 (grupo-controle, 40 como C3, e 41 como C4. As medidas obtidas nos diferentes grupos foram comparadas entre si. RESULTADOS: A média da amplitude de movimento da articulação tíbio-társica do grupo C0 foi de 42,4º (variação de 26-54; a do grupo C3 foi de 37,9º (variação de 10-61; e a do grupo C4 foi de 24,5º (variação de 8-50. A diferença das médias de C4 e C3 foi de 36%, e a de C3 comparada com o grupo-controle (C0, de 11%, caracterizando a maior diferença entre C3 e C4. CONCLUSÃO: A goniometria do tornozelo auxilia a graduar a hipertensão venosa crônica, pois demonstra a existência de correlação entre a gravidade da anquilose e a severidade da IVC.BACKGROUND: Development of ankylosis in patients with chronic venous insufficiency (CVI can be observed in different stages of the disease as the ankle range of motion is measured by a goniometer. OBJECTIVE: To relate a reduced ankle range of motion in patients with CVI of the lower limbs measured by goniometry and the severity of CVI according to the CEAP classification. METHODS: From March 2003 to August 2004, 86 patients (67 females and 19 males with a mean

  11. VENOUS INSUFFICIENCY AND THROMBOEMBOLIC DISEASE IN BARIATRIC SURGERY PATIENTS

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    Bonno van BELLEN

    2013-09-01

    Full Text Available Context Morbid obesity is associated with various co-morbidities, including chronic venous insufficiency. Bariatric surgery is the only effective treatment for morbid obesity, but with potential risks and possible complications, including venous thromboembolism. Objective To determine the prevalence of clinical and ultrasonographic signs of chronic venous insufficiency in morbid obese patients in preparation for bariatric surgery and the incidence of post-operative venous thromboembolic disease. Methods Patients on work-up for bariatric surgery of Centro Terapêutico Especializado em Fígado (CETEFI and Pro-Gastro surgical teams of the Hospital Beneficência Portuguesa de São Paulo were included. The analysed data were pre-operative findings for venous insufficiency (CEAP - clinical, etiological, anatomical, physiopathologic - classification and venous ultrassonographic findings, type of surgery (open or laparoscopic, abdominal circumference, body mass index (BMI and post-operative ultrassonography search for venous insufficiency and deep venous thrombosis. Results Between March 2007 and December 2009, 95 patients candidates for bariatric surgery had clinical and duplex scan evaluation of the lower limbs venous system. Of the 95 patients, 53 were submitted to the surgical procedure. There was a predominance of women (77.9%, the average age was 38.5 years, average preoperative weight 124.6 kg and average BMI of 45.5 kg/m2. Regarding obesity, 16.8% were obese, and 83.1% were morbidly obese. In relation to the venous findings, 86.3% of the patients did fit CEAP classification less than 3 and 13.7% greater than or equal to 3. Among the post-operative complications, there were four cases of wound infection. Three patients developed post-operative distal venous thrombosis (7.5%, but no one had clinically manifested pulmonary embolism. Conclusion No relation between BMI, CEAP classification and venous ultrassonographic findings were found. Although

  12. Analysis of nicergoline in treating elderly chronic cerebrospinal venous insufifciency%尼麦角林治疗老年慢性脑血管功能不全的临床效果分析

    Institute of Scientific and Technical Information of China (English)

    王君; 王瑞祥

    2015-01-01

    目的:探讨尼麦角林治疗老年慢性脑血管功能不全的临床效果。方法采用随机数表法将本院神经内科2012年7月至2014年7月收治的162例老年慢性脑血管功能不全患者分为尼麦角林组和常规组,每组各81例。常规组患者采用常规治疗方法,尼麦角林组患者在常规治疗基础上加用尼麦角林。比较两组患者治疗的临床效果。结果治疗前,两组患者大脑中动脉、椎动脉的彩色多普勒超声检测指标[舒张期末流速(Vd)、收缩期峰流速(Vs)、阻力指数(RI)、搏动指数(PI)]比较差异均无显著性(P>0.05);治疗后12周,两组患者的Vd、Vs、RI、PI较组内治疗前明显好转,差异均具有显著性(P<0.05),且尼麦角林组患者的Vd、Vs、RI、PI优于常规组,差异具有显著性(P<0.05)。治疗前两组患者的简易精神状态检查量表(MMSE)评分比较差异无显著性(P>0.05);治疗后两组患者MMSE评分较治疗前均显著提高(P<0.05),且尼麦角林组患者的MMSE评分[(24.5±1.3)分]显著高于常规组[(22.9±1.5)分],差异具有显著性(P<0.05)。治疗后12周,尼麦角林组患者治疗总有效率(91.36%)高于常规组(76.54%),差异具有显著性(P<0.05)。结论尼麦角林可以改善老年慢性脑血管功能不全患者的临床症状及大脑血管血流情况,同时可以显著提高临床治疗效果。%Objective To investigate the clinical effect of nicergoline in treatment of elderly patients with chronic cerebrospinal venous insufficiency. Method Used random number table method to selected 162 cases of elderly patients with chronic cerebrovascular venous insufficiency from July 2012 to July 2014 in our hospital as research objects, they were divided into nicergoline group and routine group, 81 cases in each group. Routine group patients were treated with conventional methods, on the basis of

  13. [Homocysteine and venous thromboembolism].

    Science.gov (United States)

    Monnerat, C; Hayoz, D

    1997-09-06

    Congenital homocysteinuria is a rare inherited metabolic disorder with early onset atherosclerosis and arterial and venous trombosis. Moderate hyperhomocysteinemia is more frequently encountered and is recognized as an independent cardiovascular risk factor. Several case-control studies demonstrate an association between venous thromboembolism and moderate hyperhomocysteinemia. A patient with moderate hyperhomocysteinemia has a 2-3 relative risk of developing an episode of venous thromboembolism. The occurrence of mild hyperhomocysteinemia in heterozygotes for the mutation of Leiden factor V involves a 10-fold increase in the risk of venous thromboembolism. The biochemical mechanism by which homocysteine may promote thrombosis is not fully recognized. Homocysteine inhibits the expression of thrombomodulin, the thrombin cofactor responsible for protein C activation, and inhibits antithrombin-III binding. Treatment with folic acid reduces the plasma level of homocysteinemia, but no study has demonstrated its efficacy in reducing the incidence of venous thromboembolism or atherosclerosis. Hyperhomocysteinemia should be included in the screening of abnormalities of hemostasis and thrombosis in patients with idiopathic thromboembolism, and mild hyperhomocysteinemia may justify a trial of folic acid.

  14. Ileofemoral venous thrombectomy.

    Science.gov (United States)

    Lindhagen, J; Haglund, M; Haglund, U; Holm, J; Scherstén, T

    1978-01-01

    Twentyeight patients with ileofemoral venous thrombosis were treated surgically. Five of the patients had moderate degree of venous congestion, 18 patients had phlegmasia alba dolens and five patients had phlegmasia coerulea dolens. The mean age was 54 years, range 15-80 years, and 15 were men and 13 were women. In all cases the thrombosis was verified by phlebography. Thrombectomy was performed with a Fogarty venous thrombectomy catheter. Peroperative phlebography was used in most cases to guarantee complete extraction of thrombotic material. No operative pulmonary embolism or mortality was encountered. Postoperative continuous heparin infusion in the thrombectomized segment was used for the first week followed by dicumarol treatment. The patients were followed from 6 months to 4 years postoperatively. In two patients thrombectomy was not possible to perform. One of these patients developed a pronounced postthrombotic syndrome, the other developed venous congestion of more moderate degree. Excellent long-term time results were obtained in 82% of the patients and satisfactory in 14%. Thrombectomy is an efficient treatment of ileofemoral venous thrombosis.

  15. Plant exudates promote PCB degradation by a rhodococcal rhizobacteria

    Energy Technology Data Exchange (ETDEWEB)

    Toussaint, Jean-Patrick; Pham, Thi Thanh My; Barriault, Diane; Sylvestre, Michel [Instiut National de la Recherche Scientifique INRS, Laval, QC (Canada). Inst. Armand-Frappier

    2012-09-15

    Rhodococcus erythropolis U23A is a polychlorinated biphenyl (PCB)-degrading bacterium isolated from the rhizosphere of plants grown on a PCB-contaminated soil. Strain U23A bphA exhibited 99% identity with bphA1 of Rhodococcus globerulus P6. We grew Arabidopsis thaliana in a hydroponic axenic system, collected, and concentrated the plant secondary metabolite-containing root exudates. Strain U23A exhibited a chemotactic response toward these root exudates. In a root colonizing assay, the number of cells of strain U23A associated to the plant roots (5.7 x 105 CFU g{sup -1}) was greater than the number remaining in the surrounding sand (4.5 x 104 CFU g{sup -1}). Furthermore, the exudates could support the growth of strain U23A. In a resting cell suspension assay, cells grown in a minimal medium containing Arabidopsis root exudates as sole growth substrate were able to metabolize 2,3,4'- and 2,3',4-trichlorobiphenyl. However, no significant degradation of any of congeners was observed for control cells grown on Luria-Bertani medium. Although strain U23A was unable to grow on any of the flavonoids identified in root exudates, biphenyl-induced cells metabolized flavanone, one of the major root exudate components. In addition, when used as co-substrate with sodium acetate, flavanone was as efficient as biphenyl to induce the biphenyl catabolic pathway of strain U23A. Together, these data provide supporting evidence that some rhodococci can live in soil in close association with plant roots and that root exudates can support their growth and trigger their PCB-degrading ability. This suggests that, like the flagellated Gram-negative bacteria, non-flagellated rhodococci may also play a key role in the degradation of persistent pollutants. (orig.)

  16. Plasma endothelin in coronary venous blood from patients with either stable or unstable angina.

    OpenAIRE

    Stewart, J T; Nisbet, J A; Davies, M J

    1991-01-01

    STUDY OBJECTIVE--To test the hypothesis that the active coronary endothelial lesions in unstable angina raise the endothelin concentration in coronary venous blood. DESIGN--Systemic and coronary venous blood samples were obtained from unselected patients with the clinical syndromes of either stable or unstable angina at the time of cardiac catheterisation and coronary arteriography. Control venous blood samples were obtained from healthy laboratory workers and from patients with chronic renal...

  17. Effectiveness Of 2% And 4% Papain Gels In The Healing Of Venous Ulcers

    Directory of Open Access Journals (Sweden)

    Andréa Pinto Leite Ribeiro

    2015-06-01

    Full Text Available OBJECTIVE To analyze the effectiveness of 2% and 4% papain gels in tissue repair of venous ulcers. METHOD Quasi-experimental study with consecutive sample of 16 patients with 30 venous ulcers treated at the outpatient clinic of a teaching hospital, from April to November in 2011, using a form for clinical assessment of the patient and its lesion. Variables were analyzed by Wilcoxon and McNemar test (p < 0.05. RESULTS Most participants were female; aged between 51 and 59 years; obese; with hypertension. Regarding ulcers, there was an average decrease of 7.9 cm2 (50% of its original size in 90 days; 20% of the ulcers completely healed within 56.67 days. There was an increase in epithelialization, significant reduction in the slough and edema, improved depth, in the type and amount of exudate (p < 0.0001. CONCLUSION 2% and 4% papain gels were effective in healing venous ulcers.

  18. Enzymatic activity analysis of MMP-2 and 9 collected by swab from lower limb venous ulcers

    Directory of Open Access Journals (Sweden)

    Flávio Santos da Silva

    2014-09-01

    Full Text Available Metalloproteinases play a role in repair of venous ulcers of the lower limbs. The great majority of studies of metalloproteinase enzyme activity conducted to date have employed material from biopsies of ulcers. We evaluated the viability of using zymography to measure the enzyme activity of metalloproteinases 2 and 9 in samples of venous ulcer exudate collected on swabs. The method chosen for processing the samples proved viable in terms of its ability to provide adequate protein concentrations for analysis. Using zymography, we observed that the parameters that provided the best results for analysis of gelatinolytic activity were 0.125 to 0.5 μg of total protein content in the gels and enzymatic activation time of 19 hours (at 37 °C. Collection of venous ulcer fluid using swabs proved to be a simple, rapid and effective method for obtaining samples for measurement of gelatinolytic activity with a minimum degree of invasivity.

  19. Provisional Matrix Deposition in Hemostasis and Venous Insufficiency: Tissue Preconditioning for Nonhealing Venous Ulcers

    Science.gov (United States)

    Parker, Tony J.; Broadbent, James A.; McGovern, Jacqui A.; Broszczak, Daniel A.; Parker, Christina N.; Upton, Zee

    2015-01-01

    Significance: Chronic wounds represent a major burden on global healthcare systems and reduce the quality of life of those affected. Significant advances have been made in our understanding of the biochemistry of wound healing progression. However, knowledge regarding the specific molecular processes influencing chronic wound formation and persistence remains limited. Recent Advances: Generally, healing of acute wounds begins with hemostasis and the deposition of a plasma-derived provisional matrix into the wound. The deposition of plasma matrix proteins is known to occur around the microvasculature of the lower limb as a result of venous insufficiency. This appears to alter limb cutaneous tissue physiology and consequently drives the tissue into a ‘preconditioned’ state that negatively influences the response to wounding. Critical Issues: Processes, such as oxygen and nutrient suppression, edema, inflammatory cell trapping/extravasation, diffuse inflammation, and tissue necrosis are thought to contribute to the advent of a chronic wound. Healing of the wound then becomes difficult in the context of an internally injured limb. Thus, interventions and therapies for promoting healing of the limb is a growing area of interest. For venous ulcers, treatment using compression bandaging encourages venous return and improves healing processes within the limb, critically however, once treatment concludes ulcers often reoccur. Future Directions: Improved understanding of the composition and role of pericapillary matrix deposits in facilitating internal limb injury and subsequent development of chronic wounds will be critical for informing and enhancing current best practice therapies and preventative action in the wound care field. PMID:25785239

  20. Hormonal contraception and venous thromboembolism

    DEFF Research Database (Denmark)

    Lidegaard, Øjvind; Milsom, Ian; Geirsson, Reynir Tomas;

    2012-01-01

    New studies about the influence of hormonal contraception on the risk of venous thromboembolism (VTE) have been published.......New studies about the influence of hormonal contraception on the risk of venous thromboembolism (VTE) have been published....

  1. Vegetable exudates as food for Callithrix spp. (Callitrichidae: exploratory patterns.

    Directory of Open Access Journals (Sweden)

    Talitha Mayumi Francisco

    Full Text Available Marmosets of the genus Callithrix are specialized in the consumption of tree exudates to obtain essential nutritional resource by boring holes into bark with teeth. However, marmoset preferences for particular tree species, location, type, and other suitable factors that aid in exudate acquisition need further research. In the current study, the intensity of exudate use from Anadenanthera peregrina var. peregrina trees by hybrid marmosets Callithrix spp. groups was studied in five forest fragments in Viçosa, in the state of Minas, Brazil. Thirty-nine A. peregrina var. peregrina trees were examined and 8,765 active and non-active holes were analyzed. The trunk of A. peregrina var. peregrina had a lower number of holes than the canopy: 11% were found on the trunk and 89% were found on the canopy. The upper canopy was the preferred area by Callithrix spp. for obtaining exudates. The intensity of tree exploitation by marmosets showed a moderate-to-weak correlation with diameter at breast height (DBH and total tree height. The overall results indicate that Anadenanthera peregrina var. peregrina provides food resources for hybrid marmosets (Callithrix spp. and these animals prefer to explore this resource on the apical parts of the plant, where the thickness, location, and age of the branches are the main features involved in the acquisition of exudates.

  2. Vegetable exudates as food for Callithrix spp. (Callitrichidae): exploratory patterns.

    Science.gov (United States)

    Francisco, Talitha Mayumi; Couto, Dayvid Rodrigues; Zanuncio, José Cola; Serrão, José Eduardo; Silva, Ita de Oliveira; Boere, Vanner

    2014-01-01

    Marmosets of the genus Callithrix are specialized in the consumption of tree exudates to obtain essential nutritional resource by boring holes into bark with teeth. However, marmoset preferences for particular tree species, location, type, and other suitable factors that aid in exudate acquisition need further research. In the current study, the intensity of exudate use from Anadenanthera peregrina var. peregrina trees by hybrid marmosets Callithrix spp. groups was studied in five forest fragments in Viçosa, in the state of Minas, Brazil. Thirty-nine A. peregrina var. peregrina trees were examined and 8,765 active and non-active holes were analyzed. The trunk of A. peregrina var. peregrina had a lower number of holes than the canopy: 11% were found on the trunk and 89% were found on the canopy. The upper canopy was the preferred area by Callithrix spp. for obtaining exudates. The intensity of tree exploitation by marmosets showed a moderate-to-weak correlation with diameter at breast height (DBH) and total tree height. The overall results indicate that Anadenanthera peregrina var. peregrina provides food resources for hybrid marmosets (Callithrix spp.) and these animals prefer to explore this resource on the apical parts of the plant, where the thickness, location, and age of the branches are the main features involved in the acquisition of exudates.

  3. Microcirculatory efficacy of topical treatment with aescin + essential phospholipids gel in venous insufficiency and hypertension: new clinical observations.

    Science.gov (United States)

    Belcaro, G; Cesarone, M R; Dugall, M

    2004-01-01

    Aescin + essential phospholipids (AEPL) topical gels are used for local treatment of venous and microcirculatory alterations (varicose veins, chronic venous insufficiency). Bruises, swelling, thrombophlebitis, and contusions are effectively treated with AEPL. Active ingredients are escinate and essential phospholipids (EPL). The aim of this new study was the evaluation of the efficacy of the effects of AEPL gel on the microcirculation in subjects with chronic venous insufficiency, venous hypertension (CVH), and venous microangiopathy. Patients were assessed measuring skin flux with laser-Doppler flowmetry (LDF). After 2 weeks of local treatment, all individual values (100%) were significantly decreased (p < 0.05), indicating an improvement in the microcirculation. In all treated patients, flux decreased at least 30% (indicating a decrease in the level of venous microangiopathy) (p < 0.05). Considering these observations, topical treatment with AEPL in areas of venous microangiopathy is beneficial, can prevent ulceration, and improves the skin healing processes.

  4. Microcirculatory efficacy of topical treatment with aescin + essential phospholipids gel on transcutaneous PO2 in venous insufficiency.

    Science.gov (United States)

    Cesarone, M R; Belcaro, G; Ippolito, E; Ricci, A; Ruffini, M; Dugall, M

    2004-01-01

    A gel including aescin, essential phospholipids (EPL), and heparin (EG) has been used for many years for local treatment of venous, microcirculatory alterations (varicose veins, chronic venous insufficiency). Bruises, swelling, thrombophlebitis, and contusions are effectively treated with this compound. The aim of this study was the evaluation of the efficacy of the effects of an AEPL (aescin+EPL) gel on the microcirculation in subjects with chronic venous insufficiency, venous hypertension (CVH), and venous microangiopathy. Transcutaneous PO(2) was measured at the perimalleolar region. After 2 weeks of treatment, all individual values (100%) were significantly increased (p < 0.05). In all patients, PO(2) increased, indicating a decrease in level of venous microangiopathy. Considering transcutaneous skin PO(2), treatment with AEPL in areas of venous microangiopathy is beneficial in the prevention of ulceration and improves skin healing.

  5. Resultados do tratamento da Insuficiência Venosa Crônica grave com espuma de polidocanol guiada por ultrassom Results of treatment of severe chronic venous insufficiency with ultrasound-guided polidocanol foam

    Directory of Open Access Journals (Sweden)

    Melissa Andreia de Moraes Silva

    2012-09-01

    Full Text Available CONTEXTO: A insuficiência venosa crônica (IVC em suas formas mais graves, com ulceração e lesões inflamatórias, associa-se a um tratamento cirúrgico convencional de difícil execução. A escleroterapia de veias tronculares com espuma de polidocanol é considerada uma alternativa terapêutica com resultados satisfatórios. OBJETIVO: Relatar os resultados da escleroterapia com espuma de polidocanol no tratamento de pacientes com IVC de membros inferiores com úlcera ativa. MÉTODOS: Em um período de 48 meses, 71 pacientes (76 membros foram submetidos à escleroterapia de veias tronculares com espuma de polidocanol a 3% guiada por ultrassom. O seguimento pós-procedimento foi feito por meio de questionário clínico, exame físico e ultrassom Doppler, realizados em sete dias, um e seis meses e, a partir de então, semestralmente. Analisou-se tempo de cicatrização da úlcera, melhora de sintomas clínicos, recanalização, recidiva dos sintomas e complicações. RESULTADOS: O sexo feminino correspondeu a 61% dos casos, e a idade variou de 25 a 85 anos (média de 59 anos. O tempo médio de acompanhamento foi de 460 dias. O refluxo do sistema venoso profundo foi observado em 53,4% dos membros. A cicatrização das úlceras ocorreu em 84,2% dos casos, com um tempo médio de cicatrização de 37 dias. A recanalização ocorreu em 31,5%, porém a recidiva de sintomas, com ressurgimento de úlcera, foi de 11,8%. CONCLUSÃO: A esclerose com espuma é efetiva e apresenta altas taxas de cicatrização de úlceras, com baixos índices de complicações, em pacientes com IVC grave.BACKGROUND: Chronic Venous Insufficiency (CVI in its most severe forms, with ulceration and inflammatory lesions, is associated with a conventional surgical treatment of difficult execution. Polidocanol foam sclerotherapy of saphenous veins is considered an alternative therapy with satisfactory results. OBJECTIVE: To report the results of polidocanol foam sclerotherapy in

  6. Jugular venous oximetry

    Directory of Open Access Journals (Sweden)

    Avanish Bhardwaj

    2015-01-01

    Full Text Available The measurement of saturation of venous blood as it drains out of brain by sampling it from the jugular bulb provides us with an estimate of cerebral oxygenation, cerebral blood flow and cerebral metabolic requirement. Arterio-jugular venous difference of the oxygen content (AVDO 2 and jugular venous oxygen saturation (SjVO 2 values per se helps clinicians in identifying the impairment of cerebral oxygenation due to various factors thereby prompting implementation of corrective measures and the prevention of secondary injury to the brain due to ischaemia. SjVO 2 values are also used for prognostication of patients after traumatic brain injury and in other clinical situations. Sampling and measuring SjVO 2 intermittently or continuously using fibreoptic oximetry requires the tip of the catheter to be placed in the jugular bulb, which is a relatively simple bedside procedure. In the review below we have discussed the relevant anatomy, physiology, techniques, clinical applications and pitfalls of performing jugular venous oximetry as a tool for measurement of cerebral oxygenation.

  7. Central venous line - infants

    Science.gov (United States)

    A central venous line (CVL) is a long, soft, plastic tube that is put into a large vein in the chest. WHY IS A CVL USED? A CVL is often put in when a baby cannot get a ... (MCC). A CVL can be used to give nutrients or medicines to a ...

  8. Venous thromboembolism: The intricacies

    Directory of Open Access Journals (Sweden)

    Dutta T

    2009-01-01

    Full Text Available Venous thromboembolism (VTE has been a subject of great interest of late. Since Rudolph Virchow described the famous Virchow′s triad in 1856, there have been rapid strides in the understanding of the pathogenesis and factors responsible for it. Discovery of various thrombophilic factors, both primary and acquired, in the last 40 years has revolutionized prognostication and management of this potentially life-threatening condition due to its associated complication of pulmonary thromboembolism. Detailed genetic mapping and linkage analyses have been underlining the fact that VTE is a multifactorial disorder and a complex one. There are many gene-gene and gene-environment interactions that alter and magnify the clinical picture in this disorder. Point in case is pregnancy, where the risk of VTE is 100-150 times increased in the presence of Factor V Leiden, prothrombin mutation (Prothrombin 20210A and antithrombin deficiency. Risk of VTE associated with long-haul air flight has now been well recognized. Thrombotic events associated with antiphospholipid syndrome (APS are 70% venous and 30% arterial. Deep venous thrombosis and pulmonary embolism are the most common venous events, though unusual cases of catastrophes due to central vein thrombosis like renal vein thrombosis and Budd-Chiari syndrome (catastrophic APS may occur.

  9. Venous Thromboembolism in China

    Institute of Scientific and Technical Information of China (English)

    赵永强

    2005-01-01

    @@ Deep vein thrombosis (DVT) and pulmonary thromboembolism (PTE) are two manifesttions of venous thromboembolism (VTE) . Although the controversy remained,it has been widely accepted for many years that Chinese people have lower incidence of VTE than Caucasians with the different etiology and clinical features.

  10. AUTOMATIC RETINA EXUDATES SEGMENTATION WITHOUT A MANUALLY LABELLED TRAINING SET

    Energy Technology Data Exchange (ETDEWEB)

    Giancardo, Luca [ORNL; Meriaudeau, Fabrice [ORNL; Karnowski, Thomas Paul [ORNL; Li, Yaquin [University of Tennessee, Knoxville (UTK); Tobin Jr, Kenneth William [ORNL; Chaum, Edward [University of Tennessee, Knoxville (UTK)

    2011-01-01

    Diabetic macular edema (DME) is a common vision threatening complication of diabetic retinopathy which can be assessed by detecting exudates (a type of bright lesion) in fundus images. In this work, two new methods for the detection of exudates are presented which do not use a supervised learning step and therefore do not require ground-truthed lesion training sets which are time consuming to create, difficult to obtain, and prone to human error. We introduce a new dataset of fundus images from various ethnic groups and levels of DME which we have made publicly available. We evaluate our algorithm with this dataset and compare our results with two recent exudate segmentation algorithms. In all of our tests, our algorithms perform better or comparable with an order of magnitude reduction in computational time.

  11. Bacterial attraction and quorum sensing inhibition in Caenorhabditis elegans exudates.

    Science.gov (United States)

    Kaplan, Fatma; Badri, Dayakar V; Zachariah, Cherian; Ajredini, Ramadan; Sandoval, Francisco J; Roje, Sanja; Levine, Lanfang H; Zhang, Fengli; Robinette, Steven L; Alborn, Hans T; Zhao, Wei; Stadler, Michael; Nimalendran, Rathika; Dossey, Aaron T; Brüschweiler, Rafael; Vivanco, Jorge M; Edison, Arthur S

    2009-08-01

    Caenorhabditis elegans, a bacterivorous nematode, lives in complex rotting fruit, soil, and compost environments, and chemical interactions are required for mating, monitoring population density, recognition of food, avoidance of pathogenic microbes, and other essential ecological functions. Despite being one of the best-studied model organisms in biology, relatively little is known about the signals that C. elegans uses to interact chemically with its environment or as defense. C. elegans exudates were analyzed by using several analytical methods and found to contain 36 common metabolites that include organic acids, amino acids, and sugars, all in relatively high abundance. Furthermore, the concentrations of amino acids in the exudates were dependent on developmental stage. The C. elegans exudates were tested for bacterial chemotaxis using Pseudomonas putida (KT2440), a plant growth promoting rhizobacterium, Pseudomonas aeruginosa (PAO1), a soil bacterium pathogenic to C. elegans, and Escherichia coli (OP50), a non-motile bacterium tested as a control. The C. elegans exudates attracted the two Pseudomonas species, but had no detectable antibacterial activity against P. aeruginosa. To our surprise, the exudates of young adult and adult life stages of C. elegans exudates inhibited quorum sensing in the reporter system based on the LuxR bacterial quorum sensing (QS) system, which regulates bacterial virulence and other factors in Vibrio fischeri. We were able to fractionate the QS inhibition and bacterial chemotaxis activities, thus demonstrating that these activities are chemically distinct. Our results demonstrate that C. elegans can attract its bacterial food and has the potential of partially regulating the virulence of bacterial pathogens by inhibiting specific QS systems.

  12. Nontraumatic vascular emergencies: imaging and intervention in acute venous occlusion

    Energy Technology Data Exchange (ETDEWEB)

    Haage, Patrick; Schmitz-Rode, Thomas [Department of Diagnostic Radiology, University of Technology Aachen, Pauwelsstrasse 30, 52057 Aachen (Germany); Krings, Timo [Department of Neuroradiology, University of Technology Aachen, Pauwelsstrasse 30, 52057 Aachen (Germany)

    2002-11-01

    Risk factors for acute venous occlusion range from prolonged immobilization to hypercoagulability syndromes, trauma, and malignancy. The aim of this review article is to illustrate the different imaging options for the diagnosis of acute venous occlusion and to assess the value of interventional strategies for venous thrombosis treatment in an emergency setting. First, diagnosis and treatment of the most common form of venous occlusion, at the level of the lower extremities, is presented, followed by pelvic vein and inferior vena cava occlusion, mesenteric venous thrombosis, upper extremity occlusion, acute cerebral vein thrombosis, and finally acute venous occlusion of hemodialysis access. In acute venous occlusion of the lower extremity phlebography is still the reference gold standard. Presently, duplex ultrasound with manual compression is the most sensitive and specific noninvasive test. Limitations of ultrasonography include isolated distal calf vein occlusion, obesity, and patients with lower extremity edema. If sonography is nondiagnostic, venography should be considered. Magnetic resonance venography can differentiate an acute occlusion from chronic thrombus, but because of its high cost and limited availability, it is not yet used for the routine diagnosis of lower extremity venous occlusion only. Regarding interventional treatment, catheter-directed thrombolysis can be applied to dissolve thrombus in charily selected patients with symptomatic occlusion and no contraindications to therapy. Acute occlusion of the pelvic veins and the inferior vena cava, often due to extension from the femoropopliteal system, represents a major risk for pulmonary embolism. Color flow Doppler imaging is often limited owing to obesity and bowel gas. Venography has long been considered the gold standard for identifying proximal venous occlusion. Both CT scanning and MR imaging, however, can even more accurately diagnose acute pelvis vein or inferior vena cava occlusion. MRI is

  13. Absence of venous valves in mice lacking Connexin37.

    Science.gov (United States)

    Munger, Stephanie J; Kanady, John D; Simon, Alexander M

    2013-01-15

    Venous valves play a crucial role in blood circulation, promoting the one-way movement of blood from superficial and deep veins towards the heart. By preventing retrograde flow, venous valves spare capillaries and venules from being subjected to damaging elevations in pressure, especially during skeletal muscle contraction. Pathologically, valvular incompetence or absence of valves are common features of venous disorders such as chronic venous insufficiency and varicose veins. The underlying causes of these conditions are not well understood, but congenital venous valve aplasia or agenesis may play a role in some cases. Despite progress in the study of cardiac and lymphatic valve morphogenesis, the molecular mechanisms controlling the development and maintenance of venous valves remain poorly understood. Here, we show that in valved veins of the mouse, three gap junction proteins (Connexins, Cxs), Cx37, Cx43, and Cx47, are expressed exclusively in the valves in a highly polarized fashion, with Cx43 on the upstream side of the valve leaflet and Cx37 on the downstream side. Surprisingly, Cx43 expression is strongly induced in the non-valve venous endothelium in superficial veins following wounding of the overlying skin. Moreover, we show that in Cx37-deficient mice, venous valves are entirely absent. Thus, Cx37, a protein involved in cell-cell communication, is one of only a few proteins identified so far as critical for the development or maintenance of venous valves. Because Cxs are necessary for the development of valves in lymphatic vessels as well, our results support the notion of common molecular pathways controlling valve development in veins and lymphatic vessels.

  14. Primary chronic venous insufficiency of the lower extremities: preoperative color duplex Doppler ultrasound study; Insuficiencia venosa cronica primaria de los miembros inferiores. Valoracion prequirurgica con ecografia Doppler duplex color

    Energy Technology Data Exchange (ETDEWEB)

    Selfa, S.; Diago, T.; Ricart, M.; Chulia, R.; Martin, F. [Hospital Lluis Xativa. Valencia (Spain)

    2000-07-01

    To asses the role of color duplex Doppler ultrasound (CDU) in the preoperative study of patients with varicose veins in lower extremities. We employed CDU to examine varicose veins in 342 lower limbs, assessing reflux in saphenous veins (SV), deep venous system (DVS) and perforating veins (PV). We analyzed the relationship between the anatomical extent of the reflux and the clinical findings. Insufficiency of the superficial venous system alone was uncommon, occurring in only 10.8% of the limbs examined. Reflux was observed in SV and PV in 48.2% of the legs. It was detected in all three systems in 29.2% of cases. The presence of reflux in more than one system and more than one value was associated with increased clinical severity. The site of venous reflux in lower extremities with varicose veins varies. Greater clinical severity is observed in the presence of more marked reflux in the DVS and PV. CDU provides anatomic and functional data on the three venous systems of the lower limbs, allowing an individualized therapeutic surgery. Preoperative localization of incompetent PV by means of CDU facilities their ligation. CDU is the technique of choice for the preoperative examination of the venous systems of patients with varicose veins. (Author)

  15. Alginates: an effective primary dressing for exuding wounds.

    Science.gov (United States)

    Heenan, Andrew

    Alginates are an effective dressing for medium to highly exuding wounds and have been in use for the past 30 years. The literature demonstrates their value as an effective primary dressing for a range of wounds from donor sites to cavity wounds.

  16. New phenolic esters from the resinous exudate of Haplopappus taeda.

    Science.gov (United States)

    Faini, Francesca; Labbé, Cecilia; Torres, René; Rodilla, Jesús M; Silva, Lucía; Delle Monache, Franco

    2007-12-01

    Two new phenolic esters 9-trans-p-coumaroyloxy-alpha-terpineol (1) and 7-trans-p-coumaroyloxy-taedol (2), both endowed with free radical scavenger activity and cleroda-3,13 (E)-dien-15,18-diol (3) for which a cis stereochemistry at the decalin junction was found, were isolated from the resinous exudate from Haplopappus taeda upper parts.

  17. Exudative epidermitis in pigs caused by toxigenic Staphylococcus chromogenes

    DEFF Research Database (Denmark)

    Andresen, Lars Ole; Ahrens, Peter; Daugaard, Lise

    2005-01-01

    Staphylococcus chromogenes is closely related to Staphylococcus hyicus, which is recognised as the causative agent of exudative epidermitis (EE) in pigs. S. chromogenes is part of the normal skin flora of pigs, cattle and poultry and has so far been considered non-pathogenic to pigs. A strain of S...

  18. Root exudate impact on gene expression of Sporisorium reilianum.

    Science.gov (United States)

    Sabbagh, S K; Panjakeh, N; Salary, M

    2009-01-01

    Sporisorium reilianum f.sp zeae, a basidiomycetous fungus belonging to Ustilaginaceae, is the causal agent of the maize head smut disease. This soilborne pathogen infects the host plant at the seedling stage by penetrating roots. The infection is systemic, and disease symptoms become apparent only after the onset of flower development when the fungal sori replace male or female inflorescences. In order to investigate the mechanism of infection, we analysed the transcriptome of the fungus in response to root exudates during the previous phase of infection. A suppression subtractive hybridization (SSH) was used to generate cDNA libraries representing genes differentially expressed in haploid cell forms of the fungus exposed to root exudates Leading to 960 ESTs. By using cDNA macroarray hybridization, we identified 36 ESTs which were differentially expressed in response to exudates application. In this first transcriptomic analysis realized on S. reilianum, we show that maize root exudates may affect gene expression of the fungus involved in cell respiration, cell wall development, metabolism and hypothetical proteins during the previous step of infection and could play an important role in fungi growth promotion and plant pathogenesis.

  19. Venous thromboembolism and pregnancy

    Directory of Open Access Journals (Sweden)

    Maristella D’Uva

    2010-03-01

    Full Text Available Maristella D’Uva1, Pierpaolo Di Micco2, Ida Strina1, Giuseppe De Placido1Department of Obstetrics and Gynecology and Human Reproduction, “Federico II” University of Naples, Naples, Italy; 2Internal Medicine Division, Buonconsiglio Fatebenefratelli Hospital of Naples, Naples, ItalyAbstract: In recent decades, the association between a hypercoagulable state and its causes and adverse pregnancy outcome, in particular recurrent pregnancy loss (RPL has been studied extensively. Although the first studies were focused only on the association between thrombophilia and RPL, subsequent studies underlined also a potential role of antithrombotic treatment to prevent vascular complication such as venous thromboembolism (VTE during pregnancy. Thromboprophylaxis should be considered also for pregnant subjects carriers of molecular thrombophilia or that previously experienced VTE, in order to prevent VTE during pregnancy, while antithrombotic treatment for VTE should be performed during all pregnant periods.Keywords: thrombophilia, venous thromboembolism, recurrent pregnancy loss, factor V Leiden

  20. A review of the current management and treatment options for superficial venous insufficiency.

    Science.gov (United States)

    Zhan, Henry T; Bush, Ruth L

    2014-10-01

    The recognition of lower extremity venous disease as a significant cause of morbidity and lower quality of life, afflicting up to 25 % of Western populations, has led to rapid and drastic improvements in treatment options as well as an increasing awareness of the disease. Superficial venous disease, a frequent medical problem encountered in clinical practices, is now a common reason for referral to providers offering a spectrum of interventions. Venous guidelines have been set forth by the American Venous Forum and Society for Vascular Surgery covering simple spider veins to chronic venous ulcerations. (Gloviczki et al. J Vas Surg 53:2S-48S, 2011) This review provides an overview of the modern management of varicose veins and venous insufficiency.

  1. Venous Leg Ulcers.

    Science.gov (United States)

    Vivas, Alejandra; Lev-Tov, Hadar; Kirsner, Robert S

    2016-08-02

    This issue provides a clinical overview of venous leg ulcers, focusing on prevention, diagnosis, treatment, and practice improvement. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of additional science writers and physician writers.

  2. Nature's amazing biopolymer: basic mechanical and hydrological properties of soil affected by plant exudates

    Science.gov (United States)

    Naveed, Muhammad; Roose, Tiina; Raffan, Annette; George, Timothy; Bengough, Glyn; Brown, Lawrie; Keyes, Sam; Daly, Keith; Hallett, Paul

    2016-04-01

    Plant exudates are known to have a very large impact on soil physical properties through changes in mechanical and hydrological processes driven by long-chain polysaccharides and surface active compounds. Whilst these impacts are well known, the basic physical properties of these exudates have only been reported in a small number of studies. We present data for exudates obtained from barley roots and chia seeds, incorporating treatments examining biological decomposition of the exudates. When these exudates were added to a sandy loam soil, contact angle and drop penetration time increased exponentially with increasing exudate concentration. These wetting properties were strongly correlated with both exudate density and zero-shear viscosity, but not with exudate surface tension. Water holding capacity and water repellency of exudate mixed soil tremendously increased with exudate concentration, however they were significantly reduced on decomposition when measured after 14 days of incubation at 16C. Mechanical stability greatly increased with increasing exudate amendment to soils, which was assessed using a rheological amplitude sweep test near saturation, at -50 cm matric potential (field capacity) using indentation test, and at air-dry condition using the Brazilian test. This reflects that exudates not only attenuate plant water stress but also impart mechanical stability to the rhizosphere. These data are highly relevant to the understanding and modelling of rhizosphere development, which is the next phase of our research.

  3. 生活质量调查表在下肢慢性静脉功能不全术后随访中的应用%The use of life quality questionnaire for postoperative follow-up of patients with chronic venous insufficiency

    Institute of Scientific and Technical Information of China (English)

    张岚; 张柏根

    2004-01-01

    目的评估下肢慢性静脉功能不全(chronic venous insufficiency,CVI)术后的生活质量.方法采用生活质量调查表(chronic venous insufficiency questionnaire,CIVIQ)4类20项调查内容,评价3种不同术式组:浅静脉组术式、交通静脉组术式、深静脉组术式169例CVI患者术后的生活质量;CIVIQ均值80分以上定为良好.结果 3种术式CIVIQ均值分别为:浅静脉组84±15;交通支组88±14;深静脉组82±16.结论深静脉瓣膜重建术后患者生活质量是满意的;CIVIQ的应用是合理和可行的.

  4. [Present and future in the management of venous vascular diseases].

    Science.gov (United States)

    Gavorník, Peter; Dukát, Andrej; Gašpar, Ľudovít; Gavorníková, Eva

    2015-02-01

    The prevalence and the incidence of chronic and acute venous vascular disease has been shown to be globally very high, in both industrialized and developing countries. Chronic venous diseases of lower extremities are being an integral part of the third millennium's deadly angiopandemy, at the present time. The rate of the most severe cases with advanced stage of venous failure is approximately twice as high in the population (2.1 %) as has been assumed so far. Among venoactive drugs (VAD), micronized purified flavonoid fraction (MPFF) of diosmin hesperidin remains the agent with the highest degree of recommendation and it also indicated to pharmacotherapeutical support of leg ulcer healing, along with sulodexide and pentoxifylline. Compressive sclerotherapy, liquid or foam, is a safe and effective invasive method to treat telangiectasias, reticular varicose veins and subcutaneous varicose veins. Direct oral anticoagulants (DOAC) represent one of the therapeutic and preventive options of deep venous thrombosis (DVT) and of venous thromboembolism (VTE) with a limitation in patients with malignant conditions and in pregnancy. The most effective is triple simultaneous pharmaco-kinezio-mechano-phlebothromboemboloprophylaxis. Superficial vein thromboses longer than 5 cm are indicated to anticoagulant therapy too.

  5. Models of the venous system

    DEFF Research Database (Denmark)

    Mehlsen, J

    2000-01-01

    Cardiac output is largely controlled by venous return, the driving force of which is the energy remaining at the postcapillary venous site. This force is influenced by forces acting close to the right atrium, and internally or externally upon the veins along their course. Analogue models....... The venous capacitance is also non-linear, but may be considered linear under certain conditions. The models have to include time varying pressure sources created by respiration and skeletal muscles, and if the description includes the upright position, the partly unidirectional flow through the venous...

  6. Chronic obstructive pulmonary disease (copd) with spontaneous pneumothorax the curative effect of central venous catheter pleural closed drainage through research%慢性阻塞性肺病合并自发性气胸通过中心静脉导管胸腔闭式引流的疗效研究

    Institute of Scientific and Technical Information of China (English)

    刘书明

    2015-01-01

    Objective Central venous catheter pleural exploration and comparison analysis and thick silica gel catheter closed drainage in the treatment of patients with chronic obstructive pulmonary disease (copd) with spontaneous pneumothorax.Methods 100 cases of chronic obstructive pulmonary disease with central venous catheter group of 50 cases with spontaneous aerosols are divided into thick silica gel catheter group of 50 cases, the comparative analysis of two groups of clinical treatment effect and the incidence of adverse reactions.Results Postoperative incidence of adverse reactions of central venous catheter group was lower than that in group thick silica gel catheter (P< 0.05) and significant difference.Conclusions Choose plan of central venous catheter pleural closed drainage diagnosis and treatment of copd with spontaneous pneumothorax patients clinical effect is satisfactory.%目的:探索和对比分析中心静脉导管胸腔闭式引流和粗硅胶导管治疗慢性阻塞性肺病合并自发性气胸患者的临床效果。方法:100例慢性阻塞性肺疾病合并自发性气胸患者分为中心静脉导管组50例与粗硅胶导管组50例,对比分析两组的临床治疗效果和不良反应发生率。结果:术后的不良反应发生率中心静脉导管组明显低于粗硅胶导管组(P<0.05),差距有显著性意义。结论:选用中心静脉导管胸腔闭式引流诊疗方案治疗慢阻肺合并自发性气胸患者临床效果满意。

  7. Management of venous ulcers: State of the art.

    Science.gov (United States)

    Marola, Silvia; Ferrarese, Alessia; Solej, Mario; Enrico, Stefano; Nano, Mario; Martino, Valter

    2016-09-01

    Venous ulceration is a complex and serious problem that affects 1-2% of the global elderly population (>65 years), and its incidence is constantly increasing. The population group with higher risk of development of venous ulceration is the elderly. These lesions have a significant negative impact on patients' quality of life. Our aim was to analyze the state of the art, starting with the medical literature review. The evidence supports that managing chronic wounds with a multidisciplinary wound care team significantly increases wound healing and reduces the severity of wound-associated pain and the required daily wound treatments compared with persons who are not managed by such a team.

  8. Distribution and quantitative study of inflammatory cells infiltration in vessel wall of chronic venous insufficiency in lower limbs%下肢慢性静脉功能不全血管壁炎性细胞浸润分布和定量研究

    Institute of Scientific and Technical Information of China (English)

    陈智年; 李凤臣; 王国华; 李泽宇; 张桂凌; 任洁

    2012-01-01

    目的 探讨淋巴细胞、单核-巨噬细胞和肥大细胞在血管壁中的浸润与下肢慢性静脉功能不全( chronic venous insufficiency of low limbs,CVI)之间的关系.方法 收集不同临床分期下肢慢性静脉功能不全的主干(中段)标本,C2 ~ C3级20例,C4~C6级17例,对照组(正常静脉)7例.采用免疫组织化学染色LCA,CD68和甲苯胺蓝特殊染色分别检测淋巴细胞、单核-巨噬细胞和肥大细胞表达.结果 C2 ~ C3级、C4~C6级标本中单核-巨噬细胞表达与正常对照组差异有统计学意义(F=3.56,P<0.05);C2 ~ C3级、C4 ~ C6级标本中肥大细胞表达与正常对照组差异有统计学意义(F =5.13,P<0.05).结论 单核-巨噬细胞和肥大细胞在血管壁的浸润可能是慢性静脉功能不全的一个重要病因.%Objective To investigate the relationship between infiltration of lymphocytes,monocyte-macrophage and mast cells in vessel wall and chronic venous insufficiency of low limbs.Methods The bole specimens (midpiece) of chronic venous insufficiency in low limbs in different clinical stages were collected,20 cases of C2- C3,17 cases of C4- C6 and 7 cases of normal venous tissue.Immunohistochemical staining and toluidine bluestaining were used to detect the expression of lymphocyte,monocyte-macrophage and mast cells.Results There were significant differences in the expression levels of monocyte-macrophage cells between C2- C3,C4- C6 specimens and normal control group ( F =3.56,P < 0.05 ) ; there were significant differences in the expression levels of mast cells between C2- C3,C4- C6 specimen and normal control group ( F =5.13,P < 0.05 ).Conclusions Infiltration of monocyte-macrophages and mast cells in vessel wall could be an important cause of chronic venous insufficiency.

  9. Root Exudation: The Ecological Driver of Hydrocarbon Rhizoremediation

    Directory of Open Access Journals (Sweden)

    Fanny Rohrbacher

    2016-03-01

    Full Text Available Rhizoremediation is a bioremediation technique whereby microbial degradation of organic contaminants occurs in the rhizosphere. It is considered to be an effective and affordable “green technology” for remediating soils contaminated with petroleum hydrocarbons. Root exudation of a wide variety of compounds (organic, amino and fatty acids, carbohydrates, vitamins, nucleotides, phenolic compounds, polysaccharides and proteins provide better nutrient uptake for the rhizosphere microbiome. It is thought to be one of the predominant drivers of microbial communities in the rhizosphere and is therefore a potential key factor behind enhanced hydrocarbon biodegradation. Many of the genes responsible for bacterial adaptation in contaminated soil and the plant rhizosphere are carried by conjugative plasmids and transferred among bacteria. Because root exudates can stimulate gene transfer, conjugation in the rhizosphere is higher than in bulk soil. A better understanding of these phenomena could thus inform the development of techniques to manipulate the rhizosphere microbiome in ways that improve hydrocarbon bioremediation.

  10. Models of the venous system

    DEFF Research Database (Denmark)

    Mehlsen, J

    2000-01-01

    . The venous capacitance is also non-linear, but may be considered linear under certain conditions. The models have to include time varying pressure sources created by respiration and skeletal muscles, and if the description includes the upright position, the partly unidirectional flow through the venous...

  11. 下肢慢性静脉性溃疡病因学及治疗研究%Progress in the etiology and therapy of chronic venous leg ulcers

    Institute of Scientific and Technical Information of China (English)

    陈琉; 常李; 陈金鳌

    2012-01-01

    下肢慢性静脉性溃疡( CVLU)是下肢静脉功能不全的常见并发症.许多CVLU反复发作,久治不愈,形成难治性溃疡,成为临床治疗中的辣手问题.笔者就近年来CVLU病因学研究进展,分期疗法和个体化治疗方法进行评价及综述.%Chronic venous leg ulceration (CVLU) is a frequent complication of lower limb venous insufficiency. Many cases of CVLU, which are slow to heal and frequently recur, and finally develop into refractory ulcers, have become a difficult problem in clinical practice. This paper reviews the recent progress in the etiology of CVLU, and its staging and individualized treatment.

  12. Cerebral sinus venous thrombosis

    Directory of Open Access Journals (Sweden)

    Hernando Raphael Alvis-Miranda

    2013-01-01

    Full Text Available Cerebral sinus venous thrombosis (CSVT is a rare phenomenon that can be seen with some frequency in young patients. CSVT is a multifactorial condition with gender-related specific causes, with a wide clinical presentation, the leading causes differ between developed and developing countries, converting CSVT in a condition characterized by a highly variable clinical spectra, difficult diagnosis, variable etiologies and prognosis that requires fine medical skills and a high suspicious index. Patients who presents with CSVT should underwent to CT-scan venography (CVT and to the proper inquiry of the generating cause. This disease can affect the cerebral venous drainage and related anatomical structure. The symptoms may appear in relation to increased intracranial pressure imitating a pseudotumorcerebri. Prognosis depends on the early detection. Correcting the cause, generally the complications can be prevented. Mortality trends have diminished, and with the new technologies, surely it will continue. This work aims to review current knowledge about CSVT including its pathogenesis, etiology, clinical manifestations, diagnosis, and treatment.

  13. Cerebral sinus venous thrombosis

    Science.gov (United States)

    Alvis-Miranda, Hernando Raphael; Milena Castellar-Leones, Sandra; Alcala-Cerra, Gabriel; Rafael Moscote-Salazar, Luis

    2013-01-01

    Cerebral sinus venous thrombosis (CSVT) is a rare phenomenon that can be seen with some frequency in young patients. CSVT is a multifactorial condition with gender-related specific causes, with a wide clinical presentation, the leading causes differ between developed and developing countries, converting CSVT in a condition characterized by a highly variable clinical spectra, difficult diagnosis, variable etiologies and prognosis that requires fine medical skills and a high suspicious index. Patients who presents with CSVT should underwent to CT-scan venography (CVT) and to the proper inquiry of the generating cause. This disease can affect the cerebral venous drainage and related anatomical structure. The symptoms may appear in relation to increased intracranial pressure imitating a pseudotumorcerebri. Prognosis depends on the early detection. Correcting the cause, generally the complications can be prevented. Mortality trends have diminished, and with the new technologies, surely it will continue. This work aims to review current knowledge about CSVT including its pathogenesis, etiology, clinical manifestations, diagnosis, and treatment. PMID:24347950

  14. Sarcoidosis mimicking a venous ulcer: a case report.

    Science.gov (United States)

    Joshi, Smita S; Romanelli, Paolo; Kirsner, Robert S

    2009-11-01

    Sarcoidosis--a chronic, multisystem disease of unknown etiology characterized by noncaseating granulomas--may cause ulcerative lesions, particularly in African American women. A case of ulcerative sarcoidosis mimicking a venous ulcer is presented. The patient is a 44-year-old African American hypertensive, obese woman with a nonhealing medially based lower leg ulcer of 3 years' duration clinically consistent with a venous ulcer. The ulcer did not heal with compression therapy and pentoxifylline. Subsequent biopsies showed granulomatous inflammation consistent with sarcoidosis. When intralesional triamcinolone was added to compression therapy, the ulcer resolved after 3 months. Given its propensity toward formation on the lower extremities and ulcerative and atrophic appearance, ulcerative sarcoidosis should be considered in the differential diagnosis of a venous ulcer refractory to standard therapy, especially in African American women.

  15. ASSOCIATION BETWEEN RETINAL HARD EXUDATES AND DYSLIPIDEMIA IN TYPE 2 DIABETIC PATIENTS IN RURAL KARNATAKA

    Directory of Open Access Journals (Sweden)

    Arun Kumar B.

    2015-10-01

    Full Text Available AIM: To evaluate the association of elevated serum lipids with retinal hard exudates in type 2 diabetic patients in rural Karnataka. MATERIAL AND METHODS : Hospital based cross sectional study which included 60 (n=60 type 2 diabetic patients (60 eyes fulfilling the inclusion criteria. Patients were subjected to detailed ocular examination, fundus examination done under full dilatation using indirect ophth almoscope with 20D lens and slit lamp biomicroscope with 90D lens. Fundus photographs were obtained using fundus camera. Grading of retinal hard exudates performed by utilizing modified Airlie House classification. The modified Airlie House Classification used is as follows: Grade 0 - No evidence of hard exudates; Grade 1 : Questionable hard exudates present; Grade 2 : Hard exudates less than standard photograph 3; Grade 3 : Hard exudates greater than or equal to standard photograph 3, but less than standard p hotograph 5; Grade 4 : Hard exudates greater than or equal to standard photograph 5, but less than standard photograph 4 and Grade 5 : Hard exudates greater than or equal to standard photograph 4. These grades were further divided into three groups of patie nt severity as follows: Group 1 (absent or minimal hard exudates included patients with Grade 0, 1 or 2 hard exudates; Group 2 (hard exudates present included patients with Grade 3 or 4 hard exudates and Group 3 (prominent hard exudates included patient s with Grade 5 hard exudates. Fasting lipid profile including serum total cholesterol, low density lipoproteins, very low density lipoproteins, high density lipoproteins and triglycerides was obtained. Association of dyslipidemia with retinal hard exudates was analysed using one way ANOVA test. RESULTS: On statistical analysis with ANOVA test retinal hard exudates were significantly associated with elevated total cholesterol (p= .0001, triglycerides (p= .0001, serum LDL (p=.008, serum VLDL (p=.012, and negative correlation was found

  16. How to objectively assess jugular primary venous obstruction

    Directory of Open Access Journals (Sweden)

    Paolo Zamboni

    2014-12-01

    Full Text Available Last January The Lancet published the article by Traboulsee et al. Prevalence of extracranial venous narrowing on catheter venography in people with multiple sclerosis, their sibilings, and unrelated healthy controls: a blinded, case control study. These Authors confirmed the presence of chronic cerebrospinal venous insufficiency with a high prevalence of about 70% in the Canadian population, but without significant differences between patients and healthy controls, yet. However, they used a criterion never published to assess stenosis, in alternative to the classic measurement of the diameter in the segment immediately preceding the narrowest point. Traboulsee et al. measure the stenosis along the entire length of the internal jugular vein, by comparing the maximum diameter with the narrowest point. It has been demonstrated, from normal anatomy findings, how the jugular bulb diameter normally exceeds 50% of the minimum diameter of the internal jugular vein, clearly showing the reason why Traboulsee et al. did not find significant differences between people with multiple sclerosis, their sibilings, and unrelated healthy controls. Furthermore, as the outcome measure of Traboulsee et al., wall stenosis is a neglected part of primary venous obstruction, because in the majority of cases obstruction is the consequence of intraluminal obstacles, as a considerable part of truncular venous malformations, and/or compression; rarely of external hypoplasia. Finally, several recently published methods can be adopted for objective assessment of restricted jugular flow in course of chronic cerebrospinal venous insufficiency, by the means of non invasive magnetic resonance imaging, ultrasound and plethysmography. This may help us in improving the assessment of cerebral venous return in the near future.

  17. 原发性慢性静脉功能不全与基质金属蛋白酶、上皮间质转化之间的关系%The Relationship between Epithelial-mesenchimal Transition,Matrix Metalloproteinase and Primary Chronic Venous Insufficiency

    Institute of Scientific and Technical Information of China (English)

    周亚东

    2013-01-01

    原发性慢性静脉功能不全(PCVI)是血管外科的常见病与多发病,其病因及发病机制至今未明,关于其发病原因及机制有多种学说,其中血管重构学说是近年来研究的热点和重点,并且得到广泛认同.随着研究的深入,发现基质金属蛋白酶(MMPs)与静脉血管重构有着密切的联系,但具体作用机制不明,而近年来的研究发现,MMPs在上皮间质转化过程中也占重要地位.%Primary chronic venous insufficiency (PCVI )is a common and frequently-occurring disease in vascular surgery. The etiology and pathogenesis are still unknown, and there are a variety of theories ahout its causes and mechanisms, among which vascular remodeling theory is a widely recognized focus and emphasis of the research in recent years. Along with the deepening of the study it's found that matrix metalloproteinases ( MMPs ) and venous vascular remodeling are closely linked, but the exact mechanism is unknown. Recent studies have also found an important role of MMPs in the process of epithelial-mesenchymal transition.

  18. Overview of venous thromboembolism.

    Science.gov (United States)

    Abad Rico, José Ignacio; Llau Pitarch, Juan Vicente; Rocha, Eduardo

    2010-12-14

    Thrombosis occurs at sites of injury to the vessel wall, by inflammatory processes leading to activation of platelets, platelet adherence to the vessel wall and the formation of a fibrin network. A thrombus that goes on to occlude a blood vessel is known as a thromboembolism. Venous thromboembolism begins with deep vein thrombosis (DVT), which forms in the deep veins of the leg (calf) or pelvis. In some cases, the DVT becomes detached from the vein and is transported to the right-hand side of the heart, and from there to the pulmonary arteries, giving rise to a pulmonary embolism (PE). Certain factors predispose patients toward the development of venous thromboembolism (VTE), including surgery, trauma, hospitalization, immobilization, cancer, long-haul travel, increased age, obesity, major medical illness and previous VTE; in addition, there may also be a genetic component to VTE. VTE is responsible for a substantial number of deaths per annum in Europe. Anticoagulants are the mainstay of both VTE treatment and VTE prevention, and many professional organizations have published guidelines on the appropriate use of anticoagulant therapies for VTE. Treatment of VTE aims to prevent morbidity and mortality associated with the disease, and any long-term complications such as VTE recurrence or post-thrombotic syndrome. Generally, guidelines recommend the use of low molecular weight heparins (LMWH), unfractionated heparin (UFH) or fondaparinux for the pharmacological prevention and treatment of VTE, with the duration of therapy varying according to the baseline characteristics and risk profile of the individual. Despite evidence showing that the use of anticoagulation prevents VTE, the availability of several convenient, effective anticoagulant therapies and the existence of clear guideline recommendations, thromboprophylaxis is underused, particularly in patients not undergoing surgery. Greater adherence to guideline-recommended therapies, such as LMWH, which can be

  19. Clinical Features and Course of Patients with Peripheral Exudative Hemorrhagic Chorioretinopathy

    Directory of Open Access Journals (Sweden)

    Zafer Cebeci

    2016-10-01

    Full Text Available Objectives: To evaluate the clinical characteristics of patients who were followed in our clinic with the diagnosis of peripheral exudative hemorrhagic chorioretinopathy (PEHC. Materials and Methods: Medical records of 12 patients who were diagnosed with PEHC in İstanbul University İstanbul Faculty of Medicine, Department of Ophthalmology between July 2006 and June 2014 were reviewed retrospectively. Results: This study included 21 eyes of 12 patients. Four (33.3% of the patients were male and 8 (66.7% were female and ages ranged between 73 and 89 years. Eight (66.7% of the patients were referred to us with the diagnosis of choroidal mass. Unilateral involvement was found in 3 and bilateral involvement in 9 patients. Temporal quadrants were involved in all eyes. Fifteen eyes (71.4% had subretinal hemorrhage and hemorrhagic/serous retinal pigment epithelial detachment, 11 (52.4% had lipid exudation, 5 (23.8% had chronic retinal pigment epithelium alterations, 2 (9.5% had subretinal fibrosis and 1 (4.8% had vitreous hemorrhage. PEHC lesions were accompanied by drusen in 11 eyes (52.4%, geographic atrophy in 2 eyes (9.5%, and choroidal neovascularization scar in 2 eyes (9.5%. Treatment was done in both eyes of a patient for lesions which threatened the macula, in a patient with bilateral macular edema and in a patient with vitreous hemorrhage. The remaining eyes were followed-up without any treatment because the lesions did not threaten the macula and they showed no progression during follow-up. Conclusion: PEHC is a degenerative disease of peripheral retina that is seen in older patients, and signs of age-related macular degeneration (AMD may accompany this pathology. Especially in patients with AMD findings, the peripheral retina must be evaluated carefully for existing PEHC lesions.

  20. Placement of a port catheter through collateral veins in a patient with central venous occlusion.

    Science.gov (United States)

    Teichgräber, Ulf Karl-Martin; Streitparth, Florian; Gebauer, Bernhard; Benter, Thomas

    2010-04-01

    Long-term utilization of central venous catheters (CVCs) for parenteral nutrition has a high incidence of central venous complications including infections, occlusions, and stenosis. We report the case of a 31-year-old woman presenting with a malabsorption caused by short gut syndrome due to congenital aganglionic megacolon. The patient developed a chronic occlusion of all central neck and femoral veins due to long-term use of multiple CVCs over more than 20 years. In patients with central venous occlusion and venous transformation, the implantation of a totally implanted port system by accessing collateral veins is an option to continue long-term parenteral nutrition when required. A 0.014-in. Whisper guidewire (Terumo, Tokyo) with high flexibility and steerability was chosen to maneuver and pass through the collateral veins. We suggest this approach to avoid unfavorable translumbar or transhepatic central venous access and to conserve the anatomically limited number of percutaneous access sites.

  1. Epidemiology of recurrent venous thrombosis

    Directory of Open Access Journals (Sweden)

    D.D. Ribeiro

    2012-01-01

    Full Text Available Venous thrombosis, including deep vein thrombosis and pulmonary embolism, is a common disease that frequently recurs. Recurrence can be prevented by anticoagulants, but this comes at the risk of bleeding. Therefore, assessment of the risk of recurrence is important to balance the risks and benefits of anticoagulant treatment. This review briefly outlines what is currently known about the epidemiology of recurrent venous thrombosis, and focuses in more detail on potential new risk factors for venous recurrence. The general implications of these findings in patient management are discussed.

  2. Acroangiodermatite (pseudossarcoma de Kaposi: uma condição raramente reconhecida. Um caso na planta do pé associado a insuficiência venosa crônica Acroangiodermatitis (pseudo-Kaposi sarcoma: a rarely-recognized condition. A case on the plantar aspect of the foot associated with chronic venous insufficiency

    Directory of Open Access Journals (Sweden)

    Maria Inês Fernandes Pimentel

    2011-08-01

    Full Text Available A acroangiodermatite ou pseudossarcoma de Kaposi é entidade angioproliferativa incomum relacionada a insuficiência venosa crônica, fístulas arteriovenosas, membros paralisados, cotos de amputação, síndromes vasculares e condições trombóticas. Apresenta-se, em geral, como máculas, pápulas ou placas purpúricas no dorso dos pés (especialmente hálux e maléolos. Relatamos um caso de acroangiodermatite afetando a região plantar, por dois anos sem diagnóstico, para o qual a coloração histológica por hematoxilina-eosina e a marcação imuno-histoquímica com CD34 foram decisivas. A paciente tinha insuficiência venosa crônica e a lesão respondeu bem ao uso de bandagens elásticas e repouso com a perna elevadaAcroangiodermatitis, often known as pseudo-Kaposi sarcoma, is an uncommon angioproliferative entity related to chronic venous insufficiency, arteriovenous fistulae, paralysed limbs, amputation stumps, vascular syndromes and conditions associated with thrombosis. It presents most frequently as purple macules, papules or plaques in the dorsal aspects of the feet, especially the toes, and the malleoli. We report a case of acroangiodermatitis in the plantar aspect of the foot, misdiagnosed for two years, in which haematoxylin-eosin hystopathological stain and immunolabeling with CD34 histochemistry examination were decisive for diagnosis. Patient had chronic venous insufficiency. The lesion responded well to the treatment with a combination of leg elevation and compression

  3. Increased rheumatoid factor and deep venous thrombosis

    DEFF Research Database (Denmark)

    Meyer-Olesen, Christine L; Nielsen, Sune F; Nordestgaard, Børge G

    2015-01-01

    BACKGROUND: The risk of deep venous thrombosis is increased in patients with rheumatoid arthritis. We tested the hypothesis that increased concentrations of rheumatoid factor are associated with increased risk of deep venous thrombosis in individuals without autoimmune rheumatic disease...... venous thrombosis. CONCLUSIONS: Increased rheumatoid factor in the general population was associated with up to 3-fold increased long-term risk and up to 9-fold increased 1-year risk of deep venous thrombosis....... was incident deep venous thrombosis. There were no losses to follow-up. RESULTS: During 368381 person-years, 670 individuals developed deep venous thrombosis. A rheumatoid factor concentration ≥ vs venous thrombosis, with multivariable adjusted hazard...

  4. 腔内射频闭合术联合TriVex刨吸术治疗下肢静脉功能不全%Experience of endovenous radiofrequency combined with TriVex in treatment of chronic venous insufficiency in lower extremity

    Institute of Scientific and Technical Information of China (English)

    林少芒; 张智辉; 姚燕丹; 萧剑彬

    2009-01-01

    目的 评价腔内射频闭合术联合TriVex刨吸术治疗下肢静脉功能不全的疗效.方法 150例下肢静脉功能不全患者(150条患肢)随机分为A、B两组,每组75例.A组行大隐静脉射频闭合术联合曲张浅静脉TriVex刨吸术,B组行大隐静脉高位结扎抽剥术联合曲张浅静脉TriVex刨吸术.比较两组的手术时间、术后首次下床时间、术后48 h的疼痛视觉模拟评分(VAPS)值、术后住院天数、皮下血肿和皮下硬结的发生情况;比较患者对手术的自身评价、手术前后美国静脉联盟CEAP分级、临床严重程度计分(VCSS)、慢性静脉功能不全问卷(CIVIQ)生活质量评分的变化.结果 两组手术时间差异不显著,A组术后疼痛轻、下床时间早、住院天数少、皮下血肿发生率低,但皮下硬结发生率高于B组;术后4周对手术的评价A组优于B组;A、B手术前后CEAP分级、VCSS、CIVIQ评分变化差别有统计学意义(P0.05).结论 利用射频闭合术联合TriVex刨吸术治疗下肢静脉功能不全有效,且微创、并发症少、更具人性化;CEAP临床分级、VCSS临床计分和CIVIQ生活质量评分可用于评价其疗效.%Objective To evaluate therapeutic results of endovenous radiofrequency in combination with TriVex in treatment of venous insufficiency in lower extremities.Methods One hundred and fifty patients with chronic venous insufficiency (150 limbs) were randomly assigned to Group A (75 limbs) and Group B (75 limbs).Patients in Group A were treated with long saphenous veins radiofrequency ablation procedures in combination with TriVex.Patients in Group B were treated with long saphenous veins traditional stripping operation in combination with TriVex.The postoperative pain,average hospital stay and short-term results in hospital were compared between the two groups.Self-assessment of the operation 4 weeks after,changes of CEAP classification,venous clinical severity score (VCSS) and chronic venous

  5. Metabolomics of meat exudate: Its potential to evaluate beef meat conservation and aging

    Energy Technology Data Exchange (ETDEWEB)

    Castejón, David [Centro de Asistencia a la Investigación de Resonancia Magnética Nuclear y de Espín Electrónico, Universidad Complutense de Madrid, 28040 Madrid (Spain); García-Segura, Juan Manuel [Centro de Asistencia a la Investigación de Resonancia Magnética Nuclear y de Espín Electrónico, Universidad Complutense de Madrid, 28040 Madrid (Spain); Departamento de Bioquímica y Biología Molecular I, Facultad de Químicas, Universidad Complutense de Madrid, 28040 Madrid (Spain); Escudero, Rosa [Departamento de Nutrición, Bromatología y Tecnología de los Alimentos, Facultad de Veterinaria. Universidad Complutense de Madrid, 28040 Madrid (Spain); Herrera, Antonio [Departamento de Química Orgánica, Facultad de Químicas, Universidad Complutense de Madrid, 28040 Madrid (Spain); Cambero, María Isabel, E-mail: icambero@vet.ucm.es [Departamento de Nutrición, Bromatología y Tecnología de los Alimentos, Facultad de Veterinaria. Universidad Complutense de Madrid, 28040 Madrid (Spain)

    2015-12-11

    In this study we analyzed the exudate of beef to evaluate its potential as non invasive sampling for nuclear magnetic resonance (NMR) based metabolomic analysis of meat samples. Exudate, as the natural juice from raw meat, is an easy to obtain matrix that it is usually collected in small amounts in commercial meat packages. Although meat exudate could provide complete and homogeneous metabolic information about the whole meat piece, this sample has been poorly studied. Exudates from 48 beef samples of different breeds, cattle and storage times have been studied by {sup 1}H NMR spectroscopy. The liquid exudate spectra were compared with those obtained by High Resolution Magic Angle Spinning (HRMAS) of the original meat pieces. The close correlation found between both spectra (>95% of coincident peaks in both registers; Spearman correlation coefficient = 0.945) lead us to propose the exudate as an excellent alternative analytical matrix with a view to apply meat metabolomics. 60 metabolites could be identified through the analysis of mono and bidimensional exudate spectra, 23 of them for the first time in NMR meat studies. The application of chemometric tools to analyze exudate dataset has revealed significant metabolite variations associated with meat aging. Hence, NMR based metabolomics have made it possible both to classify meat samples according to their storage time through Principal Component Analysis (PCA), and to predict that storage time through Partial Least Squares (PLS) regression. - Highlights: • NMR spectra from beef samples and their exudates are very strongly correlated. • 23 metabolites not reported in previous NMR meat studies have been identified. • Meat exudate NMR spectra allow monitoring of biochemical changes related to aging. • PCA of exudate NMR spectra classified meat samples by their storage time. • The aging of a meat sample can be predicted by PLS analysis of its exudate.

  6. Intraretinal Exudates in Coats' Disease as Demonstrated by Spectral-Domain OCT

    OpenAIRE

    Rivka Kessner; Adiel Barak; Meira Neudorfer

    2012-01-01

    Purpose: To describe the spectral-domain optical coherence tomography (SD-OCT) findings in a case of Coats’ disease, with emphasis on the intraretinal exudates. Methods: Case report of a 4.5-year-old girl who presented with total exudative retinal detachment and organized exudates in a stellate configuration. SD-OCT was performed before and after treatment, which included surgical drainage of subretinal fluid and indirect laser application during the surgery. Results: At presentation, the SD-...

  7. Venous ulcers - self-care

    Science.gov (United States)

    Risk factors for venous ulcers include: Varicose veins History of blood clots in the legs ( deep vein thrombosis ) Blockage of the lymph vessels , which causes fluid to build up in the legs Older age, ...

  8. Venous Thromboembolism and Atherosclerosis link

    Institute of Scientific and Technical Information of China (English)

    刘泽霖

    2011-01-01

    @@ Past always venous thrombosis and arterial thrombo-sis as a separate system to be discussed, the main reason is because there is between the anatomical and pathologi-cal physiological differences, the clinical manifestations are very different.

  9. Central venous catheter - dressing change

    Science.gov (United States)

    ... during cancer treatment Bone marrow transplant - discharge Central venous catheter - flushing Peripherally inserted central catheter - flushing Sterile technique Surgical wound care - open Review Date 9/17/2016 Updated by: ...

  10. The Acute-Phase Proteins Serum Amyloid A and C Reactive Protein in Transudates and Exudates

    Science.gov (United States)

    Okino, Alessandra M.; Bürger, Cristiani; Cardoso, Jefferson R.; Lavado, Edson L.; Lotufo, Paulo A.; Campa, Ana

    2006-01-01

    The distinction between exudates and transudates is very important in the patient management. Here we evaluate whether the acute-phase protein serum amyloid A (SAA), in comparison with C reactive protein (CRP) and total protein (TP), can be useful in this discrimination. CRP, SAA, and TP were determined in 36 exudate samples (27 pleural and 9 ascitic) and in 12 transudates (9 pleural and 3 ascitic). CRP, SAA, and TP were measured. SAA present in the exudate corresponded to 10% of the amount found in serum, that is, the exudate/serum ratio (E/S) was 0.10 ± 0.13. For comparison, the exudate/serum ratio for CRP and TP was 0.39 ± 0.37 and 0.68 ± 0.15, respectively. There was a strong positive correlation between serum and exudate SAA concentration (r = 0.764;p < 0.0001). The concentration of SAA in transudates was low and did not overlap with that found in exudates (0.02-0.21 versus 0.8–360.5 g/mL). SAA in pleural and ascitic exudates results mainly from leakage of the serum protein via the inflamed membrane. A comparison of the E/S ratio of SAA and CRP points SAA as a very good marker in discriminating between exudates and transudates. PMID:16864904

  11. Squalamine lactate for exudative age-related macular degeneration.

    Science.gov (United States)

    Connolly, Brian; Desai, Avinash; Garcia, Charles A; Thomas, Edgar; Gast, Michael J

    2006-09-01

    Squalamine lactate inhibits angiogenesis by a long-lived, intracellular mechanism of action. The drug is taken up into activated endothelial cells through caveolae, small invaginations in the cellular membrane. Subsequently, the drug binds to and "chaperones" calmodulin to an intracellular membrane compartment and blocks angiogenesis at several levels. A series of basic investigations, preclinical studies, and human clinical trials have begun to establish the proof of concept, efficacy, and safety parameters for use of squalamine lactate as a therapeutic agent for exudative age-related macular degeneration and several types of malignancies.

  12. RheoStim: Development of an Adaptive Multi-Sensor to Prevent Venous Stasis

    OpenAIRE

    2016-01-01

    Chronic venous insufficiency of the lower limbs is often underestimated and, in the absence of therapy, results in increasingly severe complications, including therapy-resistant tissue defects. Therefore, early diagnosis and adequate therapy is of particular importance. External counter pulsation (ECP) therapy is a method used to assist the venous system. The main principle of ECP is to squeeze the inner leg vessels by muscle contractions, which are evoked by functional electrical stimulation...

  13. Multiple bacterial species reside in chronic wounds

    DEFF Research Database (Denmark)

    Gjødsbøl, Kristine; Christensen, Jens Jørgen; Karlsmark, Tonny;

    2006-01-01

    The aim of the study was to investigate the bacterial profile of chronic venous leg ulcers and the importance of the profile to ulcer development. Patients with persisting venous leg ulcers were included and followed for 8 weeks. Every second week, ulcer samples were collected and the bacterial s...

  14. Unna Boot in Venous Ulcer Treatment: Evaluation of 30 patients

    OpenAIRE

    Acıpayam, Mehmet; Zor, M. Hakan; Altınay, Levent; Uncu, Hasan; Halıcı, Ümit

    2013-01-01

    Aim: We aim to evaluate the results of the Unna boot practice with this prospective study. Material and Methods: This study included a total of 30 patients (1 female, 29 male; ages 23–56, mean 33.5) admitted to outpatient clinic with chronic venous leg ulcers. All patients were treated with Unna's boot. This treatment combined with oral calcium dobesilat 500 mg tabletorally twice a day. As the ulcer was healing, the treatment continued with calcium dobesilate tablets and compres...

  15. Management of varicose veins and venous insufficiency.

    Science.gov (United States)

    Hamdan, Allen

    2012-12-26

    Chronic venous disease, reviewed herein, is manifested by a spectrum of signs and symptoms, including cosmetic spider veins, asymptomatic varicosities, large painful varicose veins, edema, hyperpigmentation and lipodermatosclerosis of skin, and ulceration. However, there is no definitive stepwise progression from spider veins to ulcers and, in fact, severe skin complications of varicose veins, even when extensive, are not guaranteed. Treatment options range from conservative (eg, medications, compression stockings, lifestyle changes) to minimally invasive (eg, sclerotherapy or endoluminal ablation), invasive (surgical techniques), and hybrid (combination of ≥1 therapies). Ms L, a 68-year-old woman with varicose veins, is presented. She has had vein problems over the course of her life. Her varicose veins recurred after initial treatment, and she is now seeking guidance regarding her current treatment options.

  16. Efficacy of Percutaneous Point Incision Drainage in Chronic Venous Insufficiency Combined with Lipodermatosclerosis%点式引流手术在下肢慢性静脉功能不全伴脂质硬皮症中的疗效

    Institute of Scientific and Technical Information of China (English)

    李岩; 周海华; 宁勇; 万伯顺; 朱玉敏

    2015-01-01

    Objective:To explore the efficacy and feasibility of percutaneous point incision dralnage in patients with chronic venous insufficiency(CVI) combined with lipodermatosclerosis(LDS) .Methods:A total of 60 patients with CVI combined with LDS were randomly divided into the experiment group and the control group ,with 30 patients in each .High ligation and stripping on superficial veins of lower limbs and ligation on perforating veins of lower limbs combined with percutaneous point incision dralnage were conducted in the experiment group ,while high ligation and stripping on superficial veins of lower limbs and ligation on perforating veins of lower limbs was conducted in the control group .The thickness of subcutaneous sclerosis , the venous clinical severity score(VCSS) ,the chronic venous insufficiency questionnalre(CIVIQ) and the level of transforming growth factor‐β1(TGF‐β1) were compared between the two groups after the operations .Results:After the operations ,the patients had been followed up for 6 to 12 months with an average of 8 .6 months ,and the follow‐up rate was 100% .The clinical manifestation of LDS in the experiment group was relieved faster than that in the control group .There were 7 cases ,2 cases with subcutaneous induration at 3 months ,6 months after operation ,respectively ,in the experiment group ,while there were 22 cases ,15 cases ,respectively ,in the control group(P<0 .01) .VCSS was lower ,while CIVIQ was better ,in the experiment group ,than that in the control group ,at 1 ,3 ,6 month after surgery(P<0 .01) .The level of TGF‐β1 in the experiment group was significantly lower than that in the control group at 1 month after surgery (P< 0 .05) .Conclusions:High ligation and stripping on superficial veins of lower limbs and ligation on perforating veins of low limbs ,combined with percutaneous point incision dralnage ,demonstrated a good efficacy on CVI combined with LDS .%目的:探讨点式引流手术在下肢慢性静脉功能不全(chronic

  17. Correlation between health-related quality of life and venous leg ulcer's severity and characteristics: a cross-sectional study.

    Science.gov (United States)

    González de la Torre, Héctor; Quintana-Lorenzo, María L; Perdomo-Pérez, Estrella; Verdú, José

    2017-04-01

    This study aims to determine health-related quality of life (HRQoL) in patients suffering with venous ulceration and to correlate wound's severity status with HRQoL loss as well as identify the aspects of HRQoL most negatively affected by the presence of venous ulcers. In this observational, cross-sectional, descriptive, analytical multi-centre study, data was compiled over a period of 3·5 months. Thrity-four patients with venous ulceration were recruited. The RESVECH 2·0 scale was used to monitor wounds. The MAID scale was used to measure wound's severity. The Charing Cross Venous Ulcer Questionnaire (CCVUQe) (Spanish version) was used to evaluate quality of life. The mean CCVUQe score was 60·58 ± 16·04. The HRQoL dimension most affected was 'Emotional state' (mean score = 77. 67 ± 17·34). The average RESVECH 2.0 score for the wounds was 13·15 ± 5·07. A statistically significant association between total CCVUQ-e score and total RESVECH 2.0 score was detected [Pearson correlation coefficient r = 0·546 (P ≤ 0·001)]. Venous ulcers affect patients' HRQoL, particularly their emotional status. There is a relationship between the severity of the wound and loss of HRQoL. The presence of non-viable tissue, poor exudate control and infection all determine loss of HRQoL. New studies are needed to confirm these findings.

  18. Contemporary diagnosis of venous malformation

    Directory of Open Access Journals (Sweden)

    Lee BB

    2013-11-01

    Full Text Available BB Lee,1 I Baumgartner21Department of Surgery, George Washington University, Washington, DC, USA; 2Swiss Cardiovascular Center, University Hospital Bern, Bern, SwitzerlandAbstract: Venous malformation is a congenital vascular malformation resulting from defective development during various stages of embryogenesis and selectively affecting the venous system. Depending on the embryologic stage when the developmental arrest occurred, the clinical presentation of venous malformation is extremely variable in location, extent, severity, natural progression, and hemodynamic impact. Extratruncular lesions occur in the earlier stages of embryonic life, and retain characteristics unique to mesenchymal cells (angioblasts, growing and proliferating when stimulated internally (eg, by menarche, pregnancy, and hormones or externally (eg, by trauma or surgery. These lesions also have a significant hemodynamic impact on the venous system involved, in addition to the risk of localized intravascular coagulopathy. However, truncal lesions, as defective developments along the late stage, no longer carry the risk of proliferation and recurrence due to lack of mesenchymal characteristics. Although, they often have serious hemodynamic consequences due to direct involvement of the main vein trunk. Therefore, a thorough clinical history and careful physical examination should be followed by an appropriate combination of noninvasive and less invasive tests (eg, Doppler ultrasonography, magnetic resonance imaging, computed tomography to confirm the clinical impression as well as to define the extent and severity of the venous malformation. Invasive tests, eg, phlebography or angiography, are seldom needed for the diagnosis per se. Additional evaluation for coagulation abnormalities, eg, D-dimer and fibrinogen levels, is generally recommended, especially for the treatment of surgery and endovascular candidates with extensive lesions to assess the localized intravascular

  19. 下肢慢性静脉功能不全外科治疗的现状与争议%Discussion on the surgical treatment of chronic venous insufficiency

    Institute of Scientific and Technical Information of China (English)

    王深明

    2005-01-01

    下肢慢性静脉功能不全(chmnic venous insuffciencv,CVI)是常见的血管外科疾病,多种静脉疾病均可导致静脉功能不全,按其病因可分为原发性、继发性、先天性;按解剖范围可分为浅、深和交通静脉3个系统。下肢CVI的外科治疗主要用于原发性CVI和部分继发性CVI的病例。虽深静脉瓣膜重建术对纠正深静脉反流确有一定疗效,

  20. Pea-root exudates and their effect upon root-nodule bacteria

    NARCIS (Netherlands)

    Egeraat, van A.W.S.M.

    1972-01-01

    The main purpose of this investigation was to study the exudation (mechanism, sites) of various compounds by roots of pea seedlings in relation to the growth of Rhizobium leguminosarum.Chapter 1 gives a survey of the literature pertaining to plant-root exudates and their influence upon soil microorg

  1. Transcriptomic profiling of Bacillus amyloliquefaciens FZB42 in response to maize root exudates

    LENUS (Irish Health Repository)

    Fan, Ben

    2012-06-21

    AbstractBackgroundPlant root exudates have been shown to play an important role in mediating interactions between plant growth-promoting rhizobacteria (PGPR) and their host plants. Most investigations were performed on Gram-negative rhizobacteria, while much less is known about Gram-positive rhizobacteria. To elucidate early responses of PGPR to root exudates, we investigated changes in the transcriptome of a Gram-positive PGPR to plant root exudates.ResultsBacillus amyloliquefaciens FZB42 is a well-studied Gram-positive PGPR. To obtain a comprehensive overview of FZB42 gene expression in response to maize root exudates, microarray experiments were performed. A total of 302 genes representing 8.2% of the FZB42 transcriptome showed significantly altered expression levels in the presence of root exudates. The majority of the genes (261) was up-regulated after incubation of FZB42 with root exudates, whereas only 41 genes were down-regulated. Several groups of the genes which were strongly induced by the root exudates are involved in metabolic pathways relating to nutrient utilization, bacterial chemotaxis and motility, and non-ribosomal synthesis of antimicrobial peptides and polyketides.ConclusionsHere we present a transcriptome analysis of the root-colonizing bacterium Bacillus amyloliquefaciens FZB42 in response to maize root exudates. The 302 genes identified as being differentially transcribed are proposed to be involved in interactions of Gram-positive bacteria with plants.

  2. Bioavailability of zinc and phosphorus in calcareous soils as affected by citrate exudation

    NARCIS (Netherlands)

    Duffner, A.; Hoffland, E.; Temminghoff, E.J.M.

    2012-01-01

    Aims Zinc (Zn) and phosphorus (P) deficiency often occurs at the same time and limits crop production in many soils. It has been suggested that citrate root exudation is a response of plants to both deficiencies. We used white lupin (Lupinus albus L.) as a model plant to clarify if citrate exuded by

  3. Evaluating the role of root citrate exudation as a mechanism of aluminium resistance in maize genotypes

    NARCIS (Netherlands)

    Mariano, E.D.; Keltjens, W.G.

    2003-01-01

    Organic anion exudation by roots as a mechanism of aluminium (Al) resistance has been intensively studied lately. In the present study, we evaluated qualitative and quantitative aspects of root exudation of organic anions in maize genotypes of distinct sensitivity to Al in response to Al exposure. R

  4. Influence of plant root exudates on the mobility of fuel volatile compounds in contaminated soils.

    Science.gov (United States)

    Balseiro-Romero, María; Kidd, Petra S; Monterroso, Carmela

    2014-01-01

    Vegetation and its associated microorganisms play an important role in the behaviour of soil contaminants. One of the most important elements is root exudation, since it can affect the mobility, and therefore, the bioavailability of soil contaminants. In this study, we evaluated the influence of root exudates on the mobility of fuel derived compounds in contaminated soils. Samples of humic acid, montmorillonite, and an A horizon from an alumi-umbric Cambisol were contaminated with volatile contaminants present in fuel: oxygenates (MTBE and ETBE) and monoaromatic compounds (benzene, toluene, ethylbenzene and xylene). Natural root exudates obtained from Holcus lanatus and Cytisus striatus and ten artificial exudates (components frequently found in natural exudates) were added to the samples, individually and as a mixture, to evaluate their effects on contaminant mobility. Fuel compounds were analyzed by headspace-gas chromatography-mass spectrometry. In general, the addition of natural and artificial exudates increased the mobility of all contaminants in humic acid. In A horizon and montmorillonite, natural or artificial exudates (as a mixture) decreased the contaminant mobility. However, artificial exudates individually had different effects: carboxylic components increased and phenolic components decreased the contaminant mobility. These results established a base for developing and improving phytoremediation processes of fuel-contaminated soils.

  5. COMPREHENSIVE CHEMICAL PROFILING OF GRAMINEOUS PLANT ROOT EXUDATES USING HIGH-RESOLUTION NMR AND MS. (R825433C007)

    Science.gov (United States)

    Root exudates released into soil have important functions in mobilizing metal micronutrients and for causing selective enrichment of plant beneficial soil micro-organisms that colonize the rhizosphere. Analysis of plant root exudates typically has involved chromatographic meth...

  6. Effects of various environmental conditions on the transformation of chlorinated solvents by Methanosarcina thermophila cell exudates.

    Science.gov (United States)

    Baeseman, J L; Novak, P J

    2001-12-20

    Several microbiologically produced biomolecules have been shown to degrade chlorinated contaminants found in groundwater systems. It was discovered that the cell-free exudates of the methanogen Methanosarcina thermophila were capable of carbon tetrachloride (CT) and chloroform (CF) degradation. Characterization of the exudates suggested that the active agents were porphorinogen-type molecules, possibly containing zinc. This research was performed to determine if the exudates from M. thermophila could be used for remediation purposes. The cell exudates were found to be capable of degrading CT, CF, tetrachloroethene, trichloroethene, and 1,1,1-trichloroethane. CT degradation was used to gauge exudate activity under a variety of conditions that would be encountered in the environment. The cell exudates were active when incubated in two types of soil matrices and at temperatures ranging from 4 to 23 degrees C. Over a 35-day period approximately 10.2 micromoles of CT were degraded by M. thermophila exudates. To test the hypothesis that the exudates contained either a zinc porphorinogen or a quinone, experiments were performed with zinc 5,10,15,20-tetra (4-pyridyl)-21 H, 23 H-porphine tetrakis, protoporphyrin IX zinc, and juglone. The two zinc porphyrins were capable of mediating CT degradation at rates comparable to those observed with the M. thermophila exudates; however, juglone was only capable of very slow CT transformation. The electron-transfer activity of the M. thermophila cell exudates was therefore more consistent with the activity of porphorinogens rather than quinones. Finally, in two enrichment cultures established from aquifer material and marine sediment, the possibility of excreted agents capable of degrading CT was evident.

  7. The effects of cotton root exudates on the growth and development of Verticillium dahliae

    Institute of Scientific and Technical Information of China (English)

    Yuxiang WU; Weiping FANG; Shuijin ZHU; Kuiying JIN; Daofan JI

    2008-01-01

    The effects of upland cotton root exudates on the growth and development of Verticillium dahliae were studied, through the compared analysis of the root exudates components between the resistant and suscept-ive cotton materials, using a pair of resistant and sus-ceptive isogenic lines to Verticillium wilt, Z5629 and Z421, as well as 4 other upland cotton cultivars with different resistant levels of Verticillium wilt. The results showed that the amino acids in the root exudates of the resistant cultivars were much less than that of the sus-ceptible ones. Compared with the susceptible ones, there were a lack of aspartic acid, threonine, glutamic acid, alanine, isoleucine, leucine, phenylalanine, lysine and proline in the root exudates from the resistant cul-tivars. On the contrary, arginine was lacking in the sus-ceptive cultivars. The saccharide types in the root exudates were no different between the two kinds of cultivars, but the contents of glucose, fructose and suc-rose in the root exudates of the susceptible varieties were much higher than those in the resistant ones. The experiment of Verticillium dahliae culture showed that the cotton root exudates from resistant cultivars can effectively restrain the spore germination and mycelium growth of Verticillium dahliae, and the argi-nine was the leading amino acid in this inhibitory action, besides the nutrition of the root exudates. However, the cotton root exudates from the susceptive cotton cultivars can improve the growth and develop-ment of Verticillium dahliae effectively; among the amino acid in the exudates, alanine was the most active one in this stimulating function.

  8. Cerebral venous thrombosis in childhood

    Energy Technology Data Exchange (ETDEWEB)

    Huisman, T.A.G.M.; Martin, E.; Willi, U.V. [Dept. of Diagnostic Imaging and Radiology, University Children' s Hospital Zurich (Switzerland); Holzmann, D. [Dept. of Otorhinolaryngology, University Children' s Hospital Zurich, Zurich (Switzerland)

    2001-09-01

    This was a retrospective study to determine different etiologies of cerebral venous thrombosis (CVT) in childhood and to correlate extent and location of thrombosis with the etiology and the age of the child as well as the final outcome. In addition, the radiologic approach is discussed. This was a retrospective analysis of 19 children with CVT. The children were examined by contrast-enhanced dynamic CT. Radiologic findings were correlated with the etiology of CVT. Cerebral venous thrombosis is not as infrequent in children as has been thought. Cerebral venous thrombosis in children can occur due to trauma (n=9), infections (n=7), or coagulation disorders (n=3). Extent and location of thrombosis, as well as complications, final outcome, and therapy, depend on the etiology. Computed tomography remains a valuable primary imaging modality in the diagnosis of CVT in the acutely injured or diseased child. (orig.)

  9. Isoflavanones from the allelopathic aqueous root exudate of Desmodium uncinatum.

    Science.gov (United States)

    Tsanuo, Muniru K; Hassanali, Ahmed; Hooper, Antony M; Khan, Zeyaur; Kaberia, Festus; Pickett, John A; Wadhams, Lester J

    2003-09-01

    Three isoflavanones, 5,7,2',4'-tetrahydroxy-6-(3-methylbut-2-enyl)isoflavanone (1), 4",5"-dihydro-5,2',4'-trihydroxy-5"-isopropenylfurano-(2",3";7,6)-isoflavanone (2) and 4",5"-dihydro-2'-methoxy-5,4'-dihydroxy-5"-isopropenylfurano-(2",3";7,6)-isoflavanone (3) and a previously known isoflavone 5,7,4'-trihydroxyisoflavone [genistein (4)] were isolated and characterised spectroscopically from the root exudate of the legume Desmodium uncinatum (Jacq.) DC. We propose the names uncinanone A, B, and C for compounds 1, 2 and 3, respectively. Isolated fractions containing uncinanone B (2) induced germination of seeds from the parasitic weed Striga hermonthica (Del.) Benth. and fractions containing uncinanone C (3) moderately inhibited radical growth, the first example of a newly identified potential allelopathic mechanism to prevent S. hermonthica parasitism.

  10. Physicochemical and functional parameters of Cochlospermum vitifolium (bototo gum exudate

    Directory of Open Access Journals (Sweden)

    Maritza Coromoto Martínez

    2016-12-01

    Full Text Available The physicochemical parameters of Cochlospermum vitifolium they were evaluated and were linked to certain functional properties of industrial interest. The physicochemical parameters were determined by the classic methodology used for carbohydrates and the functional properties, as reported in the literature. The results obtained showed that the gum object of this study is low soluble in water, which corresponds with relatively high values of swelling indexes and water absorption capacity. Also, the intrinsic viscosity of the C. vitifolium exudate was related to a high molar mass, in the order of 106. Its emulsifying capacity is high, which is attributed to hydrophobic groups present in its structure. The gum gels at a minimum concentration, similar to that of the gum karaya (4.5%, but the gel that forms agglomerates, it is not uniform. The C. vitifolium gum exhibits important physicochemical and functional parameters which could serve as a criterion for testing its use in various industries.

  11. Peripheral Exudative Hemorrhagic Chorioretinopathy: A Variant of Polypoidal Choroidal Vasculopathy?

    Directory of Open Access Journals (Sweden)

    Arman Mashayekhi

    2013-01-01

    Full Text Available Purpose: To report a case of peripheral exudative hemorrhagic chorioretinopathy (PEHCR in an elderly patient. Case Report: A 74-year-old Caucasian woman, with a 20-year history of a stable choroidal nevus in her right eye, was referred for evaluation of two small hemorrhagic pigment epithelial detachments (PEDs affecting the temporal peripheral fundus of the same eye. Nine months later, the lesions became larger and indocyanine green angiography revealed polypoidal choroidal vascular changes corresponding to the location of the ophthalmoscopically visible PEDs. Despite one session of verteporfin photodynamic therapy, the lesions continued to enlarge eventually resulting in the development of a large hemorrhagic PED, which failed to respond to two subsequent injections of intravitreal bevacizumab. The final ophthalmoscopic appearance of the large hemorrhagic PED was typical of PEHCR. Conclusion: This case suggests that polypoidal choroidal vascular changes similar to that seen in our patient may underlie the development of PEHCR in some cases.

  12. A young man with nonhealing venous ulcers

    NARCIS (Netherlands)

    Vloedbeld, M. G.; Venema, A. W.; Smit, A. J.

    2006-01-01

    A 35-year-old man presented with nonhealing ulcers at an atypical location on his left foot, caused by a combination of venous insufficiency (after deep venous thrombosis) and arterial insufficiency. The underlying cause was Buerger's disease.

  13. [Automatic regulator of venous pressure and venous outflow in the perfusion system].

    Science.gov (United States)

    Smirnov, L M; Levinskiĭ, M M; Kharnas, S Sh; Cherniak, V A

    1976-01-01

    A scheme for automatic regulation of the venous pressure and venous blood outflow during extracorporeal circulation is proposed. The system consists of a photoelectric sensor placed on a tube led out of the major venous trunkline, a converter and an electromechanical eccentric clamp that compresses the venous trunkline, all of which secures stabilization of the controlled values.

  14. Observing the Effect of Aescuven Forte combined with Diosmin tablets in treatment of Chronic venous insufficiency%迈之灵合并地奥司明治疗下肢静脉功能不全的疗效观察

    Institute of Scientific and Technical Information of China (English)

    陈培栋

    2015-01-01

    目的:观察迈之灵合并地奥司明治疗下肢静脉功能不全的临床疗效。方法:随机抽取2012年4月~2013年6月在我院住院的患者50例(患有下肢静脉功能不全)。采用双盲随机分组法分为两组,其中25例单用地奥司明片,每日午餐、晚餐时各服1次,1片/次。联合治疗组25例,服用地奥司明片,每日午餐、晚餐时各服1次,1片/次;同时服用迈之灵片,每日早晚各服1次,2片/次,疗程为20d。结果:合并治疗组治疗前后小腿周径的变化有显著差异,联合治疗组治愈率及总有效率分别为40%、92%,单用地奥司明治疗组治愈率及总有效率分别为24%、68%。结论:迈之灵合并地奥司明治疗下肢静脉功能不全的疗效确切、可靠,值得推广。%Objective:To study the evaluation of Aescuven Forte combined with Diosmin tablets in treatment of Chronic venous insufficiency. Methods:50 cases of patients being in Chronic venous insufficiency from April 2012~June 2013 in our hospital,were randomly divided into one group of 25 cases, single use of Dosimin tablets ,oral 0.45g per time,two times a day, the other group of 25 cases ,oral administration of diosmin tablets 0.45g per time,two times per day, Aescuven Forte 2 tablets per time ,two times a day.Two groups of treatment for 20 days. Results:After 20 days treatment, there were significant differences between combined treatment group in crus weeks diameter. The clinical cure rate and total effective rate was 40% and 92% in the combined treatment group , 24% and 68%in monotherapy group. Conclusion:The effect of combing Aescuven Forte with Dosimin on Chronic venous insufficiency is exact and reliable.

  15. Usefulness of serum-ascites albumin difference in separating transudative from exudative ascites. Another look.

    Science.gov (United States)

    Mauer, K; Manzione, N C

    1988-10-01

    The serum-ascites albumin difference is reported to be superior to ascitic total protein, ascitic-to-serum total protein ratio, lactic dehydrogenase, and ascitic-to-serum lactic dehydrogenase ratio in differentiating between ascites from liver disease and malignant ascites, S-A greater than 1.1 reflecting portal hypertension. We analyzed ascitic fluid from 46 consecutive patients with chronic liver disease, 28 patients with ascites associated with malignancy, 10 patients with right-sided heart failure, 4 patients with hypothyroidism, and 6 patients with miscellaneous causes of ascites to determine if this albumin difference is indeed a more valuable parameter. Analysis of our data confirms with a larger number of patients that the serum-ascites albumin difference is a more reliable indicator of transudative ascites, better termed portal hypertensive ascites. Malignant ascites without liver metastases had features of nonportal hypertensive ascites, and the serum-ascites albumin difference confirms this. The characteristics of malignant ascites associated with liver metastases, however, resemble those of the portal hypertensive ascites complicating liver disease. This new parameter is also helpful in distinguishing congestive heart failure with high protein ascites and portal hypertensive ascitic features from malignant ascites without liver metastases. Of particular note, myxedematous ascitic fluid, classically categorized as exudative, had an S-A greater than 1.1, indicating the possible role of portal hypertension in the development of ascites in these patients.

  16. Diagnostic Value and Safety of Medical Thoracoscopy in the Management of Exudative Pleural Effusion

    Directory of Open Access Journals (Sweden)

    Mehmet Akif Özgül

    2016-12-01

    Full Text Available Objective: Medical thoracoscopy is a minimally invasive procedure that is performed by experienced pulmonologists under local anesthesia and conscious intravenous sedation. It allows direct observation and evaluation of the pleural space. Our aim is to evaluate the diagnostic efficacy and safety of this procedure while presenting our results of medical thoracoscopy performed by rigid thoracoscopy in our clinic. Methods: Thirty-seven patients who had gone thorough medical thoracoscopy between March 2011 and August 2014 were evaluated retrospectively. Results: Of these 37 patients, 26 were male and the average age was 50.94±15.38 years. Fourteen patients had right-sided pleural effusion, whereas 23 had left-sided pleural effusion. Closed pleural biopsy was performed previously in 16 patients with no diagnostic results. In 36 patients (97.3%, a specific diagnosis was achieved. One patient, diagnosed as lymphocytic pleuritis by medical thoracoscopy, underwent decortication and the pathology was consistent with biphasic malignant pleural mesothelioma. Another patient, diagnosed as chronic nonspecific pleuritis with medical thoracoscopy, underwent decortication and the diagnosis was fibrinous pleuritis characterized by extensive fibrosis. Three patients had expansion defects during the post-operative period. Hemothorax occurred in one patient that died of respiratory failure on day 34 of hospitalization. The median length of stay in the hospital after the procedure was 5 days (1–34. Conclusion: Medical thoracoscopy is a secure procedure with high diagnostic value in the management of exudative pleural effusion.

  17. Central venous line complications and tip detection

    OpenAIRE

    Ameneh Rezaee Gheshlaghi; Hamid Zamani Moghadam Dolu; Elham Pishbin; Maryam Salehi

    2015-01-01

    Central venous line is one of a creative instrument that saves human’s life in critical medical situation. Central venous line access is frequently involved in the disease management. It is used for rapid fluid therapy, transvenous pacemakers, infusion of some medications, hemodialysis or plasmapheresis and etc. Most of the emergency departments have some staffs that are trained for central venous line insertion but related complications occur during central venous line placement.Central veno...

  18. [Female gonadal venous insufficiency].

    Science.gov (United States)

    Fernández-Samos, R; Zorita, A; Ortega, J M; Morán, C; Morán, O; Vázquez, J; Vaquero, F

    1993-01-01

    The varicocele is a disease recognized and studied in the man. Dilatation of the ovarian veins and the pelvic varicosities secondaries to a varicocele in the woman is a rarely described disease but, if it were researched, it could be more frequent. Diverse syndromes of chronic abdominal pain in the woman with unrecognized etiology and associated with urologic and/or gynecologic symptomatology could be caused by this pathology, but the absence of a clinical description difficult the diagnosis of the most part of cases. The practice of gonadal selective venographies shows a high percentage of dilatation of the gonadal veins associated to a dilatation of the pelvic veins and of the lower limbs veins. The study of the anatomy of the gonadal veins shows diverse anomalies respect to the classical descriptions. Furthermore, the varicocele could be the cause of a high part of the "essential" varicosities presents during the pregnancy. We present a case that instead of being treated by Services of Urology or Gynecology, it was treated by the Vascular Surgery Service. So, the literature about the respect was reviewed. We think that, some entities, like the feminine varicocele, ovarian vein syndrome, pelvic congestion syndrome chronic pelvic pain, pelvic varicosities, vulvar varicosities and some "essential" pregnant varicosities at the lower limbs could be enclosed into the same clinical entity (with a common etiology, physiopathology, clinical presentation and treatment). It should be intending to unify criteria (etiologic, diagnostic and therapeutics criteria) by the different Specialized Unities in such type of pathology.

  19. Compartment syndrome in patients with massive venous thrombosis after inferior vena cava filter placement.

    Science.gov (United States)

    Mesfin, Addisu; Lum, Ying Wei; Nayfeh, Tariq; Mears, Simon C

    2011-03-11

    Massive venous thrombosis, which can occur acutely after inferior vena cava filter placement, has 2 forms: phlegmasia cerulea dolens and phlegmasia alba dolens. In phlegmasia cerulea dolens, complete occlusion of venous outflow occurs. In the milder phlegmasia alba dolens version, collateral venous flow out of the limb remains despite the venous thrombosis. This article presents, to our knowledge, the first 2 cases of massive venous thrombosis (1 phlegmasia cerulea dolens, 1 phlegmasia alba dolens) below inferior vena cava filters occurring after the acute period. Phlegmasia cerulea dolens and phlegmasia alba dolens can present as compartment syndrome. Prompt fasciotomies were performed, but the underlying massive venous thrombosis was not addressed surgically. Phlegmasia cerulea dolens and phlegmasia alba dolens have high morbidity and mortality. The patient with phlegmasia alba dolens required leg and thigh fasciotomies and eventually required an above-knee amputation. The patient with phlegmasia cerulea dolens developed compartment syndrome in the left leg, right leg, and right thigh. Although he underwent decompression of all of these compartments, he died from multiple organ failure. A multidisciplinary approach with the vascular service and the intensivists is required in the treatment of patients with massive venous thrombosis. Treatment goals include preventing additional propagation of the thrombus via anticoagulation, with strong consideration for catheter-directed thrombolysis or thrombectomy and fasciotomies for compartment syndrome. The orthopedic surgeon should keep phlegmasia cerulea dolens and phlegmasia alba dolens in the differential for compartment syndrome, especially in patients who have had a history of acute or chronic inferior vena cava filter placement.

  20. Anomalous pulmonary venous return: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Park, Gyeong Min; Kang, MinJin; Lee, Han Bee; Bae, Kyung Eun; Lee, Jaehe; Kim, Jae Hyung; Jeong, Myeong Ja; Kang, Tae Kyung [Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of)

    2013-10-15

    Partial anomalous pulmonary venous return is a type of congenital pulmonary venous anomaly. We present a rare type of partial pulmonary venous return, subaortic vertical vein drains left lung to superior vena cava, accompanying hypoplasia of the ipsilateral lung and pulmonary artery. We also review the previous report and relationship of these structures.

  1. The expression of matrix metalloproteinase-9 in the chronic venous ulcer tissues and significance%基质金属蛋白酶-9在静脉性溃疡组织中的表达及意义

    Institute of Scientific and Technical Information of China (English)

    杨帆; 李金朋; 王勇

    2016-01-01

    Objective To observe the expression of matrix metalloproteinase-9 (MMP-9) in the tissues of venous ulcer,and to explore the pathological mechanism of angiogenesis dysfunction.Methods Sixty-four ulcer samples were obtained from the patients [(56.27 ± 5.12) years old] including 52 males and 12 females with lower extremity venous ulcer treated in our hospital.The ulcer samples were divided into 2-,3-,4-,and 5-week groups based on the course of the disease,and 50 cases of traumatic ulcer [(54.42 ±6.87) years old] served as the contol group.The expression of MMP-9,and vascular endothelial growth factor receptor 2 (VEGFR2) was analyzed by Western blotting and grey ratio detection.The immunofluorescence double staining was used to observe the correlation of MMP-9/CD31 expression.Results There was significant difference in the grey ratio detection of MMP-9 between 4-,and 5-week groups with 2-,3-week groups (0.181 ± 0.031,0.007 ± 0.014 vs.0.512 ± 0.113,0.685 ± 0.174);VEGFR2 between 4-,and 5-week groups and 3-week group (0.614 ± 0.143,0.497 ± 0.262 vs.1.465 ± 0.074,P < 0.05).Immunofluorescence double staining revealed that the levels of MMP-9/CD31 was also markedly decreased in the venous ulcer group as compared with those in traumatic ulcer group,and the correlation was observed.Conclusion The low expression of VEGFR2 that is regulated by MMP-9 possibly is associated with angiogenesis dysfunction in the tissues of venous ulcer.%目的 观察静脉性溃疡组织中的基质金属蛋白酶-9(MMP-9)表达,探讨静脉性溃疡血管再生障碍机制.方法 采集我院64例静脉性溃疡患者溃疡创面标本,其中男52例,女12例,平均年龄(56.27±5.12)岁,按病程分为2周组、3周组、4周组、5周组,以创伤性溃疡50例作为对照组,平均年龄(54.42±6.87)岁,Western blot检测各组溃疡创面MMP-9、血管内皮生长因子受体2(VEGFR2)表达趋势;用免疫荧光双染色检测MMP-9/CD31在溃疡组

  2. Endovascular treatment options in the management of lower limb deep venous thrombosis.

    Science.gov (United States)

    Nazir, Sarfraz Ahmed; Ganeshan, Arul; Nazir, Sheraz; Uberoi, Raman

    2009-09-01

    Lower limb deep vein thrombosis (DVT) is a common cause of significant morbidity and mortality. Systemic anticoagulation therapy is the mainstay of conventional treatment instituted by most physicians for the management of DVT. This has proven efficacy in the prevention of thrombus extension and reduction in the incidence of pulmonary embolism and rethrombosis. Unfortunately, especially in patients with severe and extensive iliofemoral DVT, standard treatment may not be entirely adequate. This is because a considerable proportion of these patients eventually develops postthrombotic syndrome. This is characterized by chronic extremity pain and trophic skin changes, edema, ulceration, and venous claudication. Recent interest in endovascular technologies has led to the development of an assortment of minimally invasive, catheter-based strategies to deal with venous thrombus. These comprise catheter-directed thrombolysis, percutaneous mechanical thrombectomy devices, adjuvant venous angioplasty and stenting, and inferior vena cava filters. This article reviews these technologies and discusses their current role as percutaneous treatment strategies for venous thrombotic conditions.

  3. Association between venous leg ulcers and sex chromosome anomalies in men.

    Science.gov (United States)

    Gattringer, Cornelia; Scheurecker, Christine; Höpfl, Reinhard; Müller, Hansgeorg

    2010-11-01

    We report here two cases of men, aged 46 and 23 years, with refractory chronic venous leg ulcers in association with sex chromosome aberrations: one with a 47,XXY/48,XXXY karyotype (Klinefelter syndrome) and the other with a 47,XYY karyotype (Jacob syndrome). In both patients, the occurrence of leg ulcers was the reason for seeking medical care; their medical history was other-wise unremarkable. Chromosomal analyses were performed due to the unusually young age for development of venous leg ulcers. The pathophysiology behind the occurrence of venous leg ulcers in patients with numerical aberrations of the sex chromosomes is incompletely understood. Involvement of elevated plasminogen activator inhibitor-1 levels in the pathogenesis of venous leg ulcers has been reported in patients with Klinefelter syndrome. Notably, our patient with 47,XXY/48,XXXY presented with androgen deficiency but normal plasminogen activator inhibitor-1 activity.

  4. Bioassay and Identification of Root Exudates of Three Fruit Tree Species

    Institute of Scientific and Technical Information of China (English)

    Jiang-Hong Zhang; Zhi-Quan Mao; Li-Qin Wang; Huai-Rui Shu

    2007-01-01

    A laboratory bioassay was designed to determine the allelopathic potential of root exudates of three fruit tree species on apple germination. The results showed that root exudates of apple (Malus pumila L.) and peach (Prunus persica L.), each at concentrations of 0.02 and 0.2 mg/L, inhibited germination and radicle growth of apple seeds by 56.7%, 60.7%, 51.5%, and 59.3%, respectively. The corresponding shoot growth inhibition rate was 49.5%, 46.7%, 36.4%, and 44%, respectively. Root exudates of jujube (Ziziphus jujuba Mill.) had no significant effect on apple seeds.Qualitative determination of root exudates of apple, peach, and jujube tree was developed with gas chromatography-mass spectrometry. The root exudates of apple seedlings mainly contain organic acids, glycol, esters, and benzenphenol derivatives. Peach root exudates contained phenolic acids and benzenphenol derivatives in addition to two unidentified compounds. The root exudates of jujube did not contain any phenolic acids.

  5. Biological oxygen demand optode analysis of coral reef-associated microbial communities exposed to algal exudates

    Directory of Open Access Journals (Sweden)

    AK Gregg

    2013-07-01

    Full Text Available Algae-derived dissolved organic matter has been hypothesized to induce mortality of reef building corals. One proposed killing mechanism is a zone of hypoxia created by rapidly growing microbes. To investigate this hypothesis, biological oxygen demand (BOD optodes were used to quantify the change in oxygen concentrations of microbial communities following exposure to exudates generated by turf algae and crustose coralline algae (CCA. BOD optodes were embedded with microbial communities cultured from Montastraea annularis and Mussismilia hispida, and respiration was measured during exposure to turf and CCA exudates. The oxygen concentrations along the optodes were visualized with a low-cost Submersible Oxygen Optode Recorder (SOOpR system. With this system we observed that exposure to exudates derived from turf algae stimulated higher oxygen drawdown by the coral-associated bacteria than CCA exudates or seawater controls. Furthermore, in both turf and CCA exudate treatments, all microbial communities (coral-, algae-associated and pelagic contributed significantly to the observed oxygen drawdown. This suggests that the driving factor for elevated oxygen consumption rates is the source of exudates rather than the initially introduced microbial community. Our results demonstrate that exudates from turf algae may contribute to hypoxia-induced coral stress in two different coral genera as a result of increased biological oxygen demand of the local microbial community. Additionally, the SOOpR system developed here can be applied to measure the BOD of any culturable microbe or microbial community.

  6. Hormonal contraceptives and venous thrombosis

    NARCIS (Netherlands)

    Stegeman, Berendina Hendrika (Bernardine)

    2013-01-01

    Oral contraceptive use is associated with venous thrombosis. However, the mechanism behind this remains unclear. The aim of this thesis was to evaluate genetic variation in the first-pass metabolism of contraceptives, to identify the clinical implications of hormonal contraceptive use after a thromb

  7. Venous thrombosis : a patient's view

    NARCIS (Netherlands)

    Korlaar, Inez van

    2006-01-01

    The studies described in this thesis had two main aims: 1) To study the quality of life of patients with venous thrombosis and to examine the role of illness perceptions in explaining the quality of life of these patients. 2) To assess the psychological consequences of genetic testing for thrombop

  8. Venous thromboembolic disease. CT evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Goodman, L. R. [Medical College of Wisconsin, Pulmonary Medicine and Intensive Care, Dept. of Diagnostic Radiology, Milwaukee, WI (United States)

    2001-12-01

    Helical and multidetector CT has proven to be a valuable imaging modality for both pulmonary embolism and deep venous thrombosis. This paper will review the sensitivity and specificity of CT and discuss diagnostic algorithms utilizing CT and more established imaging technologies.

  9. Imaging Diagnosis of Splanchnic Venous Thrombosis

    Directory of Open Access Journals (Sweden)

    S. Rajesh

    2015-01-01

    Full Text Available Splanchnic vein thrombosis (SVT is a broad term that includes Budd-Chiari syndrome and occlusion of veins that constitute the portal venous system. Due to the common risk factors involved in the pathogenesis of these clinically distinct disorders, concurrent involvement of two different regions is quite common. In acute and subacute SVT, the symptoms may overlap with a variety of other abdominal emergencies while in chronic SVT, the extent of portal hypertension and its attendant complications determine the clinical course. As a result, clinical diagnosis is often difficult and is frequently reliant on imaging. Tremendous improvements in vascular imaging in recent years have ensured that this once rare entity is being increasingly detected. Treatment of acute SVT requires immediate anticoagulation. Transcatheter thrombolysis or transjugular intrahepatic portosystemic shunt is used in the event of clinical deterioration. In cases with peritonitis, immediate laparotomy and bowel resection may be required for irreversible bowel ischemia. In chronic SVT, the underlying cause should be identified and treated. The imaging manifestations of the clinical syndromes resulting from SVT are comprehensively discussed here along with a brief review of the relevant clinical features and therapeutic approach.

  10. Evolutionary Divergences in Root Exudate Composition among Ecologically-Contrasting Helianthus Species.

    Science.gov (United States)

    Bowsher, Alan W; Ali, Rifhat; Harding, Scott A; Tsai, Chung-Jui; Donovan, Lisa A

    2016-01-01

    Plant roots exude numerous metabolites into the soil that influence nutrient availability. Although root exudate composition is hypothesized to be under selection in low fertility soils, few studies have tested this hypothesis in a phylogenetic framework. In this study, we examined root exudates of three pairs of Helianthus species chosen as phylogenetically-independent contrasts with respect to native soil nutrient availability. Under controlled environmental conditions, seedlings were grown to the three-leaf-pair stage, then transferred to either high or low nutrient treatments. After five days of nutrient treatments, we used gas chromatography-mass spectrometry for analysis of root exudates, and detected 37 metabolites across species. When compared in the high nutrient treatment, species native to low nutrient soils exhibited overall higher exudation than their sister species native to high nutrient soils in all three species pairs, providing support for repeated evolutionary shifts in response to native soil fertility. Species native to low nutrient soils and those native to high nutrient soils responded similarly to low nutrient treatments with increased exudation of organic acids (fumaric, citric, malic acids) and glucose, potentially as a mechanism to enhance nutrition acquisition. However, species native to low nutrient soils also responded to low nutrient treatments with a larger decrease in exudation of amino acids than species native to high nutrient soils in all three species pairs. This indicates that species native to low nutrient soils have evolved a unique sensitivity to changes in nutrient availability for some, but not all, root exudates. Overall, these repeated evolutionary divergences between species native to low nutrient soils and those native to high nutrient soils provide evidence for the adaptive value of root exudation, and its plasticity, in contrasting soil environments.

  11. Thermochemical Properties of Hydrophilic Polymers from Cashew and Khaya Exudates and Their Implications on Drug Delivery.

    Science.gov (United States)

    Olorunsola, Emmanuel O; Bhatia, Partap G; Tytler, Babajide A; Adikwu, Michael U

    2016-01-01

    Characterization of a polymer is essential for determining its suitability for a particular purpose. Thermochemical properties of cashew gum (CSG) extracted from exudates of Anacardium occidentale L. and khaya gum (KYG) extracted from exudates of Khaya senegalensis were determined and compared with those of acacia gum BP (ACG). The polymers were subjected to different thermal and chemical analyses. Exudates of CSG contained higher amount of hydrophilic polymer. The pH of 2% w/v gum dispersions was in the order KYG application of cashew gum for formulation of basic and oxidizable drugs while using khaya gum for acidic drugs.

  12. Mucilage exudation facilitates root water uptake in dry soils

    Science.gov (United States)

    Ahmed, Mutez; Kroener, Eva; Holz, Maire; Zarebanadkouki, Mohsen; Carminati, Andrea

    2014-05-01

    As plant roots take up water and the soil dries, water depletion is expected to occur in the rhizosphere. However, recent experiments showed that the rhizosphere of lupines was wetter than the bulk soil during root water uptake. On the other hand, after irrigation the rhizosphere remained markedly dry and it rewetted only after one-two days. We hypothesize that: 1) drying/wetting rates of the rhizosphere are controlled by mucilage exuded by roots; 2) mucilage alters the soil hydraulic conductivity: in particular, wet mucilage increases the soil hydraulic conductivity and dry mucilage makes the soil water repellent; 3) mucilage exudation favors root water uptake in dry soil; and 4) dry mucilage limits water loss from roots to dry soils. We used a root pressure probe to measure the hydraulic conductance of artificial roots sitting in soils. As an artificial root we employed a suction cup with a diameter of 2 mm and a length of 45 mm. The root pressure probe gave the hydraulic conductance of the soil-root continuum during pulse experiments in which water was injected into or sucked from the soil. First, we performed experiments with roots in a relatively dry soil with a volumetric water content of 0.03. Then, we repeated the experiment with artificial roots covered with mucilage and then placed into the soil. As a model for mucilage, we collected mucilage from Chia seeds. The water contents (including that of mucilage) in the experiments with and without mucilage were equal. The pressure curves were fitted with a model of root water that includes rhizosphere dynamics. We found that the artificial roots covered with wet mucilage took up water more easily. In a second experimental set-up we measured the outflow of water from the artificial roots into dry soils. We compared two soils: 1) a sandy soil and 2) the same soil wetted with mucilage from Chia seeds and then let dry. The latter soil became water repellent. Due to the water repellency, the outflow of water from

  13. Clinical aspects of venous thrombophilia.

    Science.gov (United States)

    Girolami, Antonio; Fabris, Fabrizio; Girolami, Bruno

    2002-01-01

    Venous thrombophilia is the result of clotting changes namely of a hypercoagulable state together with blood flow and vessel wall changes. There is no need for all these components to be present in order for thrombosis to occur. As the matter of fact, thrombosis may occur even if only one of these conditions is present. In clinical practice a combination of factors is usualy seen. In comparison with arterial thrombophilia, clotting changes and blood flow seen to play a major role in venous thrombosis. Venous thrombophilia may remain asynptomatic or may result in a series of clinical syndromes. The commonest of these are: 1. Superficial vein thrombosis, 2. Deep vein thrombosis of legs, 3. Deep vein thrombosis of arms, 4. Caval veins thrombosis, 5. Portal vein thrombosis, 6. Hepatic veins thrombosis, 7. Renal vein thrombosis, 8. Cerebral sinuses thrombosis, 9. Right heart thrombosis, 10. Miscellaneous (ovarian, adrenal veins thrombosis, etc.). Since the first two are widely and easily recognized, these is no need for an extensive discussion. Deep vein thromboses of upper limbs are not as frequent as those of lower limbs or of superficial phlebitis but they can still be recognized on clinical grounds and non invasive techniques. The remaining 7 syndromes are less common and therefore less frequently suspected and recognized. Of particular interest, among these less common manifestations of venous thrombophilia are hepatic vein and renal vein thrombosis. Hepatic veins thrombosis, sometimes part of inferior vena cava thrombosis is most frequently due to an isolated occlusion of hepatic veins thereby causing a form of venocclusive disease. Occasionally diagnosis may be difficult because of slow onset of symptoms (hepatomegaly, right flank pain, fever, ascites etc.). The same is true for renal vein thrombosis which may also be of difficult diagnosis since it causes proteinuria and flank pain. The proteinuria is often interpreted as due to a nephrotic syndrome which

  14. Radiologically-placed venous ports in children under venous anesthesia

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Joo Yeon; Jeon, Ung Bae; Choo, Ki Seok; Hwang, Jae Yeon; Kim, Yong Woo; Lee, Yun Jin; Nam, Sang Ool; Lim, Young Tak [Pusan National University School of Medicine, Yangsan (Korea, Republic of)

    2015-02-15

    To evaluate the efficacy and safety of radiologic venous port placement in children under venous anesthesia. Between April 2009 and July 2011, 44 ports were implanted in 41 children (24 boys, 17 girls). The age of patients ranged from 9 months to 19 years (mean, 6.5 years) and their body weights ranged from 6.8 kg to 56.3 kg (mean, 23.2 kg). Right internal jugular vein access was used in 42 ports, right subclavian vein in 1, and left subclavian in 1. Durability and complications of port implantation were reviewed. The technical success rate was 100%. The catheter life was 10-661 days (mean 246 days). Two patients died during the follow-up period, 21 and 6 ports were removed at the end of treatment or as a result of complications, respectively. One port was removed and replaced by a Hickmann catheter. Three ports were explanted due to port-related sepsis, one due to a catheter kink, and two for unexplained fever or insertion site pain. The overall port-related infection was 3 cases (6.8%, 0.28/1000 catheter days). Venous port placement by interventional radiologists in children under intravenous sedation is relatively safe, with a high rate of technical success and low rate of complications.

  15. A critical review of modern and emerging absorbent dressings used to treat exuding wounds.

    Science.gov (United States)

    Sweeney, India R; Miraftab, Mohsen; Collyer, Graham

    2012-12-01

    Wound management has progressed significantly over the last five decades. This emanates from a greater understanding of wound healing, technological progression and improved clinical and scientific research. There are currently a plethora of absorbent dressings on the wound care market which claim to have the ability to manage exudates whilst encouraging healing. However, it is becoming clear, from analysing randomised controlled trials, that some of these absorbent dressings are not meeting their expectations when applied in a clinical setting. Many clinicians now feel that there should be more focus, not only on a dressing's ability to manage exudate efficiently, but on a dressing's ability to proactively encourage healing and thus exudate reduction will ensue. This paper proposes to critically review modern and emerging absorbent wound care dressings used to manage exuding wounds and discuses some advances in this area.

  16. [Gum-like exudate from Laguncularia racemosa (white mangrove) as culture media for fungi].

    Science.gov (United States)

    Mesa, L M; León-Pinto, G

    1993-01-01

    Morphological studies of eight species of fungus: Aspergillus flavus Microsporum canis, Epidermophyton floccosum, Curvularia lunata, Cladosporium carrionii, Natrassia mangífera (Edo. Scytalidium), Sporotrix schenckii y Rhizophus oligosporus, which belong to families Mucedinaceae, Dematiaceae and Mucoraceae have been carried out in support medium based in gum exudate from Laguncularia racemosa (mangle blanco). This native polimer contains galactose, arabinose, rhamnose, uronic acid and proteins. Nitrogen calcium and magnesium are microconstituents of the gum. An economical substrate which contained gum exudate (4%) and agar (1.5%) was used in these studies. The results obtained showed that gum exudate-agar medium (EGA) permits an adequate identification of the studied species, therefore, it is a possible substitute for Sabouraud. It is important to know that the gum exudate is a natural product, economical and easy to obtain.

  17. Formation of exudate droplets by Metarhizium anisopliae and the presence of destruxins.

    Science.gov (United States)

    Hutwimmer, Stefan; Wang, Hui; Strasser, Hermann; Burgstaller, Wolfgang

    2010-01-01

    Nutritional conditions causing droplet exudation by Metarhizium anisopliae var. anisopliae were studied. Exudation in droplets occurred only on media with more than one carbon source and was highly dependent on the ratio of a well metabolized sugar such as trehalose and a nonpreferred sugar, in particular arabinose. Exuded droplets contained destruxin A, B and E in concentrations similar to those on submerged culture on Czapek Dox medium with equivalent C:N ratios but was clearly less than previously reported on standard Czapek Dox or Sabouraud dextrose broth. Destruxins also were found in agar samples from directly below mycelium and from up to 2 cm from the colony edge. Exudates retrieved from different media were proven to have Pr1 protease-related enzyme activity. Additional HPLC analysis indicated that droplets from diverse media did not differ in their sugar and acid content. A hypothesis is presented regarding the trigger for guttation in Metarhizium during growth under these conditions.

  18. Potential of Root Exudates from Wetland Plants and Their Potential Role for Denitrification and Allelopathic Interactions

    DEFF Research Database (Denmark)

    Zhai, Xu

    chemicals to suppress the growth of native species. Phragmites australis is recognized as the most invasive species in wetland ecosystems in North America, and allelopathy has been reported to be involved in the invasion success of the introduced exotic P. australis. The composition of the root exudates may...... vary among different Phragmites haplotypes and consequently affect their invasion potential. The studies presented in this dissertation aimed at investigating the quantity and composition of the organic carbon released in root exudates from three common wetland species as affected by temperature...... plants contribute to nitrogen removal in high nitrate and low BOD wastewater. Also, the compositions and quantity of root exudates differed among the species of the Phragmites genus and the Phragmites haplotypes. The research could not confirm that gallic acid in root exudates is responsible...

  19. Thoracoscopic evaluation of 129 cases having undiagnosed exudative pleural effusions

    Directory of Open Access Journals (Sweden)

    Chetan Basavaraj Patil

    2016-01-01

    Full Text Available Background: Medical thoracoscopy is a minimally invasive procedure used in diagnostic and therapeutic applications for pleural diseases. In this study, we describe our experience in the outcome and analysis of thoracoscopy in undiagnosed pleural effusion presenting to our center. Materials and Methods: This is a prospective study conducted over last 2 years. We performed thoracoscopy in 129 cases of undiagnosed exudative pleural effusions using rigid thoracoscope. Clinical, radiological, cyto and histopathological data of the patients were collected prospectively and analyzed. Results: The overall diagnostic yield of thoracoscopic pleural biopsy was 110/129 (85.2% in patients with undiagnosed pleural effusion, and 19/129 (14.8% patients remained unexplained. Histopathological diagnosis confirmed malignancy in 66.4% patients (both primary and metastatic pleural carcinoma, tuberculosis in 28.2%, others including parapneumonic effusion in 4 cases followed by multiple myeloma, lupus pleuritis, and pulmonary langerhans cell histiocytosis in one case each. Procedure-related mortality was nil. Minor complications related to the procedure include hemorrhage, subcutaneous emphysema, etc. Conclusion: Thoracoscopy is relatively a safe and well-tolerated procedure with high diagnostic accuracy in undiagnosed pleural effusions, decreasing the need of formal diagnostic thoracotomy. Every chest physician must, therefore, consider this procedure to decrease the time lag in achieving the final diagnosis and to initiate the treatment as early as possible.

  20. Microbial exudate promoted dissolution and transformation of chromium containing minerals

    Science.gov (United States)

    Saad, E. M.; Sun, J.; Tang, Y.

    2015-12-01

    Because of its utility in many industrial processes, chromium has become the second most common metal contaminant in the United States. The two most common oxidation states of chromium in nature are Cr(III), which is highly immobile, and Cr(VI), which is highly mobile and toxic. In both natural and engineered environments, the most common remediation of Cr(VI) is through reduction, which results in chromium sequestration in the low solubility mixed Cr(III)-Fe(III) (oxy)hydroxide phases. Consequently, the stability of these minerals must be examined to assess the fate of chromium in the subsurface. We examined the dissolution of mixed Cr(III)-Fe(III) (oxy)hydroxides in the presence of common microbial exudates, including the siderophore desferrioxamine B (DFOB; a common organic ligand secreted by most microbes with high affinity for ferric iron and other trivalent metal ions) and oxalate (a common organic acid produced by microbes). The solids exhibited incongruent dissolution with preferential leaching of Fe from the solid phase. Over time, this leads to a more Cr rich mineral, which is known to be more soluble than the corresponding mixed mineral phase. We are currently investigating the structure of the reacted mineral phases and soluble Cr(III) species, as well as the potential oxidation and remobilization of the soluble Cr species. Results from this study will provide insights regarding the long term transport and fate of chromium in the natural environment in the presence of microbial activities.

  1. Rheological Modeling and Characterization of Ficus platyphylla Gum Exudates

    Directory of Open Access Journals (Sweden)

    Nnabuk O. Eddy

    2013-01-01

    Full Text Available Ficus platyphylla gum exudates (FP gum have been analyzed for their physicochemical parameters and found to be ionic, mildly acidic, odourless, and yellowish brown in colour. The gum is soluble in water, sparingly soluble in ethanol, and insoluble in acetone and chloroform. The nitrogen (0.39% and protein (2.44% contents of the gum are relatively low. The concentrations of the cations were found to increase according to the following trend, Mn>Fe>Zn>Pb>Cu>Mg>Cd>Ca. Analysis of the FTIR spectrum of the gum revealed vibrations similar to those found in polysaccharides while the scanning electron micrograph indicated that the gum has irregular molecular shapes, arranged randomly. The intrinsic viscosity of FP gum estimated by extrapolating to zero concentrations in Huggins, Kraemer, Schulz-Blaschke, and Martin plots has an average value of 7 dL/g. From the plots of viscosity versus shear rate/speed of rotation and also that of shear stress versus shear rate, FP gum can be classified as a non-Newtonian gum with characteristics-plastic properties. Development of the Master_s curve for FP gum also indicated that the gum prefers to remain in a dilute domain (C

  2. Tachyphylaxis during ranibizumab treatment of exudative age-related macular degeneration

    Institute of Scientific and Technical Information of China (English)

    Sibel; Doguizi; Sengul; Ozdek; Selcen; Yuksel

    2015-01-01

    <正>Dear Editor,We are intestigators from Turkey primarily studying exudative age-related macular degeneration(AMD).Here we present the results of our retrospective clinical study on tachyphylaxis development during the treatment of exudative AMD with ranibizumab,which,we believe,will form a basis for further prospective studies to predict the drug response in anti-vascular endothelial growth factor

  3. Antimicrobial susceptibility of Staphylococcus hyicus isolated from exudative epidermitis in pigs.

    OpenAIRE

    Wegener, H C; Watts, J.L.; Salmon, S A; Yancey, R J

    1994-01-01

    Exudative epidermitis or greasy pig syndrome is caused by the coagulase-variable staphylococcal species Staphylococcus hyicus. Treatment of this disease is problematic because of the limited number of antimicrobial agents available for this purpose. Thirteen antimicrobial agents were evaluated for their activities against 100 S. hyicus strains isolated from pigs with exudative epidermitis. Novobiocin was the most active compound tested, with an MIC for 90% of the strains tested (MIC90) of < o...

  4. Atypical presentation of ocular toxoplasmosis: A Case report of exudative retinal detachment and choroidal Ischemia

    Directory of Open Access Journals (Sweden)

    Yahya A Al-Zahrani

    2016-01-01

    Full Text Available A 24-year-old healthy male presented with a chief complaint of blurred vision in the right eye for 1-week. Fundus examination indicated right exudative retinal detachment and choroidal ischemia. The patient responded well to anti-toxoplasmosis medications and steroids. Exudative retinal detachment and choroidal ischemia are atypical presentations of ocular toxoplasmosis. However, both conditions responded well to anti.parasitic therapy with steroid.

  5. Atypical Presentation of Ocular Toxoplasmosis: A Case Report of Exudative Retinal Detachment and Choroidal Ischemia.

    Science.gov (United States)

    Al-Zahrani, Yahya A; Al-Dhibi, Hassan A; Al-Abdullah, Abdulelah A

    2016-01-01

    A 24-year-old healthy male presented with a chief complaint of blurred vision in the right eye for 1-week. Fundus examination indicated right exudative retinal detachment and choroidal ischemia. The patient responded well to anti-toxoplasmosis medications and steroids. Exudative retinal detachment and choroidal ischemia are atypical presentations of ocular toxoplasmosis. However, both conditions responded well to anti.parasitic therapy with steroid.

  6. Citrate exudation by maize roots; A possible mechanism of resistance to aluminium

    OpenAIRE

    Mariano, E.D.

    2003-01-01

    Low-molecular-weight organic anions have been intensively studied as possibly involved in a mechanism of Al resistance in plants, due to their involvement in many metabolic processes and to their negative charge, conferring them the capacity to complex metals. The objective of the thesis was to study the root exudation of organic anions as a potential mechanism of Al resistance operating in maize ( Zea mays L.). The effect of Al exposure on root organic anion exudation was studied with roots ...

  7. Mixed Capillary Venous Retroperitoneal Hemangioma

    Directory of Open Access Journals (Sweden)

    Mohit Godar

    2013-01-01

    Full Text Available We report a case of mixed capillary venous hemangioma of the retroperitoneum in a 61-year-old man. Abdominal ultrasonography showed a mass to be hypoechoic with increased flow in color Doppler imaging. Dynamic contrast-enhanced computed tomography revealed a centripetal filling-in of the mass, located anterior to the left psoas muscle at the level of sacroiliac joint. On the basis of imaging features, preoperative diagnosis of hemangioma was considered and the mass was excised by laparoscopic method. Immunohistochemical studies were strongly positive for CD31 and CD34, and negative for calretinin, EMA, WT1, HMB45, Ki67, synaptophysin, and lymphatic endothelial cell marker D2–40. Histologically, the neoplasm was diagnosed as mixed capillary venous hemangioma.

  8. Risk factors for post-thrombotic syndrome in patients with a first deep venous thrombos

    NARCIS (Netherlands)

    Tick, L.W.; Kramer, M.H.H.; Rosendaal, F.R.; Faber, W.R.; Doggen, C.J.M.

    2008-01-01

    Background: Post-thrombotic syndrome (PTS) is a chronic complication of deep venous thrombosis (DVT). Objectives: To determine the risk of PTS after DVT and to assess risk factors for PTS. Methods: Patients were recruited from the Multiple Environmental and Genetic Assessment (MEGA) study of risk fa

  9. Hydrocephalus in cerebral venous thrombosis.

    Science.gov (United States)

    Zuurbier, Susanna M; van den Berg, René; Troost, Dirk; Majoie, Charles B; Stam, Jan; Coutinho, Jonathan M

    2015-01-01

    Increased intracranial pressure is common in cerebral venous thrombosis (CVT), but hydrocephalus is rarely reported in these patients. We examined the frequency, pathophysiology and associated clinical manifestations of hydrocephalus in patients with CVT admitted to our hospital between 2000 and 2010 (prospectively since July 2006). Hydrocephalus was defined as a bicaudate index larger than the 95th percentile for age, and/or a radial width of the temporal horn of ≥ 5 mm. We excluded patients in whom hydrocephalus was caused by a disease other than CVT or if it was iatrogenic. 20 out of 99 patients with CVT had hydrocephalus. 6 patients with hydrocephalus were excluded from the analysis. Patients with hydrocephalus more often had focal neurological deficits (86 vs. 49%, p = 0.02) and were more frequently comatose (43 vs. 16%, p = 0.06), as compared to patients without hydrocephalus. Deep cerebral venous thrombosis (64 vs. 9%, p hydrocephalus. Intraventricular hemorrhage was present in 1 patient with hydrocephalus, compared to none among patients without hydrocephalus (7 vs. 0%, p = 0.15). Outcome at follow-up was worse in patients with hydrocephalus (mRS 0-1, 36 vs. 68%, p = 0.02; mortality 29 vs. 9%, p = 0.07). Hydrocephalus occurs more frequently in cerebral venous thrombosis than previously believed, especially in patients with deep cerebral venous thrombosis and edema of the basal ganglia. The presence of hydrocephalus is associated with a worse clinical outcome, but a direct causal relation is unlikely. Routine shunting procedures are not advisable.

  10. Citramalic acid and salicylic acid in sugar beet root exudates solubilize soil phosphorus

    Directory of Open Access Journals (Sweden)

    Karlovsky Petr

    2011-08-01

    Full Text Available Abstract Background In soils with a low phosphorus (P supply, sugar beet is known to intake more P than other species such as maize, wheat, or groundnut. We hypothesized that organic compounds exuded by sugar beet roots solubilize soil P and that this exudation is stimulated by P starvation. Results Root exudates were collected from plants grown in hydroponics under low- and high-P availability. Exudate components were separated by HPLC, ionized by electrospray, and detected by mass spectrometry in the range of mass-to-charge ratio (m/z from 100 to 1000. Eight mass spectrometric signals were enhanced at least 5-fold by low P availability at all harvest times. Among these signals, negative ions with an m/z of 137 and 147 were shown to originate from salicylic acid and citramalic acid. The ability of both compounds to mobilize soil P was demonstrated by incubation of pure substances with Oxisol soil fertilized with calcium phosphate. Conclusions Root exudates of sugar beet contain salicylic acid and citramalic acid, the latter of which has rarely been detected in plants so far. Both metabolites solubilize soil P and their exudation by roots is stimulated by P deficiency. These results provide the first assignment of a biological function to citramalic acid of plant origin.

  11. DESIGN AND DEVELOP A COMPUTER AIDED DESIGN FOR AUTOMATIC EXUDATES DETECTION FOR DIABETIC RETINOPATHY SCREENING

    Directory of Open Access Journals (Sweden)

    C. A. SATHIYAMOORTHY

    2016-04-01

    Full Text Available Diabetic Retinopathy is a severe and widely spread eye disease which can lead to blindness. One of the main symptoms for vision loss is Exudates and it could be prevented by applying an early screening process. In the Existing systems, a Fuzzy C-Means Clustering technique is used for detecting the exudates for analyzation. The main objective of this paper is, to improve the efficiency of the Exudates detection in diabetic retinopathy images. To do this, a three Stage – [TS] approach is introduced for detecting and extracting the exudates automatically from the retinal images for screening the Diabetic retinopathy. TS functions on the image in three levels such as Pre-processing the image, enhancing the image and detecting the Exudates accurately. After successful detection, the detected exudates are classified using GLCM method for finding the accuracy. The TS approach is experimented using MATLAB software and the performance evaluation can be proved by comparing the results with the existing approach’s result and with the hand-drawn ground truths images from the expert ophthalmologist.

  12. A Chemo Attractant in Onion Root Exudates Recognized by Ditylenchus dipsaci in Laboratory Bioassay.

    Science.gov (United States)

    Spiegel, Y; Burrows, P M; Bar-Eyal, M

    2003-01-01

    ABSTRACT A quantitative bioassay that translates preferences of axenically cultured and field population of Ditylenchus dipsaci, observed in vitro, into relative attractiveness of sterile root exudates preparations and their components is described. Onion (Allium cepa cv. White Lisbon) root exudates (ORE) are consistently and significantly much more attractive than the buffer control in all these assays. Exudates from oat cv. Lodi, mustard cv. Albatross and tomato cv. Rehovot 13 are significantly more attractive than the buffer but less attractive than ORE; Arabidopsis sp. cv. Landsberg erecta, oil seed rape cv. Cetes and wheat cv. Bet Hashita are as attractive as the buffer, but canary grass and clover exudates are less attractive than the buffer and, therefore, are classified as repellent. No significant differences in relative attractiveness were detected among exudates from other two cultivars of onion (Texas Grano 502 and Granex Hybrid) and one cultivar of leek (Large American Flag), but exudates from one onion (cv. Evergreen Long White Bunching) and one leek (cv. Broad London) were less attractive than ORE. Relative attractiveness is linear in relation to dilution exponent and therefore log-linear in relation to ORE concentration. Host (onion) penetration study reveals that penetration preferences by D. dipsaci follow the same pattern as those predicted by relative attractiveness coefficients estimated in the bio-assays. Preliminary characterization of the chemo attractant from ORE, using the behavioral bioassay, demonstrated that it was stable to heat and to proteolytic enzymes, nonvolatile and water soluble with a molecular mass <700 kDa.

  13. STIG1 Controls Exudate Secretion in the Pistil of Petunia and Tobacco1[w

    Science.gov (United States)

    Verhoeven, Tamara; Feron, Richard; Wolters-Arts, Mieke; Edqvist, Johan; Gerats, Tom; Derksen, Jan; Mariani, Celestina

    2005-01-01

    The lipid-rich, sticky exudate covering the stigma of solanaceous species such as tobacco (Nicotiana tabacum) and petunia (Petunia hybrida) contains several proteins, of which only some have been characterized to date. Proteome analysis of the stigmatic exudate in both species revealed the presence of a cysteine-rich, slightly acidic 12-kD protein called stigma-specific protein 1 (STIG1). In both tobacco and petunia, Stig1 is highly expressed at the mRNA level in very young and developing flowers, whereas hardly any Stig1 transcript is detected in mature flowers. This expression pattern coincides with the differentiation of the secretory zone, forming the intercellular spaces into which the exudate is secreted. Using reverse genetics, we show that STIG1 is involved in the secretion and merging of exudate lipids in the intercellular spaces of the secretory zone and that plants lacking STIG1 show an accelerated deposition of exudate onto the stigmatic surface. This phenotype was observed both in a petunia knockout mutant and in tobacco transgenic plants. We therefore propose that STIG1 plays a role in the temporal regulation of the essential exudate secretion onto the stigma. PMID:15821148

  14. Infected Venous Leg Ulcers: Management With Silver-releasing Foam Dressing .

    Science.gov (United States)

    Dimakakos, Evangelos P; Katsenis, K; Kalemikerakis, J; Arkadopoulos, N; Mylonas, S; Arapoglou, V; Tsiganis, T; Kotis, T

    2009-01-01

    The aim of this work was to study the safety and effectiveness of silver foam dressing (Contreet® Ag, Coloplast, Humlebaek, Denmark) in promoting the healing of infected venous ulcers over 9 weeks of treatment. Forty-two patients with infected venous ulcers were included and randomized into two groups. Group A had 21 patients (12 women and 9 men, mean age 61.2 years) who were treated with the silver foam for 9 weeks. Group B also had 21 patients (14 women and 7 men, mean age 58.7 years) who were treated with a nonadhesive foam (Biatain®, Coloplast, Humlebaek, Denmark) for 9 weeks. In both groups, ulcer size and depth, intensity of pain, wound exudation, bacterial load, side effects of both materials, and ulcer healing were documented and compared. There was no significant difference at the initial assessment in both groups regarding ulcer size, ulcer depth, grade of exudation, pain intensity, or bacterial load. However, group A ulcers had a significantly greater healing (P = 0.02) compared to group B. Pain intensity was significantly less in group A patients at several time points. After 9 weeks of treatment, the silver foam dressing was found to be a safe material that promotes rapid healing of venous ulcers and relieves pain. .

  15. A technique for re-utilizing catheter insertion sites in children with difficult central venous access.

    Science.gov (United States)

    Johnson, S M; Garnett, G M; Woo, R K

    2017-01-01

    Maintenance of central venous access in patients with chronic medical conditions such as short bowel syndrome demands forethought and ingenuity. We describe an innovative technique for re-utilizing central venous access sites in patients who have chronic central venous access needs. Records of patients undergoing this technique were reviewed between August 2012 and December 2015. The technique involves "cutting-down" to the sterile fibrous tunnel that naturally forms around tunneled catheters. The fibrous sheath is then isolated and controlled much as would be done for a venous "cut-down." A separate exit site is then created for the new catheter and it is tunneled to the "cut-down" site per routine. The non-functioning catheter is then removed from the surgical field. The proximal fibrous sheath is finally cannulated either directly with the new catheter or with a wire/dilator system. This technique effectively re-uses the same venous access point while allowing for a complete change of the physical line and external site. Twenty attempts at this technique were made in twelve patients; six patients underwent the site re-utilization procedure multiple times. Re-using the fibrous tunnel to re-cycle the internal catheter site was successful in seventeen of twenty attempts. All patients had chronic conditions leading to difficult long-term central venous access [short bowel syndrome (6), hemophilia (2), cystic fibrosis (1), chronic need for central IV access (3)]. Indications for catheter replacement included catheter occlusion/mechanical failure/breakage (9), dislodgement (6), infection (1), and inadequate catheter length due to patient growth (4). Broviac/Hickman catheter sites were most commonly re-used (13; one failure); re-using a portcath site was successful in 5 of 7 attempts. There were no short term infections or mechanical complications. We describe a novel technique for salvaging tunneled central venous catheter access sites. This technique is well suited

  16. A Possible Association of Diindolylmethane with Pulmonary Embolism and Deep Venous Thrombosis

    Science.gov (United States)

    Moualla, Maan

    2016-01-01

    Introduction. 3,3′-Diindolylmethane is available as a supplement in the United States for “cancer prevention” and “augmentation of physical fitness.” A derivative of indole-3-carbinol found in plants, diindolylmethane, binds to receptors associated with the sex steroid pathways and has unclear effects on estrogen and androgen physiology. We present a patient who had been taking diindolylmethane and developed right lower extremity deep venous thrombosis and bilateral pulmonary embolism. Case Presentation. A 65-year-old man presented with swelling, erythema, and warmth of his right lower extremity for three to four weeks. He had been taking diindolylmethane one tablet daily for three to four months. Risk factors for venous thromboembolism included tobacco use, personal history of possible pulmonary embolism, body mass index, and age. Imaging studies found extensive deep venous thrombosis in his right lower extremity and bilateral pulmonary embolism with probable right middle lobe infarction. Follow-up imaging showed chronic deep venous thrombosis in his right lower extremity. Discussion. As suggested in this single case, patients who take diindolylmethane may be at greater risk for venous thromboembolism. Further reports and studies are necessary in order to elucidate this possible association. Clinicians should question patients about supplements in the setting of venous thromboembolism. PMID:28050169

  17. A Possible Association of Diindolylmethane with Pulmonary Embolism and Deep Venous Thrombosis

    Directory of Open Access Journals (Sweden)

    Peter V. Bui

    2016-01-01

    Full Text Available Introduction. 3,3′-Diindolylmethane is available as a supplement in the United States for “cancer prevention” and “augmentation of physical fitness.” A derivative of indole-3-carbinol found in plants, diindolylmethane, binds to receptors associated with the sex steroid pathways and has unclear effects on estrogen and androgen physiology. We present a patient who had been taking diindolylmethane and developed right lower extremity deep venous thrombosis and bilateral pulmonary embolism. Case Presentation. A 65-year-old man presented with swelling, erythema, and warmth of his right lower extremity for three to four weeks. He had been taking diindolylmethane one tablet daily for three to four months. Risk factors for venous thromboembolism included tobacco use, personal history of possible pulmonary embolism, body mass index, and age. Imaging studies found extensive deep venous thrombosis in his right lower extremity and bilateral pulmonary embolism with probable right middle lobe infarction. Follow-up imaging showed chronic deep venous thrombosis in his right lower extremity. Discussion. As suggested in this single case, patients who take diindolylmethane may be at greater risk for venous thromboembolism. Further reports and studies are necessary in order to elucidate this possible association. Clinicians should question patients about supplements in the setting of venous thromboembolism.

  18. Ruptured venous aneurysm of cervicomedullary junction

    Directory of Open Access Journals (Sweden)

    Ashish Aggarwal

    2014-01-01

    Full Text Available Background: Ruptured venous aneurysm is often seen with arterio-venous malformation (AVM or developmental venous anomaly (DVA. However, isolated venous aneurysm is unusual. Case Description: We present a case of ruptured venous aneurysm that presented with subarachnoid hemorrhage (SAH and intraventricular hemorrhage (IVH. Digital substraction angiography (DSA revealed a saccular contrast filling pouch in the left lateral aspect of cervicomedullary junction (CMJ. Endovascular intervention was not a viable option. During surgery, a saccular pliable structure approx. 1.5 Χ 1 cm was found in the subarachnoid space that was clipped and excised. There were no arterial feeders, no evidence of surrounding AVM, and no dilated perimedullary vein. Conclusion: This is perhaps the first reported case of ruptured venous aneurysm (without associated AVM of CMJ, which was successfully managed surgically. The possible etiologies remain an unnoticed head trauma or a congenital vessel wall abnormality. Surgically clipping and excision remains the treatment of choice for such lesion.

  19. Insertion of central venous catheters for hemodialysis using angiographic techniques in patients with previous multiple catheterizations

    Energy Technology Data Exchange (ETDEWEB)

    Kotsikoris, Ioannis, E-mail: gkotsikoris@gmail.com [Department of Vascular Surgery, “Erythros Stauros” General Hospital (Greece); Zygomalas, Apollon, E-mail: azygomalas@upatras.gr [Department of General Surgery, University Hospital of Patras (Greece); Papas, Theofanis, E-mail: pfanis@otenet.gr [Department of Vascular Surgery, “Erythros Stauros” General Hospital (Greece); Maras, Dimitris, E-mail: dimmaras@gmail.com [Department of Vascular Surgery, “Erythros Stauros” General Hospital (Greece); Pavlidis, Polyvios, E-mail: polpavlidis@yahoo.gr [Department of Vascular Surgery, “Erythros Stauros” General Hospital (Greece); Andrikopoulou, Maria, E-mail: madric@gmail.com [Department of Vascular Surgery, “Erythros Stauros” General Hospital (Greece); Tsanis, Antonis, E-mail: atsanis@gmail.com [Department of Interventional Radiology, “Erythros Stauros” General Hospital (Greece); Alivizatos, Vasileios, E-mail: valiviz@hol.gr [Department of General Surgery and Artificial Nutrition Unit, “Agios Andreas” General Hospital of Patras (Greece); Bessias, Nikolaos, E-mail: bessias@otenet.gr [Department of Vascular Surgery, “Erythros Stauros” General Hospital (Greece)

    2012-09-15

    Introduction: Central venous catheter placement is an effective alternative vascular access for dialysis in patients with chronic renal failure. The purpose of this study was to evaluate the insertion of central venous catheters for hemodialysis using angiographic techniques in patients with previous multiple catheterizations in terms of efficacy of the procedure and early complications. Materials and methods: Between 2008 and 2010, the vascular access team of our hospital placed 409 central venous catheters in patients with chronic renal failure. The procedure was performed using the Seldinger blind technique. In 18 (4.4%) cases it was impossible to advance the guidewire, and so the patients were transported to the angiography suite. Results: Using the angiographic technique, the guidewire was advanced in order to position the central venous catheter. The latter was inserted into the subclavian vein in 12 (66.6%) cases, into the internal jugular vein in 4 (22.2%) and into the femoral vein in 2 (11.1%) cases. There was only one complicated case with severe arrhythmia in 1 (5.5%) patient. Conclusion: Our results suggest that insertion of central venous catheters using angiographic techniques in hemodialysis patients with previous multiple catheterizations is a safe and effective procedure with few complications and high success rates.

  20. Iliofemoral and iliocaval interventions in deep venous thrombosis; Iliofemorale und iliocavale Interventionen bei tiefer Venenthrombose

    Energy Technology Data Exchange (ETDEWEB)

    Haage, P.; Guenther, R.W. [Klinik fuer Radiologische Diagnostik, Universitaetsklinikum der RWTH Aachen (Germany)

    2005-05-01

    Significant spontaneous thrombus disintegration in deep venous thrombosis (DVT) occurs very infrequently. On the contrary, these thrombi are prone to appositional growth and migration into the pulmonary arteries. The development of chronic venous insufficiency due to postthrombotic syndrome is a frequent consequence of DVT. Therapeutic options in DVT include anticoagulation and recanalising procedures such as thrombolysis and thrombectomy. After appropriate indication assessment, the interventional radiologist can offer an efficacy-proven minimally-invasive vessel restitution approach by performing locoregional thrombolysis, pharmacomechanical therapy or, particularly in iliocaval thrombosis, mechanical thrombectomy. These methods not only serve to restitute of vessel patency, but also allow preserving venous valve function. In DVT with recurrent pulmonary embolism, retrievable filters with extended implantation duration can be deployed. In chronic proximal venous flow obstruction or in case of significant residual stenosis after thrombolysis, balloon angioplasty with stent implantation is the treatment modality of choice. Consequently, the radiologist can adopt an important role in the treatment of extensive venous disease. In this article, the treatment modalities concerning iliofemoral and iliocaval thrombosis are demonstrated and illustrated. (orig.)

  1. Sarcoidosis, Celiac Disease and Deep Venous Thrombosis: a Rare Association

    Directory of Open Access Journals (Sweden)

    Gökhan Çelik

    2011-11-01

    Full Text Available Sarcoidosis is a multisystem granulomatous disorder of unknown etiology and it may rarely be associated with a second disorder. Celiac disease is an immune-mediated enteropathy characterized with malabsorption caused by gluten intolerance, and several reports indicate an association between celiac disease and sarcoidosis. In addition, although celiac disease is associated with several extraintestinal pathologies, venous thrombosis has been rarely reported. Herein we present a rare case report of a patient with a diagnosis of sarcoidosis, celiac disease and deep venous thrombosis because of the rare association of these disorders. The patient was admitted with abdominal pain, weight loss, chronic diarrhea and a 5-day history of swelling in her right leg. A diagnosis of deep venous thrombosis was achieved by doppler ultrasonographic examination. The diagnosis of celiac disease was made by biopsy of duodenal mucosa and supported with elevated serum level of anti-gliadin IgA and IgG, and a diagnosis of sarcoidosis was achieved by transbronchial needle aspiration from the subcarinal lymph node during flexible bronchoscopy.

  2. Venous thromboembolism at uncommon sites in neonates and children.

    Science.gov (United States)

    Pergantou, Helen; Avgeri, Maria; Komitopoulou, Anna; Xafaki, Panagiota; Kapsimali, Zoey; Mazarakis, Michail; Adamtziki, Eftychia; Platokouki, Helen

    2014-11-01

    We retrospectively analyzed the data of 24 children (whereof 11 neonates), with non-central venous line-related and nonmalignancy-related venous thromboembolism (VTE) at uncommon sites, referred to our Unit from January 1999 to January 2012. Thirty patients who also suffered deep vein thrombosis, but in upper/low extremities, were not included in the analysis. The location of rare site VTE was: portal (n=7), mesenteric (n=2) and left facial vein (n=1), spleen (n=3), lung (n=3), whereas 10 neonates developed renal venous thrombosis. The majority of patients (91.7%) had at least 1 risk factor for thrombosis. Identified thrombophilic factors were: antiphospholipid antibodies (n=2), FV Leiden heterozygosity (n=6), MTHFR C677T homozygosity (n=4), protein S deficiency (n=2), whereas all neonates had age-related low levels of protein C and protein S. All but 6 patients received low-molecular-weight heparin, followed by warfarin in 55% of cases, for 3 to 6 months. Prolonged anticoagulation was applied in selected cases. During a median follow-up period of 6 years, the clinical outcome was: full recovery in 15 patients, evolution to both chronic portal hypertension and esophageal varices in 2 children, and progression to renal failure in 7 of 10 neonates. Neonates are greatly vulnerable to complications after VTE at uncommon sites, particularly renal. Future multicentre long-term studies on neonatal and pediatric VTE at unusual sites are considered worthwhile.

  3. Transpleural central venous catheter discovered during thoracotomy

    Directory of Open Access Journals (Sweden)

    Ashima Malhotra

    2014-01-01

    Full Text Available We report an uncommon complication of subclavian central venous catheterization, discovered at thoracotomy. The central venous catheter (CVC was placed by left infraclavicular route after induction of general anesthesia. CVC was secured after aspiration of blood and satisfactory central venous tracing. On thoracotomy, CVC was noticed to traverse the pleural cavity while the tracing was normal. CVC was thus removed consequent to which bleeding from each puncture site was noticed, that were secured surgically.

  4. Comparison of Poultry Exudate and Carcass Rinse Sampling Methods for the Recovery of Campylobacter spp. Subtypes Demonstrates Unique Subtypes Recovered from Exudate

    Science.gov (United States)

    The carcass rinse procedure is a method commonly used for the detection of Campylobacter spp. on processed poultry products. Alternatively, carcass exudate (weep or drip), a viscous fluid comprised of blood and water that leaks into packaging, can also be sampled. It is unknown however if these me...

  5. Central venous line complications and tip detection

    Directory of Open Access Journals (Sweden)

    Ameneh Rezaee Gheshlaghi

    2015-06-01

    Full Text Available Central venous line is one of a creative instrument that saves human’s life in critical medical situation. Central venous line access is frequently involved in the disease management. It is used for rapid fluid therapy, transvenous pacemakers, infusion of some medications, hemodialysis or plasmapheresis and etc. Most of the emergency departments have some staffs that are trained for central venous line insertion but related complications occur during central venous line placement.Central venous line might have some complications and complication follow-up should be considered. Thromboembolism and infection are two important medical complications. Arterial puncture, hematoma, pneumothorax and hemothorax are mechanical Central venous line complications. Chest X-ray and some other techniques should be used for detecting these complications.Central venous line tip misplace is a considerable problem for emergency department staffs, previously chest X-ray has been used for central venous line misplace detection. In some recent studies, contrast-enhanced ultrasonography and intravascular electrocardiography have been used for central venous line misplace.

  6. Characterizing the Risk Factors Associated With Venous Thromboembolism in Pediatric Patients After Central Venous Line Placement

    OpenAIRE

    Wisecup, Sarah; Eades, Shannan; Turiy, Yuliya

    2015-01-01

    OBJECTIVES: With the apparent increase in venous thromboembolism noted in the pediatric population, it is important to define which children are at risk for clots and to determine optimal preventative therapy. The purpose of this study was to determine the risk factors for venous thromboembolism in pediatric patients with central venous line placement.

  7. Atmospheric CO2 enrichment and drought stress modify root exudation of barley.

    Science.gov (United States)

    Calvo, Olga C; Franzaring, Jürgen; Schmid, Iris; Müller, Matthias; Brohon, Nolwenn; Fangmeier, Andreas

    2017-03-01

    Rising CO2 concentrations associated with drought stress is likely to influence not only aboveground growth, but also belowground plant processes. Little is known about root exudation being influenced by elements of climate change. Therefore, this study wanted to clarify whether barley root exudation responds to drought and CO2 enrichment and whether this reaction differs between an old and a recently released malting barley cultivar. Barley plants were grown in pots filled with sand in controlled climate chambers at ambient (380 ppm) or elevated (550 ppm) atmospheric [CO2 ] and a normal or reduced water supply. Root exudation patterns were examined at the stem elongation growth stage and when the inflorescences emerged. At both dates, root exudates were analyzed for different compounds such as total free amino acids, proline, potassium, and some phytohormones. Elevated [CO2 ] decreased the concentrations in root exudates of some compounds such as total free amino acids, proline, and abscisic acid. Moreover, reduced water supply increased proline, potassium, electric conductivity, and hormone concentrations. In general, the modern cultivar showed higher concentrations of proline and abscisic acid than the old one, but the cultivars responded differentially under elevated CO2 . Plant developmental stage had also an impact on the root exudation patterns of barley. Generally, we observed significant effects of CO2 enrichment, watering levels, and, to a lesser extent, cultivar on root exudation. However, we did not find any mitigation of the adverse effects of drought by elevated CO2 . Understanding the multitude of relationships within the rhizosphere is an important aspect that has to be taken into consideration in the context of crop performance and carbon balance under conditions of climate change.

  8. Stress differentially impacts reserve pools and root exudation: implications for ecosystem functioning and carbon balance

    Science.gov (United States)

    Landhäusser, Simon; Karst, Justine; Wiley, Erin; Gaster, Jacob

    2016-04-01

    Environmental stress can influence carbon assimilation and the accumulation and distribution of carbon between growth, reserves, and exudation; however, it is unclear how these processes vary by different stress types. Partitioning of carbon to growth and reserves in plants might also vary between different organs. Roots reserves are of particular interest as they link the plant with the soil carbon cycle through exudation. Simple models of diffusion across concentration gradients predict the more C reserves in roots, the more C should be exuded from roots. However, the mechanisms underlying the accumulation and loss of C from roots may differ depending on the stress experienced by the plants. In a controlled study we tested whether different types of stresses (shade, cold soil, and drought) have differential effects on the distribution, abundance, and form (sugar vs. starch) of carbohydrates in seedlings, and whether these changes alone could explain differences in root exudation between stress types. Non-structural carbohydrate (NSC) concentration and pool sizes varied by stress type and between organs. Mass-specific C exudation increased with fine root sugar concentration; however, stress type affected exudation independently of reserve concentration. Seedlings exposed to cold soils exuded the most C on a per root mass basis followed by shade and drought. Through 13C labeling, we also found that depending on the stress type, aspen seedlings may be less able to control the loss of C to the soil compared with unstressed seedlings, resulting in more C leaked to the rhizosphere. The loss of C beyond that predicted by simple concentration gradients might have important implications for ecosystem functioning and carbon balance. If stressed plants lose proportionally more carbon to the soil, existing interactions between plants and soils may decouple under stress, and may include unexpected C fluxes between trees, soils and the atmosphere with a changing climate.

  9. Increased risk of venous thromboembolism and arterial cardiovascular events in patients with inflammatory bowel disease

    DEFF Research Database (Denmark)

    Kristensen, Søren Lund; Ahlehoff, Ole; Lindhardsen, Jesper;

    2012-01-01

    This focused review describes the current knowledge of the association between inflammatory bowel disease (IBD) and cardiovascular disease. Atherosclerosis is a chronic inflammatory disease, and as well as venous thromboembolism this disease shares inflammatory mechanisms with IBD. Patients...... with IBD have a high risk of venous thromboembolism especially during IBD flare-ups. Their risk of arterial cardiovascular disease may also be increased. The risk of cardiovascular disease in patients with IBD warrants clinical attention, and it is possible that the risk can be modified by applying anti...

  10. The Impact of Central Venous Catheters on Pediatric Venous Thromboembolism.

    Science.gov (United States)

    Jaffray, Julie; Bauman, Mary; Massicotte, Patti

    2017-01-01

    The use of central venous catheters (CVCs) in children is escalating, which is likely linked to the increased incidence of pediatric venous thromboembolism (VTE). In order to better understand the specific risk factors associated with CVC-VTE in children, as well as available prevention methods, a literature review was performed. The overall incidence of CVC-VTE was found to range from 0 to 74%, depending on the patient population, CVC type, imaging modality, and study design. Throughout the available literature, there was not a consistent determination regarding whether a particular type of central line (tunneled vs. non-tunneled vs. peripherally inserted vs. implanted), catheter material, insertion technique, or insertion location lead to an increased VTE risk. The patient populations who were found to be most at risk for CVC-VTE were those with cancer, congenital heart disease, gastrointestinal failure, systemic infection, intensive care unit admission, or involved in a trauma. Both mechanical and pharmacological prophylactic techniques have been shown to be successful in preventing VTE in adult patients, but studies in children have yet to be performed or are underpowered. In order to better determine true CVC-VTE risk factors and best preventative techniques, an increase in large, prospective pediatric trials needs to be performed.

  11. The Impact of Central Venous Catheters on Pediatric Venous Thromboembolism

    Science.gov (United States)

    Jaffray, Julie; Bauman, Mary; Massicotte, Patti

    2017-01-01

    The use of central venous catheters (CVCs) in children is escalating, which is likely linked to the increased incidence of pediatric venous thromboembolism (VTE). In order to better understand the specific risk factors associated with CVC-VTE in children, as well as available prevention methods, a literature review was performed. The overall incidence of CVC-VTE was found to range from 0 to 74%, depending on the patient population, CVC type, imaging modality, and study design. Throughout the available literature, there was not a consistent determination regarding whether a particular type of central line (tunneled vs. non-tunneled vs. peripherally inserted vs. implanted), catheter material, insertion technique, or insertion location lead to an increased VTE risk. The patient populations who were found to be most at risk for CVC-VTE were those with cancer, congenital heart disease, gastrointestinal failure, systemic infection, intensive care unit admission, or involved in a trauma. Both mechanical and pharmacological prophylactic techniques have been shown to be successful in preventing VTE in adult patients, but studies in children have yet to be performed or are underpowered. In order to better determine true CVC-VTE risk factors and best preventative techniques, an increase in large, prospective pediatric trials needs to be performed. PMID:28168186

  12. Risk factors and anticoagulation parameters in patients of acute exacerbation of chronic obstructive pulmonary disease combined with deep venous thrombosis%慢性阻塞性肺疾病急性加重期合并深静脉血栓形成危险因素及抗凝因子检测

    Institute of Scientific and Technical Information of China (English)

    孙建英; 刘飒; 王红阳; 刘晨; 刘新茹; 贾红光

    2010-01-01

    Objective To investigate the risk factors and anticoagulation parameters in patients of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) combined with deep venous thrombosis (DVT). Methods All of 110 AECOPD patients were divided into two groups according to Doppler examination of lower extremities: DVT group and non-DVT group. The risk factors and anticoagulation parameters were compared. Results Twelve cases (10.9%) were in DVT group,of whom 2 cases (1.8%)had pulmonary embolism. The rate of lying in bed > 3 d, smoke, mechanical ventilation, hospital stays and the levels of PaCO2 were significantly higher in DVT group than those in non-DVT group (P 3 d、吸烟、机械通气的例数增多及住院时间延长(P<0.01),动脉血二氧化碳分压(PaCO2)增高(P<0.05);抗凝血酶Ⅲ活性、蛋白S含量下降(P<0.05)及血D-二聚体含量增加(P<0.05).结论 造成AECOPD患者制动的因素如长期卧床及吸烟、机械通气是发生DVT的高危因素;且Ⅱ型呼吸衰竭的患者更容易合并DVT;AECOPD合并DVT患者存在纤溶功能失衡状态,应监测纤溶指标变化.

  13. Biofilms in chronic wounds.

    Science.gov (United States)

    James, Garth A; Swogger, Ellen; Wolcott, Randall; Pulcini, Elinor deLancey; Secor, Patrick; Sestrich, Jennifer; Costerton, John W; Stewart, Philip S

    2008-01-01

    Chronic wounds including diabetic foot ulcers, pressure ulcers, and venous leg ulcers are a worldwide health problem. It has been speculated that bacteria colonizing chronic wounds exist as highly persistent biofilm communities. This research examined chronic and acute wounds for biofilms and characterized microorganisms inhabiting these wounds. Chronic wound specimens were obtained from 77 subjects and acute wound specimens were obtained from 16 subjects. Culture data were collected using standard clinical techniques. Light and scanning electron microscopy techniques were used to analyze 50 of the chronic wound specimens and the 16 acute wound specimens. Molecular analyses were performed on the remaining 27 chronic wound specimens using denaturing gradient gel electrophoresis and sequence analysis. Of the 50 chronic wound specimens evaluated by microscopy, 30 were characterized as containing biofilm (60%), whereas only one of the 16 acute wound specimens was characterized as containing biofilm (6%). This was a statistically significant difference (p<0.001). Molecular analyses of chronic wound specimens revealed diverse polymicrobial communities and the presence of bacteria, including strictly anaerobic bacteria, not revealed by culture. Bacterial biofilm prevalence in specimens from chronic wounds relative to acute wounds observed in this study provides evidence that biofilms may be abundant in chronic wounds.

  14. Organic acid exudation from the roots of Cunninghamia lanceolata and Pinus massoniana seedlings under low phosphorus stress

    Institute of Scientific and Technical Information of China (English)

    Yuanchun YU; Jian YU; Qihua SHAN; Li FANG; Defeng JIANG

    2008-01-01

    Organic acid exudation from the roots of Chinese fir (Cunninghamia lanceolata) and Masson pine (Pinus massoniana) seedlings under low phosphorus stress was studied using the solution culture method. The results revealed that organic acid exudation from the roots of Chinese fir and Masson pine seedlings under low phosphorus stress increased. Compared with P3 (KH2PO4, 0.5 mmol/L), the average organic acid exuda-tion from the root of Masson pine seedlings under P0 (KH2PO4, 0 mmol/L), P1 (KH2PO4, 0.03 mmol/L) and P2(KH2PO4, 0.09 mmol/L) increased by 328.6%, 267.9% and 126.4% respectively. Masson pine from Zhejiang Province in China had the highest organic acid exuda-tion. Under low phosphorus stress, the increase in organic acid exudation from the different provinces of Chinese fir and Masson pine varied. Masson pine from Zhejiang Province mainly increased oxalic acid, tartaric acid, citric acid and malic acid exudation, that from Guangxi Province mainly increased oxalic acid and tartaric acid exudation, and that from Guizhou Province, China mainly increased oxalic acid, tartaric acid and malic acid exudation. Chinese fir mainly increased oxalic acid and tartaric acid exudation.

  15. Nitrogen and phosphorus fertilization negatively affects strigolactone production and exudation in sorghum.

    Science.gov (United States)

    Yoneyama, Kaori; Xie, Xiaonan; Kisugi, Takaya; Nomura, Takahito; Yoneyama, Koichi

    2013-11-01

    Strigolactones (SLs) are essential host recognition signals for both root parasitic plants and arbuscular mycorrhizal fungi, and SLs or their metabolites function as a novel class of plant hormones regulating shoot and root architecture. Our previous study indicated that nitrogen (N) deficiency as well as phosphorus (P) deficiency in sorghum enhanced root content and exudation of 5-deoxystrigol, one of the major SLs produced by sorghum. In the present study, we examined how N and P fertilization affects SL production and exudation in sorghum plants subjected to short- (5 days) or long-term (10 days) N or P deficiency and demonstrated their common and distinct features. The root contents and exudation of SLs in the N- or P-deficient sorghum plants grown for 6, 12 or 24 h with or without N or P fertilization were quantified by LC-MS/MS. In general, without fertilization, root contents and exudation of SLs stayed at similar levels at 6 and 12 h and then significantly increased at 24 h. The production of SLs responded more quickly to P fertilization than the secretion of SLs, while regulation of SL secretion began earlier after N fertilization. It is suggested that sorghum plants regulate SL production and exudation when they are subjected to nutrient deficiencies depending on the type of nutrient and degree of deficiency.

  16. Methylobacterium-plant interaction genes regulated by plant exudate and quorum sensing molecules

    Directory of Open Access Journals (Sweden)

    Manuella Nóbrega Dourado

    2013-12-01

    Full Text Available Bacteria from the genus Methylobacterium interact symbiotically (endophytically and epiphytically with different plant species. These interactions can promote plant growth or induce systemic resistance, increasing plant fitness. The plant colonization is guided by molecular communication between bacteria-bacteria and bacteria-plants, where the bacteria recognize specific exuded compounds by other bacteria (e.g. homoserine molecules and/or by the plant roots (e.g. flavonoids, ethanol and methanol, respectively. In this context, the aim of this study was to evaluate the effect of quorum sensing molecules (N-acyl-homoserine lactones and plant exudates (including ethanol in the expression of a series of bacterial genes involved in Methylobacterium-plant interaction. The selected genes are related to bacterial metabolism (mxaF, adaptation to stressful environment (crtI, phoU and sss, to interactions with plant metabolism compounds (acdS and pathogenicity (patatin and phoU. Under in vitro conditions, our results showed the differential expression of some important genes related to metabolism, stress and pathogenesis, thereby AHL molecules up-regulate all tested genes, except phoU, while plant exudates induce only mxaF gene expression. In the presence of plant exudates there is a lower bacterial density (due the endophytic and epiphytic colonization, which produce less AHL, leading to down regulation of genes when compared to the control. Therefore, bacterial density, more than plant exudate, influences the expression of genes related to plant-bacteria interaction.

  17. [Effects of wheat root exudates on cucumber growth and soil fungal community structure].

    Science.gov (United States)

    Wu, Feng-Zhi; Li, Min; Cao, Peng; Ma, Ya-Fei; Wang, Li-Li

    2014-10-01

    With wheat as the donor plant and cucumber as the receptor plant, this study investigated the effects of root exudates from wheat cultivars with different allelopathic potentials (positive or negative) and companion cropping with wheat on soil fungal community structure by PCR-DGGE method and cucumber growth. Results showed that the wheat root exudates with positive allelopathic potential increased height and stem diameter of cucumber seedlings significantly, compared to the control seedlings (W) after 6 days and 12 days treatment, respectively. Also, wheat root exudates with both positive and negative allelopathic potential increased the seedling height of cucumber significantly after 18 days treatment. The wheat root exudates with different allelopathic potentials decreased the band number, Shannon and evenness indices of soil fungal community significantly in cucumber seedling rhizosphere, and those in the soil with the control seedlings (W) were also significantly higher than that in the control soil without seedlings (Wn) after 6 days treatment. The band number, Shannon and evenness indices in all the treatments were significantly higher than those in the control soil without seedlings (Wn) after 18 days treatment. Companion cropping with negative allelopathic potential wheat decreased the Shannon and evenness indices of soil fungi community significantly in the cucumber seedling rhizosphere, suggesting the wheat root exudates and companion cropping with wheat changed soil fungal community structure in the cucumber seedling rhizosphere. The results of DGGE map and the principal component analysis showed that companion cropping with wheat cultivars with different allelopathic potentials changed soil fungal community structure in cucumber seedling rhizosphere.

  18. Sex-specific aspects of venous thrombosis

    NARCIS (Netherlands)

    Roach, Rachel Elizabeth Jo

    2014-01-01

    Venous thrombosis is a disease that occurs in 1-2 per 1000 people per year. At the time of their first venous thrombosis, approximately 50% of women are exposed to reproductive risk factors (oral contraception, postmenopausal hormone therapy, pregnancy and the puerperium). In this thesis, we showed

  19. U turn to venous air embolism

    Directory of Open Access Journals (Sweden)

    Singh Harsimran

    2009-01-01

    Full Text Available There is a definitive risk of venous air embolism when the fluid infusion is complete and the drip set is still open in a glass bottle.We have devised a novel way of preventing the chances of air embolism when the fluid in the glass bottle finishes. It really gives a "U" turn to the chances of venous air embolism.

  20. Developmental Venous Anomaly: Benign or Not Benign

    Science.gov (United States)

    AOKI, Rie; SRIVATANAKUL, Kittipong

    2016-01-01

    Developmental venous anomalies (DVAs), previously called venous angiomas, are the most frequently encountered cerebral vascular malformations. However, DVA is considered to be rather an extreme developmental anatomical variation of medullary veins than true malformation. DVAs are composed of dilated medullary veins converging centripetally into a large collecting venous system that drains into the superficial or deep venous system. Their etiology and mechanism are generally accepted that DVAs result from the focal arrest of the normal parenchymal vein development or occlusion of the medullary veins as a compensatory venous system. DVAs per se are benign and asymptomatic except for under certain unusual conditions. The pathomechanisms of symptomatic DVAs are divided into mechanical, flow-related causes, and idiopathic. However, in cases of DVAs associated with hemorrhage, cavernous malformations (CMs) are most often the cause rather than DVAs themselves. The coexistence of CM and DVA is common. There are some possibilities that DVA affects the formation and clinical course of CM because CM related to DVA is generally located within the drainage territory of DVA and is more aggressive than isolated CM in the literature. Brain parenchymal abnormalities surrounding DVA and cerebral varix have also been reported. These phenomena are considered to be the result of venous hypertension associated with DVAs. With the advance of diagnostic imagings, perfusion study supports this hypothesis demonstrating that some DVAs have venous congestion pattern. Although DVAs should be considered benign and clinically silent, they can have potential venous hypertension and can be vulnerable to hemodynamic changes. PMID:27250700

  1. An unusual Complication of Central Venous Cannulation

    Directory of Open Access Journals (Sweden)

    Ashvini Kumar

    2013-04-01

    Full Text Available Central venous catheter (CVC hub fracture is a rare complication of central venous cannulation. We report a case where catheter hub fracture was detected immediately after CVC insertion. Causes of catheter hub fracture and its complications are discussed.

  2. Diagnosis and treatment of venous ulcers.

    Science.gov (United States)

    Collins, Lauren; Seraj, Samina

    2010-04-15

    Venous ulcer, also known as stasis ulcer, is the most common etiology of lower extremity ulceration, affecting approximately 1 percent of the U.S. population. Possible causes of venous ulcers include inflammatory processes resulting in leukocyte activation, endothelial damage, platelet aggregation, and intracellular edema. The primary risk factors for venous ulcer development are older age, obesity, previous leg injuries, deep venous thrombosis, and phlebitis. On physical examination, venous ulcers are generally irregular, shallow, and located over bony prominences. Granulation tissue and fibrin are typically present in the ulcer base. Associated findings include lower extremity varicosities, edema, venous dermatitis, and lipodermatosclerosis. Venous ulcers are usually recurrent, and an open ulcer can persist for weeks to many years. Severe complications include cellulitis, osteomyelitis, and malignant change. Poor prognostic factors include large ulcer size and prolonged duration. Evidence-based treatment options for venous ulcers include leg elevation, compression therapy, dressings, pentoxifylline, and aspirin therapy. Surgical management may be considered for ulcers that are large in size, of prolonged duration, or refractory to conservative measures.

  3. Risk factors for venous thromboembolism during pregnancy

    DEFF Research Database (Denmark)

    Jensen, Thomas Bo; Gerds, Thomas Alexander; Grøn, Randi;

    2013-01-01

    Pregnant women are at an increased risk of venous thromboembolism (VTE). Risk factors for VTE among pregnant women are not sufficiently investigated.......Pregnant women are at an increased risk of venous thromboembolism (VTE). Risk factors for VTE among pregnant women are not sufficiently investigated....

  4. Venous thromboembolism in cancer patients

    Directory of Open Access Journals (Sweden)

    Mehmet Fuat Eren

    2013-09-01

    Full Text Available Venous thromboembolism (VTE is a major complication of cancer and represents an important cause of morbidity and mortality. The incidence of VTE is 0.6-7.8% in patients with cancer more than double the incidence of VTE in patients without cancer. The risk of VTE which includes deep venous thrombosis (DVT and pulmonary embolism (PE is increased two to seven fold in patients with cancer. VTE risk is especially high among certain groups such as hospitalized patients with cancer and those receiving active antineoplastic therapy. Also cancer patients, who undergoing major surgery, are increased risk of VTE. Trauma, long-haul travel, increased age, obesity, previous VTE and genetic component are also predisposing factors for VTE. Patients with cancer who develop VTE should be managed multidisciplinary treatment guidelines. The primary goal of thromboprophylaxis in patients with cancer is to prevent VTE. The large majority of cancer patients should be treated with therapeutic doses of unfractioned heparin (UFH or low molecular weight heparin (LMWH. Prophylaxis should include cancer patients who underwent major surgery for cancer and patients with a history of VTE.

  5. Wartime major venous vessel injuries.

    Science.gov (United States)

    Hudorovic, Narcis

    2008-02-01

    The aim of this study is to declare our experience and to identify the important factors that influence the mortality and morbidity in patients with combat-related penetrating wounds of the abdomen (CR-PWA) with major venous vessel injuries. Twenty-six wounded with combat-related injuries of major abdominal venous vessels, admitted in the University Clinic cardiovascular surgery department during the period from 1 August 1991 through 30 October 1995, were analyzed. Patients with concomitant injured arteries and extra-abdominal injuries (n=150; 85.2%) were excluded from this study. The Penetrating Abdominal Trauma Index (PATI) score for each patient was calculated. Fifteen patients (57.69%) sustained with PATI score greater than 25 died. The mean duration of hospitalization was 16 days (range 0-86). The average hospitalization time for those surviving their complications was 17 days with a PATI of 25 or less, and 43 days with a score more than 25. Three clinical assessments of the long-term outcome were performed after a median of about 3, 5 and 10 years, respectively. Surviving patients (42.31%) were symptom free and had normal Duplex scans as well as no other surgical related complications. Higher PATI scores, postoperative complications and reoperations exert an unfavorable effect on patient outcome.

  6. Compression for Primary Prevention, Treatment, and Prevention of Recurrence of Venous Leg Ulcers: An Evidence-and Consensus-Based Algorithm for Care Across the Continuum.

    Science.gov (United States)

    Ratliff, Catherine R; Yates, Stephanie; McNichol, Laurie; Gray, Mikel

    2016-01-01

    Chronic venous insufficiency is a prevalent disease that frequently leads to development of venous leg ulcers. While a number of evidence-based clinical practice guidelines have been developed that provide guidance for clinicians when caring for patients with chronic venous insufficiency, they lack adequate detail concerning selection and application of compression for prevention and management of venous leg ulcers. In order to address this need, the WOCN Society appointed a task force to develop an algorithm for compression for primary prevention, treatment, and prevention of recurrent venous leg ulcers in persons with chronic venous insufficiency. The task force used findings from a scoping literature review to identify current best evidence needed to support decision points and pathways within the algorithm. In addition, the task force convened a panel of 20 clinicians and researchers with expertise in lower extremity venous disorders in order to establish consensus around pathways and decision points within the algorithm lacking robust evidence. Following initial construction of the algorithm, a second interdisciplinary group of expert clinicians established content validity and provided additional qualitative feedback used to complete final revisions of the algorithm. This article reviews the process used to create this landmark algorithm, including generation of the evidence- and consensus-based statements used in its construction, the various pathways, and rich supplemental materials embedded within the algorithm, and the process used to establish content validity.

  7. Sustaining Behavior Changes Following a Venous Leg Ulcer Client Education Program

    Directory of Open Access Journals (Sweden)

    Charne Miller

    2014-09-01

    Full Text Available Venous leg ulcers are a symptom of chronic insufficiency of the veins. This study considered the sustainability of behavior changes arising from a client focus e-Learning education program called the “Leg Ulcer Prevention Program” (LUPP for people with a venous leg ulcer. Data from two related studies were used to enable a single sample (n = 49 examination of behavior maintenance across an average 8 to 9 months period. Physical activity levels increased over time. Leg elevation, calf muscle exercises, and soap substitute use were seen to fluctuate over the follow up time points. The use of a moisturizer showed gradual decline over time. The provision of a client-focused venous leg ulcer program was associated with behavior changes that had varied sustainability across the evaluation period.

  8. Sustaining Behavior Changes Following a Venous Leg Ulcer Client Education Program

    Science.gov (United States)

    Miller, Charne; Kapp, Suzanne; Donohue, Lisa

    2014-01-01

    Venous leg ulcers are a symptom of chronic insufficiency of the veins. This study considered the sustainability of behavior changes arising from a client focus e-Learning education program called the “Leg Ulcer Prevention Program” (LUPP) for people with a venous leg ulcer. Data from two related studies were used to enable a single sample (n = 49) examination of behavior maintenance across an average 8 to 9 months period. Physical activity levels increased over time. Leg elevation, calf muscle exercises, and soap substitute use were seen to fluctuate over the follow up time points. The use of a moisturizer showed gradual decline over time. The provision of a client-focused venous leg ulcer program was associated with behavior changes that had varied sustainability across the evaluation period. PMID:27429280

  9. Overview of guidelines for the prevention and treatment of venous leg ulcers: a US perspective

    Directory of Open Access Journals (Sweden)

    White-Chu EF

    2014-02-01

    Full Text Available E Foy White-Chu,1 Teresa A Conner-Kerr2 1Oregon Health and Science University, Portland VA Medical Center, Portland, OR, 2Winston-Salem State University, Department of Physical Therapy, Winston Salem, NC, USA Abstract: Comprehensive care of chronic venous insufficiency and associated ulcers requires a multipronged and interprofessional approach to care. A comprehensive treatment approach includes exercise, nutritional assessment, compression therapy, vascular reconstruction, and advanced treatment modalities. National guidelines, meta-analyses, and original research studies provide evidence for the inclusion of these approaches in the patient plan of care. The purpose of this paper is to review present guidelines for prevention and treatment of venous leg ulcers as followed in the US. The paper further explores evidence-based yet pragmatic tools for the interprofessional team to use in the management of this complex disorder. Keywords: venous insufficiency, varicose ulcer, wound, compression bandages

  10. Antimicrobial susceptibility of Staphylococcus hyicus Isolated from exudative epidermitis in pigs

    DEFF Research Database (Denmark)

    Wegener, Henrik Caspar; Watts, J.L.; Salmon, S.A.;

    1994-01-01

    Exudative epidermitis or greasy pig syndrome is caused by the coagulase-variable staphylococcal species Staphylococcus hyicus. Treatment of this disease is problematic because of the limited number of antimicrobial agents available for this purpose. Thirteen antimicrobial agents were evaluated...... for their activities against 100 S. hyicus strains isolated from pigs with exudative epidermitis. Novobiocin was the most active compound tested, with an MIC for 90% of the strains tested (MIC(90)) of less than or equal to 0.06 mu g/ml. Enrofloxacin, ampicillin, and ceftiofur were the next most active compounds...... at ratios of 1:2 (lincomycin to spectinomycin) and 1:8 were more active, with MIC(90)s of 16.0 and 4.0 mu g/ml, respectively. These results indicate that novobiocin and sulfadiazine-trimethoprim were the most active compounds tested against the S. hyicus strains isolated from pigs with exudative epidermitis...

  11. Improvement of the Hard Exudates Detection Method Used For Computer- Aided Diagnosis of Diabetic Retinopathy

    Directory of Open Access Journals (Sweden)

    Feroui Amel

    2012-05-01

    Full Text Available Diabetic retinopathy is a severe and widely spread eye disease. Early diagnosis and timely treatment of these clinical signs such as hard exudates could efficiently prevent blindness. The presence of exudates within the macular region is a main hallmark of diabetic macular edema and allows its detection with high sensitivity. In this paper, we combine the k-means clustering algorithm and mathematical morphology to detect hard exudates (HEs in retinal images of several diabetic patients. This method is tested on a set of 50 ophthalmologic images with variable brightness, color, and forms of HEs. The algorithm obtained a sensitivity of 95.92%, predictive value of 92.28% and accuracy of 99.70% using a lesion-based criterion.

  12. Two cases of exudative retina detachment and uveitis following H1N1 influenza vaccination

    Institute of Scientific and Technical Information of China (English)

    TAO Yong; CHANG Li-bing; ZHAO Min; LI Xiao-xin

    2011-01-01

    Uveitis was a rare adverse event of vaccination.We met two cases of acute uveitis with exudative retinal detachment following vaccination of H1N1 influenza.Case 1 was a 10-year-old boy who was admitted for bilateral blurred vision at 10 days after vaccination of H1N1 influenza.Vitreous opacity was obvious in both eyes.Broad exudative retinal detachment was observed in the right eye.Case 2 was a 47-year-old female who suffered from an acute high fever at 2 days after the vaccination of H1 N1 influenza.Later,she encountered bilateral headache and decreasing vision.In both eyes,mutton fat keratic precipitates,positive Tyndall phenomenon,congestion of optic disc and exudative retinal detachment were observed.

  13. Molecular responses in root-associative rhizospheric bacteria to variations in plant exudates

    Science.gov (United States)

    Abdoun, Hamid; McMillan, Mary; Pereg, Lily

    2015-04-01

    Plant exudates are a major factor in the interface of plant-soil-microbe interactions and it is well documented that the microbial community structure in the rhizosphere is largely influenced by the particular exudates excreted by various plants. Azospirillum brasilense is a plant growth promoting rhizobacterium that is known to interact with a large number of plants, including important food crops. The regulatory gene flcA has an important role in this interaction as it controls morphological differentiation of the bacterium that is essential for attachment to root surfaces. Being a response regulatory gene, flcA mediates the response of the bacterial cell to signals from the surrounding rhizosphere. This makes this regulatory gene a good candidate for analysis of the response of bacteria to rhizospheric alterations, in this case, variations in root exudates. We will report on our studies on the response of Azospirillum, an ecologically, scientifically and agriculturally important bacterial genus, to variations in the rhizosphere.

  14. Multiscale model of a freeze-thaw process for tree sap exudation

    CERN Document Server

    Graf, Isabell; Stockie, John M

    2015-01-01

    Sap transport in trees has long fascinated scientists, and a vast literature exists on experimental and modelling studies of trees during the growing season when large negative stem pressures are generated by transpiration from leaves. Much less attention has been paid to winter months when trees are largely dormant but nonetheless continue to exhibit interesting flow behaviour. A prime example is sap exudation, which refers to the peculiar ability of sugar maple (Acer saccharum) and related species to generate positive stem pressure while in a leafless state. Experiments demonstrate that ambient temperatures must oscillate about the freezing point before significantly heightened stem pressures are observed, but the precise causes of exudation remain unresolved. The prevailing hypothesis attributes exudation to a physical process combining freeze-thaw and osmosis, which has some support from experimental studies but remains a subject of active debate. We address this knowledge gap by developing the first math...

  15. EFFECT OF ROOT EXUDATES OF TAGETES SP. ON EGG HATCHING BEHAVIOR OF MELOIDOGYNE INCOGNITA

    Directory of Open Access Journals (Sweden)

    Iruthaya Kalaiselvam

    2011-10-01

    Full Text Available The effect root exudates of pre-planted marigold intercropped with tomato in regulating the hatching behavior of root-knot nematode - Meloidogyne incognita eggs were investigated. Marigold cultivars Tagetes patula, T. minuta, T. erecta, T. erecta (var. Orange, T. erecta (var. Yellow significantly reduced the numbers of second-stage juveniles (J2s in subsequent tomato compared to the tomato-tomato control. Four different concentrations (25, 50, 75 and 100 % of water soluble extract from the selected varieties of Marigold cultivars were filtered and added to the petri dish and infested with the eggs of M. incognita. Data indicate that egg hatching was significantly affected by root exudates of Tagetes sp. however, nematicidal activity was species dependent. Root exudates of T. erecta were lethal to J2 of M. incognita and were inhibitory to the hatch of eggs at the concentration of 75 % or higher.

  16. Pleural Effusion in Meigs' Syndrome-Transudate or Exudate?: Systematic Review of the Literature.

    Science.gov (United States)

    Krenke, Rafal; Maskey-Warzechowska, Marta; Korczynski, Piotr; Zielinska-Krawczyk, Monika; Klimiuk, Joanna; Chazan, Ryszarda; Light, Richard W

    2015-12-01

    Although Meigs' syndrome is regarded as a well-defined entity, contradictory data on pleural fluid characteristics have been presented, with some papers classifying it as a transudate, whereas others stating that it is an exudate.The aims of the study were: (1) to evaluate pleural fluid characteristics in patients with Meigs' syndrome and (2) to analyze the prevalence of transudative and exudative pleural effusion in relation to the applied definition of the syndrome.We performed a search through medical databases (MEDLINE, EMBASE, SCOPUS, and GOOGLE SCHOLAR) to identify papers on Meigs' syndrome published between 1940 and 2013. Two authors independently reviewed each paper searching for prespecified data: (1) signs and symptoms, (2) tumor characteristics, (3) clinical and laboratory data on ascites, (4) clinical, radiological, and laboratory data on pleural fluid, (5) clinical course after tumor removal. All case reports were reclassified according to a new unequivocal classification of Meigs' syndrome-related entities.A total of 653 papers were initially identified, and 454 articles reporting 541 patients were included in the final analysis. After reclassification according to our case definitions, there were 196, 113, and 108 patients defined as classic Meigs' syndrome, nonclassic Meigs' syndrome, and pseudo-Meigs' syndrome, respectively. Significantly more patients presented with right-sided than left-sided and bilateral pleural effusions (P  3.0 g/dL was applied as a criterion of pleural exudate, 88.8% (80/90) of effusions were classified as exudates. Increasing the cut-off level to 3.5 g/dL resulted in only a modest decrease in the percentage of exudative effusions (81%, 73/90).Surprisingly few reports on Meigs' syndrome present data reliably defining the character of pleural effusion. The available data indicate, however, that the majority of pleural effusions in patients with this entity are exudates. This finding may be a prerequisite for the

  17. Tall fescue cultivar and fungal endophyte combinations influence plant growth and root exudate composition.

    Science.gov (United States)

    Guo, Jingqi; McCulley, Rebecca L; McNear, David H

    2015-01-01

    Tall fescue [Lolium arundinaceum (Schreb.)] is a cool-season perennial grass used in pastures throughout the Southeastern United States. The grass can harbor a shoot-specific fungal endophyte (Epichloë coenophiala) thought to provide the plant with enhanced resistance to biotic and abiotic stresses. Because alkaloids produced by the common variety of the endophyte cause severe animal health issues, focus has been on replacing the common-toxic strain with novel varieties that do not produce the mammal-toxic alkaloids but maintain abiotic and biotic stress tolerance benefits. Little attention has been given to the influence of the plant-fungal symbiosis on rhizosphere processes. Therefore, our objective was to study the influence of this relationship on plant biomass production and root exudate composition in tall fescue cultivars PDF and 97TF1, which were either not infected with the endophyte (E-), infected with the common toxic endophyte (CTE+) strain or with one of two novel endophytes (AR542E+, AR584E+). Plants were grown sterile for 3 weeks after which plant biomass, total organic carbon, total phenolic content and detailed chemical composition of root exudates were determined. Plant biomass production and exudate phenolic and organic carbon content were influenced by endophyte status, tall fescue cultivar, and their interaction. GC-TOF MS identified 132 compounds, including lipids, carbohydrates and carboxylic acids. Cluster analysis showed that the interaction between endophyte and cultivar resulted in unique exudate profiles. This is the first detailed study to assess how endophyte infection, notably with novel endophytes, and tall fescue cultivar interact to influence root exudate composition. Our results illustrate that tall fescue cultivar and endophyte status can influence plant growth and root exudate composition, which may help explain the observed influence of this symbiosis on rhizosphere biogeochemical processes.

  18. Tall fescue cultivar and fungal endophyte combinations influence plant growth and root exudate composition

    Directory of Open Access Journals (Sweden)

    Jingqi eGuo

    2015-04-01

    Full Text Available Tall fescue (Lolium arundinaceum (Schreb. is a cool-season perennial grass used in pastures throughout the Southeastern United States. The grass can harbor a shoot-specific fungal endophyte (Epichloë coenophiala thought to provide the plant with enhanced resistance to biotic and abiotic stresses. Because alkaloids produced by the common variety of the endophyte cause severe animal health issues, focus has been on replacing the common-toxic strain with novel varieties that do not produce the mammal-toxic alkaloids but maintain abiotic and biotic stress tolerance benefits. Little attention has been given to the influence of the plant-fungal symbiosis on rhizosphere processes. Therefore, our objective was to study the influence of this relationship on plant biomass production and root exudate composition in tall fescue cultivars PDF and 97TF1, which were either not infected with the endophyte (E-, infected with the common toxic endophyte (CTE+ strain or with one of two novel endophytes (AR542E+, AR584E+. Plants were grown sterile for three weeks after which plant biomass, total organic carbon, total phenolic content and detailed chemical composition of root exudates were determined. Plant biomass production and exudate phenolic and organic carbon content were influenced by endophyte status, tall fescue cultivar, and their interaction. GC-TOF MS identified 132 compounds, including lipids, carbohydrates and carboxylic acids. Cluster analysis showed that the interaction between endophyte and cultivar resulted in unique exudate profiles. This is the first detailed study to assess how endophyte infection, notably with novel endophytes, and tall fescue cultivar interact to influence root exudate composition. Our results illustrate that tall fescue cultivar and endophyte status can influence plant growth and root exudate composition, which may help explain the observed influence of this symbiosis on rhizosphere biogeochemical processes.

  19. Bioavailability of zinc and phosphorus in calcareous soils as affected by citrate exudation

    OpenAIRE

    Duffner, A.; Hoffland, E.; Temminghoff, E. J. M.

    2012-01-01

    Aims Zinc (Zn) and phosphorus (P) deficiency often occurs at the same time and limits crop production in many soils. It has been suggested that citrate root exudation is a response of plants to both deficiencies. We used white lupin (Lupinus albus L.) as a model plant to clarify if citrate exuded by roots could increase the bioavailability of Zn and P in calcareous soils. Methods White lupin was grown in nutrient solution and in two calcareous soils in a rhizobox. Rhizosphere soil solution wa...

  20. Enhanced root exudation stimulates soil nitrogen transformations in a subalpine coniferous forest under experimental warming.

    Science.gov (United States)

    Yin, Huajun; Li, Yufei; Xiao, Juan; Xu, Zhenfeng; Cheng, Xinyin; Liu, Qing

    2013-07-01

    Despite the perceived importance of exudation to forest ecosystem function, few studies have attempted to examine the effects of elevated temperature and nutrition availability on the rates of root exudation and associated microbial processes. In this study, we performed an experiment in which in situ exudates were collected from Picea asperata seedlings that were transplanted in disturbed soils exposed to two levels of temperature (ambient temperature and infrared heater warming) and two nitrogen levels (unfertilized and 25 g N m(-2)  a(-1) ). Here, we show that the trees exposed to an elevated temperature increased their exudation rates I (μg C g(-1) root biomass h(-1) ), II (μg C cm(-1)  root length h(-1) ) and III (μg C cm(-2)  root area h(-1) ) in the unfertilized plots. The altered morphological and physiological traits of the roots exposed to experimental warming could be responsible for this variation in root exudation. Moreover, these increases in root-derived C were positively correlated with the microbial release of extracellular enzymes involved in the breakdown of organic N (R(2)  = 0.790; P = 0.038), which was coupled with stimulated microbial activity and accelerated N transformations in the unfertilized soils. In contrast, the trees exposed to both experimental warming and N fertilization did not show increased exudation rates or soil enzyme activity, indicating that the stimulatory effects of experimental warming on root exudation depend on soil fertility. Collectively, our results provide preliminary evidence that an increase in the release of root exudates into the soil may be an important physiological adjustment by which the sustained growth responses of plants to experimental warming may be maintained via enhanced soil microbial activity and soil N transformation. Accordingly, the underlying mechanisms by which plant root-microbe interactions influence soil organic matter decomposition and N cycling should be incorporated

  1. Advanced management of acute iliofemoral deep venous thrombosis: emergency department and beyond.

    Science.gov (United States)

    Pollack, Charles V

    2011-06-01

    Recent attention to the increasing incidence of venous thromboembolism has included a call to action from the surgeon general and new guidelines from various specialty organizations. The standard of care for treatment of deep venous thrombosis in the emergency department (ED), supported by the 2008 American College of Chest Physicians (ACCP) guidelines, involves initiation of anticoagulation with low-molecular-weight heparin, pentasaccharide, or unfractionated heparin. For selected appropriate patients with extensive acute proximal deep venous thrombosis, the ACCP guidelines now recommend thrombolysis in addition to anticoagulation to reduce not only the risk of pulmonary embolism but also the risk of subsequent postthrombotic syndrome and recurrent deep venous thrombosis. Postthrombotic syndrome is a potentially debilitating chronic cluster of lower-extremity symptoms occurring in 20% to 50% of deep venous thrombosis patients subsequent to the acute insult, sometimes not until years later. A strategy of early thrombus burden reduction or frank removal might reduce the incidence of postthrombotic syndrome, as per natural history studies, venous thrombectomy data, observations after systemic and catheter-directed thrombolysis, and the still-limited number of randomized trials of catheter-directed thrombolysis (with anticoagulation) versus anticoagulation alone. Contemporary invasive (endovascular) treatments mitigate the drawbacks historically associated with thrombolytic approaches by means of intrathrombus delivery of drugs with greater fibrin specificity and lower allergenicity, followed by mechanical dispersion to accelerate lysis and then aspiration of remaining drug and clot debris. With a 2016 target completion date, the National Heart, Lung, and Blood Institute--sponsored Acute Venous Thrombosis: Thrombus Removal With Adjunctive Catheter-Directed Thrombolysis trial is comparing the safety and efficacy, in terms of both deep venous thrombosis and

  2. Combined therapy of Ulmo honey (Eucryphia cordifolia and ascorbic acid to treat venous ulcers

    Directory of Open Access Journals (Sweden)

    Mariano del Sol Calderon

    2015-04-01

    Full Text Available OBJECTIVE: to assess the clinical effect of topical treatment using Ulmo honey associated with oral ascorbic acid in patients with venous ulcers. METHOD: longitudinal and descriptive quantitative study. During one year, 18 patients were assessed who were clinically diagnosed with venous ulcer in different stages, male and female, adult, with a mean injury time of 13 months. Ulmo honey was topically applied daily. The dressing was applied in accordance with the technical standard for advanced dressings, combined with the daily oral consumptions of 500 mg of ascorbic acid. The monitoring instrument is the assessment table of venous ulcers. RESULTS: full healing was achieved in 100% of the venous ulcers. No signs of complications were observed, such as allergies or infection. CONCLUSION: the proposed treatment showed excellent clinical results for the healing of venous ulcers. The honey demonstrated debriding and non-adherent properties, was easy to apply and remove and was well accepted by the users. The described results generated a research line on chronic wound treatment.

  3. Cerebral venous outflow and cerebrospinal fluid dynamics

    Directory of Open Access Journals (Sweden)

    Clive B. Beggs

    2014-12-01

    Full Text Available In this review, the impact of restricted cerebral venous outflow on the biomechanics of the intracranial fluid system is investigated. The cerebral venous drainage system is often viewed simply as a series of collecting vessels channeling blood back to the heart. However there is growing evidence that it plays an important role in regulating the intracranial fluid system. In particular, there appears to be a link between increased cerebrospinal fluid (CSF pulsatility in the Aqueduct of Sylvius and constricted venous outflow. Constricted venous outflow also appears to inhibit absorption of CSF into the superior sagittal sinus. The compliance of the cortical bridging veins appears to be critical to the behaviour of the intracranial fluid system, with abnormalities at this location implicated in normal pressure hydrocephalus. The compliance associated with these vessels appears to be functional in nature and dependent on the free egress of blood out of the cranium via the extracranial venous drainage pathways. Because constricted venous outflow appears to be linked with increased aqueductal CSF pulsatility, it suggests that inhibited venous blood outflow may be altering the compliance of the cortical bridging veins.

  4. Haemoptysis due to pulmonary venous stenosis

    Directory of Open Access Journals (Sweden)

    Silke Braun

    2014-06-01

    Full Text Available Haemoptysis is a potentially life-threatening condition with the need for prompt diagnosis. In about 10–20% of all cases the bleeding source remains unexplained with the standard diagnostic approach. The aim of this article is to show the necessity of widening the diagnostic approach to haemoptysis with consideration of pulmonary venous stenosis as a possible cause of even severe haemoptysis and haemoptoe. A review of the literature was performed using the Medline/PubMed database with the terms: “pulmonary venous stenosis”, “pulmonary venous infarction” and “haemoptysis”. Further references from the case reports were considered. 58 case reports and case collections about patients with haemoptysis due to pulmonary venous stenosis were detected. This review gives an overview about the case reports and discusses the underlying pathophysiology and the pros and cons of different imaging techniques for the detection of pulmonary venous stenosis. Several conditions predispose to the obstruction of the mediastinal pulmonary veins. Clinical findings are unspecific and may be misleading. Pulmonary venous stenosis can be detected using several imaging techniques, yet three-dimensional magnetic resonance-angiography and three-dimensional contrast-enhanced computed tomography are the most appropriate. Pulmonary venous stenosis should be considered in patients with haemoptysis.

  5. Determination of Organic Acids in Root Exudates by High Performance Liquid Chromatography:Ⅲ.Effects of Interfering Factors

    Institute of Scientific and Technical Information of China (English)

    SHENJIANBO; ZHANGFUSUO; 等

    1999-01-01

    A solution culture experiment was conducted to investigate the effects of collection time and interfering ions on separation and determination of low-molecular-weight organic acids in root exudates of soybean using the method for directly collecting root exudates.The suitable cooection time of root exudates and the interferiung ions affecting organic acid determination were determined.The method for removing the interfering ions was established and analyzed.The release amount of root exudates increased with the increase of collection time from 0 to 120min but decreased with increasing of collection time from 120to 240min.The maximum exuding amounts of organic acids were observed in root exudates at the collection time of 120min.There was a significant difference of organic acid components between the treatments of collection time of 120min and 240min,Citric acid was founnd only in the treatment of 120min collection time,NO3- was the main interfering ion in organic acid determination and had the same retention time as oxalic acid.Anion exchange resin(SAX)properly treated by HPLC(high performance liquid chromatography)solvent could remove NO3- anion in sample solution of root exudates,thus enhancing the recoveries of organic acids in root exudates.There was no significant effect of the chemicals added into sample solution such as H3PO4,SAX and KNO3 on the retention time of organic acids.

  6. Redox transformations of iron in the presence of exudate from the cyanobacterium Microcystis aeruginosa under conditions typical of natural waters.

    Science.gov (United States)

    Wang, Kai; Garg, Shikha; Waite, T David

    2017-02-24

    Interaction of the exudate secreted by a toxic strain of the cyanobacterium Microcystis aeruginosa with Fe(II) and Fe(III) was investigated here under both acidic (pH 4) and alkaline (pH 8) conditions. At the concentrations of iron and exudate used, iron was present as dissolved iron (< 0.025 µm) at pH 4 but principally as small (< 0.45 µm) iron oxyhydroxide particles at pH 8 with only ~3-27% present in the dissolved form as a result of iron binding by the organic exudate. The formation of strong Fe(III)-exudate and relatively weak Fe(II)-exudate complexes alters the reduction potential of the Fe(III)/Fe(II) redox couple facilitating more rapid oxidation of Fe(II) at pH 4 and 8 than was the case in the absence of exudate. Our results further show that the organic exudate contains Fe(III) reducing moieties resulting in production of measureable concentrations of Fe(II). However, these reducing moieties are short-lived (with a half-life of 1.9 hours) and easily oxidized in air-saturated environments. A kinetic model was developed that adequately describes the redox transformation of Fe in the presence of exudate both at pH 4 and pH 8.

  7. The role of prophylactic ibuprofen and N-acetylcysteine on the level of cytokines in periapical exudates and the post-treatment pain

    Directory of Open Access Journals (Sweden)

    Ehsani Maryam

    2012-09-01

    Full Text Available Abstract Background Periapical lesions are inflammatory diseases that result in periapical bone destruction because of host defensive–microbial disturbances. Objective To evaluate the role of prophylactic ibuprofen and N-acetylcysteine (NAC on the levels of tumor necrosis factor alpha (TNF- α, interleukin- 6(IL-6 and IL-17 and post-treatment pain level in chronic periapical lesions. Materials and methods Eighty patients with chronic apical lesions less than 1 cm were randomly assigned to receive NAC tablets (400 mg, ibuprofen tablets (400 mg, NAC (400 mg/ibuprofen (200 mg combination and placebo 90 minutes prior to sampling. Periapical exudates were collected from root canals. TNF- α, IL-6 and IL-17 levels were determined by ELISA and post-treatment pain was assessed using a visual analog scale (VAS. Results There was a significant difference in IL-6 level between ibuprofen group and placebo (p = 0.019. Significant difference in IL-17 level was observed between NAC/ibuprofen combination group and placebo (p = 0.043. Four hours after treatment, a significant difference was observed in VAS pain score between ibuprofen group and placebo (p = 0.017. Eight hours post-treatment, VAS pain score for NAC group was statistically lower than placebo group (p = 0.033. After 12 hours VAS pain score showed a significant decrease in NAC group compared to placebo (p = 0.049. Conclusion The prophylactic ibuprofen and NAC failed to clearly reflect their effect on cytokines levels in exudates of chronic periapical lesions. On the other hand it seems that NAC can be a substitute for ibuprofen in the management of post endodontic pain.

  8. Upper Body Venous Compliance Exceeds Lower Body Venous Compliance in Humans

    Science.gov (United States)

    Watenpaugh, Donald E.

    1996-01-01

    Human venous compliance hypothetically decreases from upper to lower body as a mechanism for maintenance of the hydrostatic indifference level 'headward' in the body, near the heart. This maintains cardiac filling pressure, and thus cardiac output and cerebral perfusion, during orthostasis. This project entailed four steps. First, acute whole-body tilting was employed to alter human calf and neck venous volumes. Subjects were tilted on a tilt table equipped with a footplate as follows: 90 deg, 53 deg, 30 deg, 12 deg, O deg, -6 deg, -12 deg, -6 deg, O deg, 12 deg, 30 deg, 53 deg, and 90 deg. Tilt angles were held for 30 sec each, with 10 sec transitions between angles. Neck volume increased and calf volume decreased during head-down tilting, and the opposite occurred during head-up tilt. Second, I sought to cross-validate Katkov and Chestukhin's (1980) measurements of human leg and neck venous pressures during whole-body tilting, so that those data could be used with volume data from the present study to calculate calf and neck venous compliance (compliance = (Delta)volume/(Delta)pressure). Direct measurements of venous pressures during postural chances and whole-body tilting confirmed that the local changes in venous pressures seen by Katkov and Chestukhin (1980) are valid. The present data also confirmed that gravitational changes in calf venous pressure substantially exceed those changes in upper body venous pressure. Third, the volume and pressure data above were used to find that human neck venous compliance exceeds calf venous compliance by a factor of 6, thereby upholding the primary hypothesis. Also, calf and neck venous compliance correlated significantly with each other (r(exp 2) = 0.56). Fourth, I wished to determine whether human calf muscle activation during head-up tilt reduces calf venous compliance. Findings from tilting and from supine assessments of relaxed calf venous compliance were similar, indicating that tilt-induced muscle activation is

  9. Current perspective of venous thrombosis in the upper extremity

    NARCIS (Netherlands)

    Flinterman, L.E.; Meer, van der F.J.M.; Rosendaal, F.R.; Doggen, C.J.M.

    2008-01-01

    Venous thrombosis of the upper extremity is a rare disease. Therefore, not as much is known about risk factors, treatment and the risk of recurrence as for venous thrombosis of the leg. Only central venous catheters and strenuous exercise are commonly known risk factors for an upper extremity venous

  10. [Ultrasound-guided peripheral venous access].

    Science.gov (United States)

    Fuzier, Régis; Rougé, Pierre; Pierre, Sébastien

    2016-02-01

    International guidelines advocate the use of first-line ultrasound for central venous catheter, particularly for the internal jugular vein. The role of ultrasound in peripheral venous access remains questionable. In some specific situations, such as pediatrics, obesity and patients with poor venous network, problems to cannulate peripheral vein may occur. Success rate of peripheral intravenous access increases with the diameter of the vein and for a depth of the vein between 0.3 and 1.5 cm. The type of puncture (long-axis or short-axis) and the type of catheters have little influence on the success rate. Specific considerations have to be taken concerning infection control.

  11. Current opinion on iliofemoral venous thrombectomy.

    Science.gov (United States)

    Stephens, G L

    1976-02-01

    Iliofemoral venous thrombosis is discussed and a technique of iliofemoral venous thrombectomy is presented. Operative phlebography is recommended. The personal recommendations of leading American vascular surgeons in treating the patient with acute iliofemoral venous thrombosis are presented. I recommend thrombectomy for phlegmasia cerulea dolens, and in previously healthy, young ambulatory patients with phlegmasia alba dolens who are seen within 48 hours following thrombosis and have failed to show clinical improvement after a trial of bed rest, elevation of the lower extremities, and intravenous heparin. The majority of patients seen with phlegmasia alba dolens will best be served with nonoperative treatment.

  12. Peritumoral Tissue Compression is Predictive of Exudate Flux in a Rat Model of Cerebral Tumor: an MRI Study in an Embedded Tumor

    OpenAIRE

    Ewing, James R; Nagaraja, Tavarekere N.; Aryal, Madhava P.; Keenan, Kelly A.; Elmghirbi, Rasha; Bagher-Ebadian, Hassan; Panda, Swayamprava; Lu, Mei; Mikkelsen, Tom; Cabral, Glauber; Brown, Stephen L.

    2015-01-01

    MRI estimates of extracellular volume and tumor exudate flux in peritumoral tissue are demonstrated in an experimental model of cerebral tumor. Peritumoral extracellular volume predicted the tumor exudate flux.

  13. Acacia Senegal Gum Exudate Offers Protection Against Cyclophosphamide-Induced Urinary Bladder Cytotoxicity

    Directory of Open Access Journals (Sweden)

    Abdulaziz A. Al-Yahya

    2009-01-01

    Full Text Available Cylophosphamide (CYCL is a strong anticancer and immunosuppressive agent but its urotoxicity presents one of the major toxic effects that limit its wide usage particularly in high dose regimens. Therefore, this study aimed to investigate Acacia Senegal gum exudate, Gum Arabic (GA, for its possible role as a natural, nontoxic agent against CYCL-induced urotoxicity. Male Swiss albino rats were exposed to CYCL (150 mg/kg BW, once i.p with or without GA oral supplementation (7.5 g/kg/day for 6 days through drinking water. Glutathione (GSH, Malondialdehyde (MDA and Nitric oxide (NO bladder contents were assessed. Responsiveness of the bladder rings to acetylcholine (ACh in vitro, microscopic and macroscopic features are also investigated. CYCL produced pronounced harmful effects on bladder urothelial lining with significant increases in (MDA and NO levels in the tissue homogenates. Bladder-GSH content is dropped by over 60% following CYCL injection. Bladder contractility, as measured by its responsiveness to ACh, recorded a marked reduction. The isolated bladders exhibited such macroscopic changes as severe edema, inflammation and extravasation. The bladder weight increased as well. Histological changes were evident in the form of severe congestion, petechial hemorrhage and chronic inflammatory reaction in the lamina propria accompanied with desquamated epithelia. GA, a potential protective agent, produced an almost complete reversal of NO induction, lipid peroxidation or cellular GSH bladder contents in the GA + CYCL-treated group. Likewise, bladder inflammation and edema were reduced. Bladder rings showed a remarkable recovery in their responsiveness to ACh. Bladder histological examination showed a near normal configuration and structural integrity, with a significant reduction in inflammation and disappearance of focal erosions. These remarkable effects of GA may be attributed to its ability to neutralize acrolein, the reactive metabolite of CYCL

  14. The possibility for use of venous flaps in plastic surgery

    Energy Technology Data Exchange (ETDEWEB)

    Baytinger, V. F., E-mail: baitinger@mail.tomsknet.ru; Kurochkina, O. S., E-mail: kurochkinaos@yandex.ru; Selianinov, K. V.; Baytinger, A. V. [Research Institute of Microsurgery, Tomsk (Russian Federation); Dzyuman, A. N. [Siberian State Medical University, Tomsk (Russian Federation)

    2015-11-17

    The use of venous flaps is controversial. The mechanism of perfusion of venous flaps is still not fully understood. The research was conducted on 56 white rats. In our experimental work we studied two different models of venous flaps: pedicled venous flap (PVF) and pedicled arterialized venous flap (PAVF). Our results showed that postoperative congestion was present in all flaps. However 66.7% of all pedicled venous flaps and 100% of all pedicled arterialized venous flaps eventually survived. Histological examination revealed that postoperatively the blood flow in the skin of the pedicled arterialized venous flap became «re-reversed» again; there were no differences between mechanism of survival of venous flaps and other flaps. On the 7-14th day in the skin of all flaps were processes of neoangiogenesis and proliferation. Hence the best scenario for the clinical use of venous flaps unfolds when both revascularization and skin coverage are required.

  15. The possibility for use of venous flaps in plastic surgery

    Science.gov (United States)

    Baytinger, V. F.; Kurochkina, O. S.; Selianinov, K. V.; Baytinger, A. V.; Dzyuman, A. N.

    2015-11-01

    The use of venous flaps is controversial. The mechanism of perfusion of venous flaps is still not fully understood. The research was conducted on 56 white rats. In our experimental work we studied two different models of venous flaps: pedicled venous flap (PVF) and pedicled arterialized venous flap (PAVF). Our results showed that postoperative congestion was present in all flaps. However 66.7% of all pedicled venous flaps and 100% of all pedicled arterialized venous flaps eventually survived. Histological examination revealed that postoperatively the blood flow in the skin of the pedicled arterialized venous flap became «re-reversed» again; there were no differences between mechanism of survival of venous flaps and other flaps. On the 7-14th day in the skin of all flaps were processes of neoangiogenesis and proliferation. Hence the best scenario for the clinical use of venous flaps unfolds when both revascularization and skin coverage are required.

  16. Upper-extremity deep venous thrombosis: a review.

    Science.gov (United States)

    Mai, Cuc; Hunt, Daniel

    2011-05-01

    Upper-extremity deep venous thrombosis is less common than lower-extremity deep venous thrombosis. However, upper-extremity deep venous thrombosis is associated with similar adverse consequences and is becoming more common in patients with complex medical conditions requiring central venous catheters or wires. Although guidelines suggest that this disorder be managed using approaches similar to those for lower-extremity deep venous thrombosis, studies are refining the prognosis and management of upper-extremity deep venous thrombosis. Physicians should be familiar with the diagnostic and treatment considerations for this disease. This review will differentiate between primary and secondary upper-extremity deep venous thromboses; assess the risk factors and clinical sequelae associated with upper-extremity deep venous thrombosis, comparing these with lower-extremity deep venous thrombosis; and describe an approach to treatment and prevention of secondary upper-extremity deep venous thrombosis based on clinical evidence.

  17. Treatment of hepatic venous stenosis by transfemoral venous balloon dilation following living donor liver transplantation: a case report

    Institute of Scientific and Technical Information of China (English)

    Weiwei Jiang; Yangsui Liu; Lianbao Kong

    2009-01-01

    Hepatic venous stenosis may be a cause of graft failure in living donor liver transplantation (LDLT). Balloon dilation and metallic frame approaches have been used successfully to treat hepatic venous stenosis. Here, we report the effect of transfemoral venous balloon dilation for treating a child with hepatic venous stenosis after LDLT.

  18. Bacteria from Wheat and Cucurbit Plant Roots Metabolize PAHs and Aromatic Root Exudates: Implications for Rhizodegradation

    DEFF Research Database (Denmark)

    Ely, Cairn S; Smets, Barth F.

    2017-01-01

    for growth on anthracene and chrysene on PAH-amended plates. Rhizosphere isolates metabolized 3- and 4-ring PAHs and PAH catabolic intermediates in liquid incubations. Aromatic root exudate compounds, namely flavonoids and simple phenols, were also substrates for isolated rhizobacteria. In particular...

  19. Malate Exudation by Six Aerobic Rice Genotypes Varying in Zinc Uptake Efficiency

    NARCIS (Netherlands)

    Gao, X.; Zhang, F.; Hoffland, E.

    2009-01-01

    Received for publication February 2, 2009. Zinc (Zn) uptake by plant roots from soils low in plant-available Zn may be increased by Zn-mobilizing rhizosphere processes, including exudation of low-molecular-weight organic anions. A rhizotron experiment with a low Zn clay soil and a nutrient solution

  20. [Root exudates and soil microbes in three Picea asperata plantations with different stand ages].

    Science.gov (United States)

    Li, Jiao; Jiang, Xian-Min; Yin, Hua-Jun; Yin, Chun-Ying; Wei, Yu-Hang; Liu, Qing

    2014-02-01

    This study investigated the dynamics of in situ root exudates and soil microbial composition among three Picea asperata plantations with different stand ages (9, 13 and 31 a) in Miyaluo, west Sichuan, China. The results showed that the secretion rates of root exudation per fine biomass, length, surface area and tip were significantly different among the three plantations with different stand ages. The secretion rate of root exudation was the highest in the 9-year-old plantation stand. The root activity of P. asperata was the weakest in the 13-year-old plantation stand. Besides, soil microbial biomass C (MBC) and N (MBN) between rhizosphere and non-rhizosphere soils were significantly different among the three plantation stands. MBC and MBN contents of rhizosphere soil gradually increased with stand ages, while those of non-rhizosphere soil were the largest in the 13-year-old plantation stand. The phospholipid fatty acids (PLFAs) of bacteria, fungi, actinomycetes and their summation in rhizosphere soil presented a trend of high-low-high with stand ages. The opposite pattern was found in the PLFAs of bacteria, fungi, the summation of PLFA, and the ratio of fungi number to bacteria in non-rhizosphere soil. It is suggested that root exudates might have a positive rhizosphere effect on soil microbial biomass C, N and PLFAs of functional groups.

  1. Inhibition of Nitrification by Root Exudates and Plant Materials fromBrachiaria humidicola

    Directory of Open Access Journals (Sweden)

    M.K Suri

    2011-02-01

    Full Text Available Abstract Nitrification inhibitors are synthetic or natural compounds highly specific in inhibiting ammonium oxidation to nitrate. Therefore, they are widely used in combination with ammonium fertilizers. Among plants, grasses always are interested for their role in controlling nitrification, and recently the form of nitrogen (ammonium vs. nitrate was shown to be an important factor in release of natural nitrification inhibitors (NNI from grasses. In this study production and release of natural nitrification inhibitors in Brachiaria humidicola was investigated. To study the effects of nitrogen forms on production and release of NNIs, brachiaria seedlings were grown in nutrient solution culture with either ammonium or nitrate, under controlled conditions. Root exudates were collected in two different mediums, distilled water or ammonium chloride, and with shoot and root homogenates were applied separately for their potential nitrification inhibition effect. The results, however, showed that when root exudates were collected in distilled water, there was no inhibitory effect on nitrification, but when root exudates were collected in a medium containing 1 mM NH4Cl, it showed significant nitrification inhibition in our soil nitrification test (bioassay. Leaf but not root homogenates also showed significant nitrification inhibition, independent of N form. This in turn suggests that synthesis of natural nitrification inhibitors in this grass is independent of nitrogen form. Keywords: Nitrification, Root exudates, Ammonium, Nitrate, Brachiaria humidicola, Leaf and root homogenates

  2. Study on the antibiosis of exudate JK-91-b against rice sheath blight (SHB)

    Institute of Scientific and Technical Information of China (English)

    CHENZhiyi; YINShangzhi; GAOXianting

    1994-01-01

    Antagonistic bacterial strain 91-b possessed stronger antagonistic ability against SHB infection. The control effects of the bacterization against SHB were 58.1% in greenhouse and 45.1% in paddy. The effect of antibiosis JK-91-b exudated by strain 91-b was studied in the present research.

  3. Organic anion exudation by lowland rice (Oryza sativa L.) at zinc and phosphorus deficiency

    NARCIS (Netherlands)

    Hoffland, E.; Wei, C.Z.; Wissuwa, M.

    2006-01-01

    The objectives of this paper were to determine (1) if lowland rice (Oryza sativa L.) plants respond similarly to low zinc (Zn) and phosphorus (P) availability by increased root exudation of low-molecular weight organic anions (LMWOAs) and (2) if genotypic variation in tolerance to low soil supply of

  4. Plant root exudates mediate neighbour recognition and trigger complex behavioural changes.

    Science.gov (United States)

    Semchenko, Marina; Saar, Sirgi; Lepik, Anu

    2014-11-01

    Some plant species are able to distinguish between neighbours of different genetic identity and attempt to pre-empt resources through root proliferation in the presence of unrelated competitors, but avoid competition with kin. However, studies on neighbour recognition have met with some scepticism because the mechanisms by which plants identify their neighbours have remained unclear. In order to test whether root exudates could mediate neighbour recognition in plants, we performed a glasshouse experiment in which plants of Deschampsia caespitosa were subjected to root exudates collected from potential neighbours of different genetic identities, including siblings and individuals belonging to the same or a different population or species. Our results show that root exudates can carry specific information about the genetic relatedness, population origin and species identity of neighbours, and trigger different responses at the whole root system level and at the level of individual roots in direct contact with locally applied exudates. Increased root density was mainly achieved through changes in morphology rather than biomass allocation, suggesting that plants are able to limit the energetic cost of selfish behaviour. This study reveals a new level of complexity in the ability of plants to interpret and react to their surroundings.

  5. Current perspective of venous thrombosis in the upper extremity

    OpenAIRE

    Flinterman, L.E.; Meer, van der, D; Rosendaal, F.R.; Doggen, C. J. M.

    2008-01-01

    Venous thrombosis of the upper extremity is a rare disease. Therefore, not as much is known about risk factors, treatment and the risk of recurrence as for venous thrombosis of the leg. Only central venous catheters and strenuous exercise are commonly known risk factors for an upper extremity venous thrombosis. In this review an overview of the different risk factors, possible treatments and the complications for patients with a venous thrombosis of the upper extremity is given

  6. Marsh plant response to metals: Exudation of aliphatic low molecular weight organic acids (ALMWOAs)

    Science.gov (United States)

    Rocha, A. Cristina S.; Almeida, C. Marisa R.; Basto, M. Clara P.; Vasconcelos, M. Teresa S. D.

    2016-03-01

    Metal exposure is known to induce the production and secretion of substances, such as aliphatic low molecular weight organic acids (ALMWOAs), into the rhizosphere by plant roots. Knowledge on this matter is extensive for soil plants but still considerably scarce regarding marsh plants roots adapted to high salinity media. Phragmites australis and Halimione portulacoides, two marsh plants commonly distributed in European estuarine salt marshes, were used to assess the response of roots of both species, in terms of ALMWOAs exudation, to Cu, Ni and Cd exposure (isolated and in mixture since in natural environment, they are exposed to mixture of metals). As previous studies were carried out in unrealistic and synthetic media, here a more natural medium was selected. Therefore, in vitro experiments were carried out, with specimens of both marsh plants, and in freshwater contaminated with two different Cu, Ni and Cd concentrations (individual metal and in mixture). Both marsh plants were capable of liberating ALMWOAs into the surrounding medium. Oxalic, citric and maleic acids were found in P. australis root exudate solutions and oxalic and maleic acids in H. portulacoides root exudate solutions. ALMWOA liberation by both plants was plant species and metal-dependent. For instance, Cu affected the exudation of oxalic acid by H. portulacoides and of oxalic and citric acids by P. australis roots. In contrast, Ni and Cd did not stimulate any specific response. Regarding the combination of all metals, H. portulacoides showed a similar response to that observed for Cu individually. However, in the P. australis case, at high metal concentration mixture, a synergetic effect led to the increase of oxalic acid levels in root exudate solution and to a decrease of citric acid liberation. A correlation between ALMWOAs exudation and metal accumulation could not be established. P. australis and H. portulacoides are considered suitable metal phytoremediators of estuarine impacted areas

  7. How far roots and exudates can transform the soil structure and porosity?

    Science.gov (United States)

    Johannes, Alice; Kohler-Milleret, Roxane; Lamy, Frédéric; Boivin, Pascal

    2014-05-01

    Aims The impact of plant-roots on soil physical porosity and structure is still to be deciphered. Recent results revealed root-induced increases in soil pore volume whose magnitude could not be attributed to root-drilling effect, thus suggesting an indirect effect via microbial activity enhanced by root exudates (Milleret et al., 2009, Kholer-Milleret et al., 2013). This is discussed in the present study by quantifying the soil hydro-structural changes induced by root exudates and microorganisms in the absence of roots. Methods The experiment was performed on series of structured repacked samples from two soils previously experimented with plants in mesocosms (Anthrosol and Luvisol). The samples received a daily input of artificial root exudates for three months. The soil structural changes were then assessed using shrinkage analysis and aggregate stability test. Microbial activity was measured with CO2 emanation. Results In agreement with previous findings, root exudates increased microbial activity and aggregate stability. Oppositely, the observed structural changes were contradictory both in magnitude and pattern with those observed in the presence of plant roots. The soil bulk porosity was almost not changed while the small-diameter structural porosity was decreased in the presence of root exudates. Moreover, the hydro-structural stability of the soil decreased while the aggregate stability increased. Conclusions Though the structural changes observed in the presence of roots cannot be attributed to direct root drilling effect, they are not observed when only root exudates are delivered to the soil. Our results suggest that the soil structure is engineered by a complex soil-plant-microbe interaction combining root mechanical effect and micro-aggregate stabilisation effect. Cumulative structural pore volume increase could result from aggregates rearrangements induced by root growth, either by drilling or lever effect, further stabilized by microorganism

  8. Links between arterial and venous disease.

    Science.gov (United States)

    Prandoni, P

    2007-09-01

    An increasing body of evidence suggests the likelihood of a link between arterial and venous disease. According to the results of recent studies, atherosclerosis and venous thromboembolism (VTE) share common risk factors, including age, obesity, diabetes mellitus and metabolic syndrome. Atherosclerosis has the potential to promote the development of thrombotic disorders in the venous system. Another scenario assumes that the two clinical conditions are simultaneously triggered by biological stimuli responsible for activating coagulation and inflammatory pathways in both the arterial and the venous system. Several recent studies have consistently shown that patients with VTE of unknown origin are at a higher risk of cardiovascular diseases, including atherosclerotic complications, than patients with secondary VTE and matched control individuals. Future studies are needed to clarify the nature of this association, to assess its extent and to evaluate its implications for clinical practice.

  9. Clinical quality indicators of venous leg ulcers

    DEFF Research Database (Denmark)

    Kjaer, Monica L; Mainz, Jan; Soernsen, Lars T

    2005-01-01

    %) were assessed for venous surgery. Distal arterial pressure was measured following initial examination in 33 of the patients (34%). All patients (100%) were prescribed compression therapy. Of the 98 patients, 11 (11%) had ulcers recur in 3 months and 72 (73%) healed in 12 months, which is in line......In the clinical setting, diagnosis and treatment of venous leg ulcers can vary considerably from patient to patient. The first step to reducing this variation is to document venous leg ulcer care through use of quantitative scientific documentation principles. This requires the development of valid...... and reliable evidence-based quality indicators of venous leg ulcer care. A Scandinavian multidisciplinary, cross-sectional panel of wound healing experts developed clinical quality indicators on the basis of scientific evidence from the literature and subsequent group nominal consensus of the panel...

  10. [Emphysematous gastritis with concomitant portal venous air].

    Science.gov (United States)

    Jeong, Min Yeong; Kim, Jin Il; Kim, Jae Young; Kim, Hyun Ho; Jo, Ik Hyun; Seo, Jae Hyun; Kim, Il Kyu; Cheung, Dae Young

    2015-02-01

    Emphysematous gastritis is a rare form of gastritis caused by infection of the stomach wall by gas forming bacteria. It is a very rare condition that carries a high mortality rate. Portal venous gas shadow represents elevation of intestinal luminal pressure which manifests as emphysematous gastritis or gastric emphysema. Literature reviews show that the mortality rate is especially high when portal venous gas shadow is present on CT scan. Until recently, the treatment of emphysematous gastritis has been immediate surgical intervention. However, there is a recent trend of avoiding surgery because of the frequent occurrence of post-operative complications such as anastomosis leakage. In addition, aggressive surgical treatment has failed to show significant improvement in prognosis. Recently, the authors experienced a case of emphysematous gastritis accompanied by portal venous gas which was treated successfully by conservative treatment without immediate surgical intervention. Herein, we present a case of emphysematous gastritis with concomitant portal venous air along with literature review.

  11. A Rare Venous Port Complication: Supraventriculer Tachycardia

    Directory of Open Access Journals (Sweden)

    Tamer Yoldaş

    2016-04-01

    Full Text Available Implantable central venous port catheters are widely used in the management of children with cancer undergoing long term chemotherapy. These catheters can manifest a number of complications such as arrhythmia. Central venous port catheter was placed on a ten years old boy for chemotherapy. Before insertion of port catheter his physical examination, laboratory parameters, electrocardiography and echocardiography were normal. The patient felt palpitations shortly after the insertion of the port catheter. At that time the heart rate was 200 beats/minute but immediately normal sinus rhythm was restored. A chest roentgenogram revealed that the distal fragment of the port catheter was inside the right atrium. The port catheter was pulled back somewhat and then tachycardia attacks stopped. To our knowledge there are a few reports of supraventricular tachycardia (SVT in children associated with central venous port catheter. Here we aimed to present a pediatric case with SVT after placement of central venous port catheter and his management.

  12. Imaging of head and neck venous malformations

    Energy Technology Data Exchange (ETDEWEB)

    Flis, Christine M.; Connor, Stephen E. [King' s College Hospital, Neuroradiology Department, London (United Kingdom)

    2005-10-01

    Venous malformations (VMs) are non proliferative lesions that consist of dysplastic venous channels. The aim of imaging is to characterise the lesion and define its anatomic extent. We will describe the plain film, ultrasound (US) (including colour and duplex Doppler), computed tomography (CT), magnetic resonance imaging (MRI), conventional angiographic and direct phlebographic appearances of venous malformations. They will be illustrated at a number of head and neck locations, including orbit, oral cavity, superficial and deep facial space, supraglottic and intramuscular. An understanding of the classification of such vascular anomalies is required to define the correct therapeutic procedure to employ. Image-guided sclerotherapy alone or in combination with surgery is now the first line treatment option in many cases of head and neck venous malformations, so the radiologist is now an integral part of the multidisciplinary management team. (orig.)

  13. Prospects of Jugular Venous Pulse Assessment

    Directory of Open Access Journals (Sweden)

    M D Bhattarai

    2010-09-01

    Full Text Available There is no controversy regarding the current clinical method of examination of waveform of jugular vein pulse. However there are limitations of clinical assessment of central venous pressure by jugular vein pressure measurement from the level of sternal angle. There are variations in the reported distances from sternal angle to right atrium as well as to upper limit of JVP. In erect position, anterior end of fourth intercostal space is at about the level of mid-right atrium. In patients with visible JVP at neck in erect position, measurement of CVP can be done more accurately directly from the anterior end of fourth intercostal space. For others, the position of mid-right atrium can be marked in lateral chest wall first in erect position at the mid-point of an anteroposterior line from anterior end of fourth intercostal space to back. Subsequently in reclining position, the vertical height of venous pressure can be measured from the horizontal plane of the midpoint marked at lateral chest wall to visible upper limit of JVP. Such measurement can be done in a more reliable way with venous pressure (VP manometer with its indicator rod at the horizontal plane of mid-right atrium and with its horizontal surface at upper limit of JVP. The venous pressure manometer can also be used to measure relatively less reliable upper limb venous pressure (ULVP, as indicated by the vertical distance at which veins of upper limb collapse, especially when JVP is not visualized due to subnormal CVP as in hypovolemia. Keywords: CVP, JVP, right atrium, sternal angle, upper limp venous pressure, venous pressure, venous pressure manometer

  14. Entrapment of guidewire during central venous catheterization

    Directory of Open Access Journals (Sweden)

    Tarun S.

    2016-07-01

    Full Text Available Central venous catheterization (CVC is common in the setting of ICU for various reasons like monitoring of CVP, fluid administration and vasopressor or drug infusions. Guidewires are routinely used in the Seldinger technique during central venous catheter placement CVC placement is not innocuous as numerous complications may occur, with varying frequency and severity. [Int J Res Med Sci 2016; 4(7.000: 3080-3081

  15. Multiple Extrasplanchnic Venous Thromboses: A Rare Complication of Pancreatitis. A Case Report

    Directory of Open Access Journals (Sweden)

    Hardik Parikh

    2012-05-01

    Full Text Available Context Venous thrombosis has been described in patients with acute and chronic pancreatitis. This is especially common in portal vein, splenic vein and superior mesenteric vein. To the best of our knowledge, involvement of superior vena cava and subclavian vessel due to pancreatitis has not been reported. Case report We present here a case of an adult male with alcoholic chronic pancreatitis who presented with multiple vessel thromboses involving superior vena cava, inferior vena cava, bilateral subclavian, internal jugular vein, axillary, iliac and renal vein without involvement of portal, splenic and superior mesenteric vein that was effectively treated with i.v. anticoagulation therapy. Conclusion Venous thromboses can occur outside the splanchnic circulation in pancreatitis.

  16. Species-dependent effects of border cell and root tip exudates on nematode behavior.

    Science.gov (United States)

    Zhao, X; Schmitt, M; Hawes, M C

    2000-11-01

    ABSTRACT Effects of border cell and root tip exudates on root knot nematode (Meloidogyne incognita) behavior were examined. In whole-plant assays using pea, M. incognita second-stage juveniles (J2) accumulated rapidly around the 1- to 2-mm apical region ensheathed by border cells, but not in the region of elongation. Within 15 to 30 min, J2 which had accumulated within detached clumps of border cells lost motility and entered into a quiescent state. When border cells (and associated root tip exudates) were washed from pea roots prior to challenge with nematodes, no such accumulation and quiescence was induced. Attraction of nematodes by roots was species dependent: no attraction or accumulation occurred in snap bean. Using a quantitative assay, three categories of chemotaxis responses occurred: attraction (pea and alfalfa cv. Thor), repulsion (alfalfa cv. Moapa 69), and no response (snap bean and alfalfa cv. Lahonton). In contrast, total root tip exudates from all three plant species acted as a repellent for M. incognita in the sand assay. An in vitro assay was developed to characterize the induced quiescence response. When total root tip exudate from the tested legumes (as well as corn) was incubated with J2 populations, >80% of the nematodes lost motility. A similar response occurred in Caenorhabditis elegans. Border cell exudates did not induce or contribute to the induction of quiescence. Cocultivation of pea border cells with M. incognita resulted in changes in border cell shape similar to those observed in response to exogenous plant hormones. No such changes occurred in snap bean border cells. Understanding the cell- and host-specific extracellular recognition that occurs between roots and pathogenic nematodes in the early stages before infection occurs could lead to new avenues for disease control.

  17. Macromolecular composition of phloem exudate from white lupin (Lupinus albus L.

    Directory of Open Access Journals (Sweden)

    Mann Anthea J

    2011-02-01

    Full Text Available Abstract Background Members of the legume genus Lupinus exude phloem 'spontaneously' from incisions made to the vasculature. This feature was exploited to document macromolecules present in exudate of white lupin (Lupinus albus [L.] cv Kiev mutant, in particular to identify proteins and RNA molecules, including microRNA (miRNA. Results Proteomic analysis tentatively identified 86 proteins from 130 spots collected from 2D gels analysed by partial amino acid sequence determination using MS/MS. Analysis of a cDNA library constructed from exudate identified 609 unique transcripts. Both proteins and transcripts were classified into functional groups. The largest group of proteins comprised those involved in metabolism (24%, followed by protein modification/turnover (9%, redox regulation (8%, cell structural components (6%, stress and defence response (6% with fewer in other groups. More prominent proteins were cyclophilin, ubiquitin, a glycine-rich RNA-binding protein, a group of proteins that comprise a glutathione/ascorbate-based mechanism to scavenge oxygen radicals, enzymes of glycolysis and other metabolism including methionine and ethylene synthesis. Potential signalling macromolecules such as transcripts encoding proteins mediating calcium level and the Flowering locus T (FT protein were also identified. From around 330 small RNA clones (18-25 nt 12 were identified as probable miRNAs by homology with those from other species. miRNA composition of exudate varied with site of collection (e.g. upward versus downward translocation streams and nutrition (e.g. phosphorus level. Conclusions This is the first inventory of macromolecule composition of phloem exudate from a species in the Fabaceae, providing a basis to identify systemic signalling macromolecules with potential roles in regulating development, growth and stress response of legumes.

  18. Estrogenic activity in extracts and exudates of cyanobacteria and green algae.

    Science.gov (United States)

    Sychrová, E; Štěpánková, T; Nováková, K; Bláha, L; Giesy, J P; Hilscherová, K

    2012-02-01

    Here is presented some of the first information on interactions of compounds produced by cyanobacteria and green algae with estrogen receptor signaling. Estrogenic potency of aqueous extracts and exudates (culture spent media with extracellular products) of seven species of cyanobacteria (10 different laboratory strains) and two algal species were assessed by use of in vitro trans-activation assays. Compounds produced by cyanobacteria and algae, and in particular those excreted from the cells, were estrogenic. Most exudates were estrogenic with potencies expressed at 50% of the maximum response under control of the estrogen receptor ranging from 0.2 to 7.2 ng 17β-estradiol (E(2)) equivalents (EEQ)/L. The greatest estrogenic potency was observed for exudates of Microcystis aerigunosa, a common species that forms water blooms. Aqueous extracts of both green algae, but only one species of cyanobacteria (Aphanizomenon gracile) elicited significant estrogenicity with EEQ ranging from 15 to 280 ng 17β-estradiol (E(2))/g dry weight. Scenedesmus quadricauda exudates and extracts of Aphanizomenon flos-aquae were antagonistic to the ER when coexposed to E(2). The EEQ potency was not correlated with concentrations of cyanotoxins, such as microcystin and cylindrospermopsin, which suggests that the EEQ was comprised of other compounds. The study demonstrates some differences between the estrogenic potency of aqueous extracts prepared from the same species, but of different origin, while the effects of exudates were comparable within species. The observed estrogenic potencies are important namely in relation to the possible mass expansion of cyanobacteria and release of the active compounds into surrounding water.

  19. Mapping Soil Carbon from Cradle to Grave: C Transformations of Root Exudates and Plant Litter

    Science.gov (United States)

    Pett-Ridge, J.; Keiluweit, M.; Nuccio, E.; Bougoure, J.; Weber, P. K.; Brodie, E.; Mayali, X.; Shi, S.; Hwang, M.; Thelen, M.; Firestone, M.; Kleber, M.; Nico, P. S.

    2013-12-01

    Carbon cycling in the rhizosphere is a nexus of biophysical interactions between plant roots, microorganisms, and the soil organo-mineral matrix. Plant roots provide 30-40% of soil organic C inputs, accelerate the rate of organic matter mineralization by ~10X, and support an active microhabitat for microbial transformation of soil C. Our research on how roots influence decomposition of soil organic matter in both simplified and complex microcosms uses geochemical characterization, molecular microbiology, isotope tracing, metabolomics and novel imaging approaches (';ChipSIP' and ';STXM-SIMS') to trace the fate of isotopically labelled root exudates and plant tissues. Our previous work suggests root exudates drive O2 limitation, alter metal chemistry and mineralogy, and influence the availability of SOM. Our most recent experiments using synthetic rhizospheres were designed to identify the role of root exudates on ligno-cellulose decomposition in soils. Cultures of 13C/15N-labeled single plant cells (lignin-rich tracheary elements) were added to rhizosphere microcosm soils, and their decomposition followed under the influence of different root exudates using the dual imaging approach ';STXM-SIMS'. Using this combination of X-ray spectromicroscopy and NanoSIMS, we imaged the deconstruction of 13C/15N-labeled ligno-cellulose in situ, and mapped associations of plant cell-derived decomposition products with specific soil minerals. We've also looked at microbial community function in the more complex rhizospheres surrounding roots of the annual grass Avena fatua. Using an isotope array that allows us to follow root C into bacterial, fungal, and microfaunal communities, we tracked the movement of 13C from labeled exudates and 15N from labeled root litter into the soil microbial community. Our results indicate that the microbial communities involved in litter decomposition differ in rhizosphere versus bulk soils, which may have implications for carbon stabilization in soil.

  20. Chronic venous disease as a clinical manifestation of tibial osteochondroma

    Directory of Open Access Journals (Sweden)

    Marcelo Fernandes Lima

    2013-06-01

    Full Text Available Osteochondromas are the most common type of benign tumor of the skeleton. They most frequently affect the distal extremity of the femur, with the tibia being the second most commonly affected long bone. Vascular complications of these lesions are rare, but pseudoaneurysm formation is the most frequently reported of them. In this case report, we describe a case of compression of the popliteal neurovascular bundle by a tibial osteochondroma in a diabetic patient who had been admitted to hospital to treat an infected lesion on his left foot and complained of edema and paresthesia of the left lower limb.

  1. The role of magnetic resonance imaging in assessing venous vascular abnormalities in the head and neck: a demonstration of cerebrospinal venous insufficiency in a subset of multiple sclerosis patients

    Directory of Open Access Journals (Sweden)

    E. Mark Haacke

    2015-06-01

    Full Text Available The study of chronic cerebrospinal venous insufficiency (CCSVI and its impact on the development and progression of multiple sclerosis (MS remains controversial. Although the initial thrust in evaluating CCSVI was with ultrasound, other modalities including magnetic resonance imaging (MRI have been used to study venous vascular abnormalities. This review focuses on the findings of a number of past MRI studies including a look at a combined study of four previous works with a cohort of 559 MS patients regarding structure and function of the extra-cranial vasculature. Strengths and limitations of each paper are discussed which give insight into conflicting reports of venous abnormalities in MS patients and healthy controls. Guidelines for data acquisition and analysis for future studies related to extra-cranial structure and flow, both arterial and venous, are discussed. This includes the grading of stenosis of the internal jugular veins (IJVs as well as normalized flows through major veins of the neck. The lack of agreement between most studies is likely due to inconsistent data acquisition and incomplete data analysis. Our own work over four independent sites shows good agreement, indicating that there is a high incidence of stenosis and structural venous abnormalities in the MS population and that this change results in reduced outflow of the IJVs and increased collateralization of venous return to the heart compared to healthy controls.

  2. Venous catheterization with ultrasound navigation

    Science.gov (United States)

    Kasatkin, A. A.; Urakov, A. L.; Nigmatullina, A. R.

    2015-11-01

    By ultrasound scanning it was determined that respiratory movements made by chest of healthy and sick person are accompanied by respiratory chest rise of internal jugular veins. During the exhalation of an individual diameter of his veins increases and during the breath it decreases down to the complete disappearing if their lumen. Change of the diameter of internal jugular veins in different phases can influence significantly the results of vein puncture and cauterization in patients. The purpose of this research is development of the method increasing the efficiency and safety of cannulation of internal jugular veins by the ultrasound visualization. We suggested the method of catheterization of internal jugular veins by the ultrasound navigation during the execution of which the puncture of venous wall by puncture needle and the following conduction of J-guide is carried out at the moment of patient's exhalation. This method decreases the risk of complications development during catheterization of internal jugular vein due to exclusion of perforating wound of vein and subjacent tissues and anatomical structures.

  3. Venous catheterization with ultrasound navigation

    Energy Technology Data Exchange (ETDEWEB)

    Kasatkin, A. A., E-mail: ant-kasatkin@yandex.ru; Nigmatullina, A. R. [Izhevsk State Medical Academy, Kommunarov street, 281, Izhevsk, Russia, 426034 (Russian Federation); Urakov, A. L., E-mail: ant-kasatkin@yandex.ru [Institute of Mechanics Ural Branch of Russian Academy of Sciences, T.Baramzinoy street 34, Izhevsk, Russia, 426067, Izhevsk (Russian Federation); Izhevsk State Medical Academy, Kommunarov street, 281, Izhevsk, Russia, 426034 (Russian Federation)

    2015-11-17

    By ultrasound scanning it was determined that respiratory movements made by chest of healthy and sick person are accompanied by respiratory chest rise of internal jugular veins. During the exhalation of an individual diameter of his veins increases and during the breath it decreases down to the complete disappearing if their lumen. Change of the diameter of internal jugular veins in different phases can influence significantly the results of vein puncture and cauterization in patients. The purpose of this research is development of the method increasing the efficiency and safety of cannulation of internal jugular veins by the ultrasound visualization. We suggested the method of catheterization of internal jugular veins by the ultrasound navigation during the execution of which the puncture of venous wall by puncture needle and the following conduction of J-guide is carried out at the moment of patient’s exhalation. This method decreases the risk of complications development during catheterization of internal jugular vein due to exclusion of perforating wound of vein and subjacent tissues and anatomical structures.

  4. What happens after venous thromboembolism?

    Science.gov (United States)

    Baglin, T

    2009-07-01

    Venous thromboembolism (VTE) comprises deep vein thrombosis (DVT) with or without symptomatic pulmonary embolus (PE). The incidence of a first episode of VTE is 1.5 per 1000 person-years [1] (J Thromb Haemost, 2007;5:692-9) with a per-person lifetime incidence of 5% [2] (Arch Intern Med 1998;158:585-93). The risk of recurrence after DVT and PE is similar but the pattern of recurrence tends to reflect the initial event, for example recurrence with PE is more common in patients with previous PE [3] (Circulation 2003;107:122-30). At least 50% of patients, who present with symptomatic DVT, have asymptomatic PE and conversely, a majority presenting with symptomatic PE have asymptomatic DVT [3] (Circulation 2003;107:122-30). This suggests that whilst DVT and PE are manifestations of the same pathology, the phenotypic expression of the disease is predetermined. This may be an important consideration for long-term anticoagulant therapy as the risk of fatal PE is the greatest in patients with previous PE [4] (Ann Intern Med 2007;147:766-74). At present, the only factor reported to be associated with the pattern of VTE is the factor V Leiden mutation [5] (Thromb Haemost 1999;81:345-8). This suggests that the kinetics of thrombin generation and the resulting fibrinolytic response may influence clot structure and likelihood of embolization.

  5. 脉络舒通颗粒和喜辽妥乳膏治疗下肢静脉功能不全皮肤色素沉着的随机对照临床研究%Efficacy of Chinese herbal medicine Mailuo Shutong Granule and Hirudoid cream for chronic venous disorder-induced pigmentation in lower extremities: a prospective, randomized controlled trial

    Institute of Scientific and Technical Information of China (English)

    魏小龙; 冯睿; 赵志青; 景在平

    2011-01-01

    背景:下肢静脉功能不全(chronic venous disorder,CVD)常导致色素沉着等皮肤营养改变,如不能获得有效治疗,可发展至皮肤溃疡坏死等严重并发症.目的:评估脉络舒通颗粒和喜辽妥乳膏治疗下肢CVD色素沉着的临床疗效.设计、场所、对象和干预措施:所有病例均为2010年8月至12月长海医院血管外科的门诊CVD患者.采用随机、对照的研究方法,将108例CVD色素沉着患者分为脉络舒通组(仅给予脉络舒通颗粒)、喜辽妥组(仅给予喜辽妥乳膏)和联合治疗组(同时给予脉络舒通颗粒和喜辽妥乳膏).疗程为28 d.主要结局指标:观察治疗前后CVD色素沉着区域的面积和平均灰度值的改变.结果:脉络舒通组33例,喜辽妥组34例,联合治疗组31例纳入统计分析.经治疗后3组患者皮肤色素沉着面积均减小,平均灰度值均降低(P<0.05).联合治疗组色素沉着面积减小和平均灰度值降低程度较脉络舒通组和喜辽妥组更为明显(P<0.05),而脉络舒通组和喜辽妥组组间比较差异无统计学意义(P>0.05).结论:脉络舒通颗粒和喜辽妥软膏对下肢CVD皮肤色素沉着均具有良好的疗效,二者合用则效果更佳.%Background: Chronic venous disorder (CVD) of the lower extremities generally induces dermatologic complicationsin lower extremity skin, such as hyperpigmentation. If not treated effectively, the lesions may develop intosevere outcomes, including dermal ulcer or necrosis.Objective; To evaluate the clinical efficacy of Mailuo Shutong Granule, a compound traditional Chinese herbalmedicine, and Hirudoid cream (heparinoid), in treatment of patients with dermal hyperpigmentation of skincaused by CVD.Design, setting, participants and interventions; A total of 108 CVD outpatients with pigmentation fromDepartment of Vascular Surgery, Shanghai Changhai Hospital were randomly divided into Mailuo Shutonggroup, Hirudoid group and combined therapy group

  6. Plasma membrane H-ATPase-dependent citrate exudation from cluster roots of phosphate-deficient white lupin.

    Science.gov (United States)

    Tomasi, Nicola; Kretzschmar, Tobias; Espen, Luca; Weisskopf, Laure; Fuglsang, Anja Thoe; Palmgren, Michael Gjedde; Neumann, Günter; Varanini, Zeno; Pinton, Roberto; Martinoia, Enrico; Cesco, Stefano

    2009-05-01

    White lupin (Lupinus albus L.) is able to grow on soils with sparingly available phosphate (P) by producing specialized structures called cluster roots. To mobilize sparingly soluble P forms in soils, cluster roots release substantial amounts of carboxylates and concomitantly acidify the rhizosphere. The relationship between acidification and carboxylate exudation is still largely unknown. In the present work, we studied the linkage between organic acids (malate and citrate) and proton exudations in cluster roots of P-deficient white lupin. After the illumination started, citrate exudation increased transiently and reached a maximum after 5 h. This effect was accompanied by a strong acidification of the external medium and alkalinization of the cytosol, as evidenced by in vivo nuclear magnetic resonance (NMR) analysis. Fusicoccin, an activator of the plasma membrane (PM) H+-ATPase, stimulated citrate exudation, whereas vanadate, an inhibitor of the H+-ATPase, reduced citrate exudation. The burst of citrate exudation was associated with an increase in expression of the LHA1 PM H+-ATPase gene, an increased amount of H+-ATPase protein, a shift in pH optimum of the enzyme and post-translational modification of an H+-ATPase protein involving binding of activating 14-3-3 protein. Taken together, our results indicate a close link in cluster roots of P-deficient white lupin between the burst of citrate exudation and PM H+-ATPase-catalysed proton efflux.

  7. Quality of life assessment of patients with and without venous ulcer

    Directory of Open Access Journals (Sweden)

    Thalyne Yurí Araújo Farias Dias

    2014-08-01

    Full Text Available OBJECTIVES: to compare the quality of life of patients with chronic venous disease with and without ulcer and to identify the most affected aspects.METHOD: cross-sectional study with a sample of 204 patients with chronic venous disease. The quality of life was assessed with the help of the SF-36 questionnaire. To compare the scores between the groups, the Mann-Whitney test was used, considering a statistically significant difference when p<0.05.RESULTS: the quality of life score of patients with ulcer was lower when compared to that of patients without ulcer, in all domains and dimensions of the SF-36, particularly in the domains physical aspect and functional capacity, with very low scores.CONCLUSION: all aspects of quality of life were more compromised in people with ulcers. These findings can contribute towards a better understanding of the effects of chronic venous disease on the quality of life and towards a better orientation of therapeutic interventions in this population.

  8. Femoral venous oxygen saturation is no surrogate for central venous oxygen saturation

    NARCIS (Netherlands)

    van Beest, Paul A.; van der Schors, Alice; Liefers, Henriette; Coenen, Ludo G. J.; Braam, Richard L.; Habib, Najib; Braber, Annemarije; Scheeren, Thomas W. L.; Kuiper, Michael A.; Spronk, Peter E.

    2012-01-01

    Objective:  The purpose of our study was to determine if central venous oxygen saturation and femoral venous oxygen saturation can be used interchangeably during surgery and in critically ill patients. Design:  Prospective observational controlled study. Setting:  Nonacademic university-affiliated t

  9. Cortical blindness as a rare presentation of cerebral venous thrombosis.

    Science.gov (United States)

    Wang, Bonnie; Moon, Seong-Jin; Olivero, William C; Wang, Huan

    2013-05-09

    Cerebral venous thrombosis (CVT) remains a diagnostic and therapeutic challenge for clinicians. Manifesting in a remarkably wide spectrum of symptoms and signs, CVT often presents in a misleading fashion-if unrecognized or misdiagnosed, it carries potentially fatal consequences. Visual loss is quite rare as the initial presentation of CVT and is typically a finding more frequent in chronic cases with associated papilledema on funduscopy Ferro, Lopes, Rosas and Fontes (Delay in Hospital Admission of Patients with Cerebral Vein and Dural Sinus Thrombosis. Cerebrovasc Dis 2005;19: :152-6). We report a rare case of acute cortical blindness as the initial presentation of CVT in an 18-year-old female patient and review the current literature.

  10. The stoichiometry of root exudation- insights from a model and a field experiment in a temperate forest

    Science.gov (United States)

    Drake, J. E.; Finzi, A. C.

    2011-12-01

    Forest trees allocate large amounts of C belowground to fuel root processes and the activity of soil microbes through root exudation, rhizodeposition, and the support of mycorrhizal associations. There is a growing recognition that the microbial response to this flux of C belowground can have large impacts on ecosystem function. Here, we use a theoretical enzyme-driven model of decomposition and a field experiment of exudation treatments using root simulators to develop the idea that the response of decomposition to root exudation (i.e. priming of decomposition) depends on the interaction between exudate and microbial stoichiometry (C:N ratios). We added an exudation module to an existing model of decomposition (Schimel and Weintraub, 2003, Soil Biology & Biochemistry). In this model, microbes expend resources (C and N) for maintenance, growth, and the synthesis of exo-enzymes. These exo-enzymes solubilize soil organic C and N (SOC and SON) into dissolved forms (DOC and DON), which are then available for microbial uptake. Exuding DOC had little influence on priming of SOC decomposition, because microbes became N-limited following an exudate pulse and were thus unable to synthesize the N-rich exo-enzymes. However, exuding small amounts of DON in addition to DOC resulted in a large priming pulse of SOC decomposition, as the microbes utilized the DON for exo-enzyme synthesis, and the resulting pulse of enzyme activity decomposed SOC and SON. We tested these model simulations at Harvard Forest (MA- USA) by pumping exudation solutions into forest soils at realistic rates for 6-weeks using an automated system of peristaltic pumps and microlysimeters. Delivering C and N exudates with a C:N ratio of 10 significantly increased soil respiration, microbial biomass, and rates of exo-enzyme activity, while adding C exudates or water only did not affect these measurements of microbial biomass and activity. These results suggest that plants may achieve a positive return on

  11. Chronic pancreatitis

    Science.gov (United States)

    Chronic pancreatitis - chronic; Pancreatitis - chronic - discharge; Pancreatic insufficiency - chronic; Acute pancreatitis - chronic ... alcohol abuse over many years. Repeated episodes of acute ... chronic pancreatitis. Genetics may be a factor in some cases. ...

  12. Pharmacologic treatment of venous leg ulcers.

    Science.gov (United States)

    Dormandy, J A

    1995-01-01

    In terms of prevalence, total cost and morbidity, venous leg ulcers are probably by far the most important type of ulcerations in the leg. The macrocirculatory defect leading to a raised ambulatory venous pressure is now accepted as a common initial pathologic pathway. Most current treatment modalities, such as surgery or external compression, are designed to control the macrovascular defect. However, it is the microcirculatory consequences of the venous hypertension that give rise to the trophic skin changes and ultimately to ulceration. At this microcirculatory level, pharmacotherapy may be a useful adjunct in the treatment of venous leg ulcers. The microcirculatory pathophysiologic changes include decreased fibrinolytic activity, elevated plasma fibrinogen, microcirculatory thrombi, and inappropriate activation of the white blood cells. The oxidative burst from the activated white cells probably plays a key role by releasing locally leukocyte-derived free radicals, proteolytic enzymes, cytokines, platelet-activating factor, and a number of other noxious mediators. An important additional component in recalcitrant venous ulcers is co-existing arterial disease, which is probably present in 15-20% of cases. Decreased arterial perfusion pressure will further aggravate the ischemic changes caused by the venous hypertension. Pentoxifylline downregulates leukocyte activation, reduces leukocyte adhesion, and also has fibrinolytic effects. A number of clinical studies have therefore been carried out to examine the clinical efficacy of pentoxifylline in treatment of venous leg ulcers. Probably the largest published placebo-controlled, double-blind randomized study was reported in 1990. In this study, 80 patients received either pentoxifylline 400 mg three times a day orally or matching placebo for 6 months or until their reference ulcer healed if this occurred sooner. Complete healing of the reference ulcer occurred in 23 of the 38 patients treated with pentoxifylline

  13. Familial risk of venous thromboembolism: a nationwide cohort study

    DEFF Research Database (Denmark)

    Sørensen, H T; Riis, A H; Diaz, L J

    2011-01-01

    Background: Venous thromboembolism has genetic determinants, but population-based data on familial risks are limited. Objectives: To examine the familial risk of venous thromboembolism. Methods: We undertook a nationwide study of a cohort of patients with deep venous thrombosis or pulmonary...... and expected number of venous thromboembolism cases among siblings, using population-specific, gender-specific and age-specific incidence rates. Results: We identified 30 179 siblings of 19 599 cases of venous thromboembolism. The incidence among siblings was 2.2 cases per 1000 person-years, representing...... with pulmonary embolism. Conclusion: Venous thromboembolism has a strong familial component....

  14. Venous injury in abusive head trauma

    Energy Technology Data Exchange (ETDEWEB)

    Choudhary, Arabinda K. [Nemours A. I. duPont Hospital for Children, Department of Radiology, Wilmington, DE (United States); Bradford, Ray; Thamburaj, K.; Boal, Danielle K.B. [Hershey Medical Center, Department of Radiology, Hershey, PA (United States); Dias, Mark S. [Hershey Medical Center, Department of Neurosurgery, Hershey, PA (United States)

    2015-11-15

    Abusive head trauma (AHT) is an important cause of serious brain injury in infants and young children who have characteristic clinical and imaging findings that are discordant with the clinical history provided. Recent attention has focused on abnormalities of the cranial venous sinuses and cortical veins, both on MRI and at autopsy. Although many have interpreted these to be secondary to the AHT, some have recently argued that these venous abnormalities represent primary cortical sinus and venous thrombosis that leads secondarily to subdural hemorrhage and secondary brain injury. Direct trauma to the veins and sinuses has been reported at autopsy in AHT, but there has been no systematic study of venous abnormalities in cases of AHT. The purpose of this study was to define the incidence and characteristics of venous and sinus abnormalities in AHT. We included all children <36 months of age who were diagnosed with abusive head trauma between 2001 and 2012 and who had MRI and magnetic resonance (MR) venography as part of their diagnostic workup. We analyzed age, gender and clinical findings. MRI and MR venography were analyzed independently by two neuroradiologists with a focus on abnormalities involving the intracranial veins and venous sinuses. A total of 45 children were included. The median age was 3 months (range 15 days to 31 months) and 28 were boys (62%). Clinical findings included retinal hemorrhage in 71% and extracranial fractures in 55%. CT or MRI demonstrated subdural hemorrhage in 41 (91%); none had subdural effusions. In 31 cases (69%) MR venography demonstrated mass effect on the venous sinuses or cortical draining veins, with either displacement or partial or complete effacement of the venous structures from an adjacent subdural hematoma or brain swelling. We also describe the lollipop sign, which represents direct trauma to the cortical bridging veins and was present in 20/45 (44%) children. Evidence of displacement or compression of cortical veins

  15. Radiologic placement of tunneled central venous catheter

    Energy Technology Data Exchange (ETDEWEB)

    Hahn, Seong Tae; Yang, Po Song; Yang, Dong Hunn; Kim, Ki Tae; Kim, Choon Yul; Shinn, Kyung Sub [The Catholic Univ. College of Medicine, Seoul (Korea, Republic of); Yun, Eun Joo [Korea Veterans Hospital, Seoul (Korea, Republic of)

    1996-01-01

    To evaluate the efficacy and safety of fluoroscopy-guided, radiologic placement of a tunneled central venous catheter into the superior vena cava (SVC). Thirty five patients underwent tunneled central venous catheter placement to facilitate long-term chemotherapy. They included 33 leukemic patients, one colon cancer patient, and one multiple myeloma patient. After confirming central venous patency with a injection of contrast media via the peripheral cephalic or basilic vein in the wrist joint, the subclavian vein was punctured under fluoroscopic guidance. A 7F double lumen TPN catheter was placed into the SVC through a subcutaneous tunnel in the anterior chest wall. Catheter placements were successful in all patients. The mean procedure time was 17.2minutes, mean fluooscopy time was 1.3minutes, mean number of punctures was 1.4, and mean volume of injhected contrast media was 43.5cc. Only two of all leukemic patients developed mild hematomas at the puncture site, but these soon resolved themselves. None of the patients developed pneumothorax or hemothorax. But late complications included local infection in two patients (6%) and thrombotic occlusion of the catheter in one (3%). The occluded catheter was successfully recanalized with Urokinase infusion. Fluoroscopy-guided, radiologic placement of a tunneled central venous catheter is an easy and safe method, and useful for patients requiring long-term venous access.

  16. Treatment strategies for extensive chronic SFA occlusions: indications and results.

    NARCIS (Netherlands)

    Lensvelt, M.M.A.; Reijnen, M.M.P.J.; Wallis de Vries, B.M.; Zeebregts, C.J.A.

    2012-01-01

    Treatment modalities for extensive chronic occlusive disease of the superficial femoral artery (SFA) have changed during the last decades. In this chapter we provide an overview of current treatment modalities for extensive chronic occlusive disease of the SFA. Although the autologous venous conduit

  17. Treatment strategies for extensive chronic SFA occlusions : indications and results

    NARCIS (Netherlands)

    Lensvelt, M. M. A.; Reijnen, M. M. P. J.; De Vries, B. M. Wallis; Zeebregts, C. J.

    2012-01-01

    Treatment modalities for extensive chronic occlusive disease of the superficial femoral artery (SFA) have changed during the last decades. In this chapter we provide an overview of current treatment modalities for extensive chronic occlusive disease of the SFA. Although the autologous venous conduit

  18. Prospective, Descriptive Study of Critically Colonized Venous Leg Ulcers Managed With Silver Containing Absorbent Dressings and Compression.

    Science.gov (United States)

    Moore, Michael F

    2013-08-01

    Chronic non-healing venous ulcers are by their very nature colonized with bacteria. The amount and make up will vary based on many variables. The transition from colonization to contamination, critical colonization, and infection complicates the treatment of these ulcers. Silver has been shown to be an effective antimicrobial agent with a diverse antimicrobial footprint, minimal allergic reactions, and has been employed for over twenty-five years with little resistance being encountered. Based on these factors, this study was initiated to evaluate the impact of silver containing absorbent dressings on critically colonized venous leg ulcers.

  19. We still go for the jugular: implications of the 3SITES central venous catheter study for nephrology.

    Science.gov (United States)

    Wyatt, Christina M; Vassalotti, Joseph A

    2016-03-01

    The 3SITES study randomly assigned a nontunneled central venous catheter site in over 3000 adults treated in intensive care units. The subclavian site was associated with a lower rate of short-term complications, including catheter-related bloodstream infection and deep venous thrombosis, compared to the femoral or internal jugular site. Nephrologists should be aware of this study and should continue to advocate for alternatives to subclavian vein catheter placement in patients with chronic kidney disease who are expected to require arteriovenous access for dialysis in the future.

  20. Effect of soil water content on spatial distribution of root exudates and mucilage in the rhizosphere

    Science.gov (United States)

    Holz, Maire; Zarebanadkouki, Mohsen; Kuzyakov, Yakov; Carminati, Andrea

    2016-04-01

    Water and nutrients are expected to become the major factors limiting food production. Plant roots employ various mechanisms to increase the access to these limited soil resources. Low molecular root exudates released into the rhizosphere increase nutrient availability, while mucilage improves water availability under low moisture conditions. However, studies on the spatial distribution and quantification of exudates in soil are scarce. Our aim was therefore to quantify and visualize root exudates and mucilage distribution around growing roots using neutron radiography and 14C imaging at different levels of water stress. Maize plants were grown in rhizotrons filled with a silty soil and were exposed to varying soil conditions, from optimal to dry. Mucilage distribution around the roots was estimated from the profiles of water content in the rhizosphere - note that mucilage increases the soil water content. The profiles of water content around different root types and root ages were measured with neutron radiography. Rhizosphere extension was approx. 0.7 mm and did not differ between wet and dry treatments. However, water content (i.e. mucilage concentration) in the rhizosphere of plants grown in dry soils was higher than for plants grown under optimal conditions. This effect was particularly pronounced near the tips of lateral roots. The higher water contents near the root are explained as the water retained by mucilage. 14C imaging of root after 14CO2 labeling of shoots (Pausch and Kuzyakov 2011) was used to estimate the distribution of all rhizodeposits. Two days after labelling, 14C distribution was measured using phosphor-imaging. To quantify 14C in the rhizosphere a calibration was carried out by adding given amounts of 14C-glucose to soil. Plants grown in wet soil transported a higher percentage of 14C to the roots (14Croot/14Cshoot), compared to plants grown under dry conditions (46 vs. 36 %). However, the percentage of 14C allocated from roots to

  1. [Regulation effects of grafting on cinnamic acid and vanillin in eggplant root exudates].

    Science.gov (United States)

    Chen, Shao-li; Zhou, Bao-li; Wang, Ru-hua; Fu, Ya-wen

    2008-11-01

    Cinnamic acid and vanillin are the allelochemicals commonly existed in eggplant root exudates. With pot culture experiment, the regulation effects of grafting on the cinnamic acid and vanillin in eggplant root exudates were studied, and the results showed that grafting decreased the amount of the two substances, especially of vanillin, in eggplants root system. The maximum reduction amount of cinnamic acid reached 68.96%, and that of vanillin reached 100%. Under the stress of exotic cinnamic acid and vanillin, especially of exotic cinnamic acid, grafting relieved the autotoxicity of the two substances on eggplants. Compared with own-rooted eggplant, grafted eggplant had a higher plant height and a larger stem diameter, its leaf chlorophyll content increased by 5.26%-13.12%, root electric conductivity and MDA content decreased, and root SOD activity enhanced.

  2. Automatic differentiation of color fundus images containing drusen or exudates using a contextual spatial pyramid approach.

    Science.gov (United States)

    van Grinsven, Mark J J P; Theelen, Thomas; Witkamp, Leonard; van der Heijden, Job; van de Ven, Johannes P H; Hoyng, Carel B; van Ginneken, Bram; Sánchez, Clara I

    2016-03-01

    We developed an automatic system to identify and differentiate color fundus images containing no lesions, drusen or exudates. Drusen and exudates are lesions with a bright appearance, associated with age-related macular degeneration and diabetic retinopathy, respectively. The system consists of three lesion detectors operating at pixel-level, combining their outputs using spatial pooling and classification with a random forest classifier. System performance was compared with ratings of two independent human observers using human-expert annotations as reference. Kappa agreements of 0.89, 0.97 and 0.92 and accuracies of 0.93, 0.98 and 0.95 were obtained for the system and observers, respectively.

  3. Lactoferrin, myeloperoxidase, lysozyme and eosinophil cationic protein in exudate in delayed type hypersensitivity

    DEFF Research Database (Denmark)

    Lerche, A; Bisgaard, H; Christensen, J D;

    1988-01-01

    A skin window technique was used to study the morphology of leucocytes in upper dermis and exudate during nickel challenge in patients with contact allergy to nickel. Contact allergic patients and healthy volunteers tested with a skin widow without addition of nickel to the chamber medium served...... as controls. The morphology of the leucocytes in dermis was studied in biopsies taken 8, 24, or 48 h after skin window application, and in a parallel test the morphology of the exudate was examined by sequential collection of the chamber medium during a 48 h period. The infiltrate in dermis of contact...... in contact allergic patients exposed to nickel showed a dominance of polymorphonuclear granulocytes throughout the study period, while mononuclear cells, eosinophils and basophils were detected at a much lower quantity and with a considerable delay. Further, we studied the kinetics of the leucocyte granule...

  4. A two-scale Stefan problem arising in a model for tree sap exudation

    CERN Document Server

    Konrad, Isabell; Stockie, John M

    2016-01-01

    The study of tree sap exudation, in which a (leafless) tree generates elevated stem pressure in response to repeated daily freeze-thaw cycles, gives rise to an interesting multi-scale problem involving heat and multiphase liquid/gas transport. The pressure generation mechanism is a cellular-level process that is governed by differential equations for sap transport through porous cell membranes, phase change, heat transport, and generation of osmotic pressure. By assuming a periodic cellular structure based on an appropriate reference cell, we derive an homogenized heat equation governing the global temperature on the scale of the tree stem, with all the remaining physics relegated to equations defined on the reference cell. We derive a corresponding strong formulation of the limit problem and use it to design an efficient numerical solution algorithm. Numerical simulations are then performed to validate the results and draw conclusions regarding the phenomenon of sap exudation, which is of great importance in...

  5. Micropropagation and Phenolic exudation protocol for Excoecaria agallocha-an important mangrove

    Institute of Scientific and Technical Information of China (English)

    Manickam Arumugam; Rajaram Panneerselvam

    2012-01-01

    Objective: To develop a standard micropropagation protocol for an important vulnerable mangrove Excoecaria agallocha. Methods: Collection of explants, surface sterilization, phenolic exudation and medium was standardized. Shoot induction, shoot multiplication and rooting were carried out in MMS medium supplemented with BAP, Kinetin, Zeatin, 2ip, NAA, IAA and IBA. Hardening was carried out after root well established. Results: The best phenolic exudation removal was resulted in 4 g/L activated charcoal. The maximum shoot induction response showed in MMS medium and better shoot induction was performed in the concentration of BAP (3.9 μmol) and NAA (1.34 μmol). Rooting induction was performed high range at 5.02 μmol of IAA. Well rooted micro-shoots were hardened and acclimatized. Conclusions: From the present investigation, it can be concluded that a standard micropropagation protocol was developed for an important vulnerable mangrove species.

  6. Role of Root Exudates in Adaptative Reactions of Buckwheat Plants in Aluminium-acid Stress

    Directory of Open Access Journals (Sweden)

    A.E. Smirnov

    2014-03-01

    Full Text Available Aliminium toxicity is major limiting factor of crop production in acidic soils. It is known that mechanisms of toxic effects of aluminium are differing in biochemical characters, research of aluminium toxicity complicated by variety of its chemical forms and migration in soil and water ability. The root exudates qualitative composition of common buckwheat was evaluated. Organic complexing agents – oxalic acid and phenolic compounds were revealed. The role of these complexing agents in the buckwheat aluminium resistance under acidic stress, participation in processes of external and internal detoxification was shown. Spectrophometric assay revealed an increase in root secretion of oxalic acid by 2.5 times and decrease in content of phenolic compounds in root exudates solution by 3 times upon aluminium (50 µM treatment. In the meanwhile the same concentration of the metal had induced phenylalanine ammonia-lyase activity by 2 times.

  7. Structural and functional findings in exudative age-related long-term macular degeneration

    OpenAIRE

    Riusala, Aila

    2013-01-01

    Age-related macular degeneration (AMD) is the leading cause of visual disability. During past years, new treatments have been studied frequently. However, only some studies have examined its long-term natural outcome. In the future, these kinds of studies are no longer possible because all the AMD lesions are treated. The purpose of this project was to investigate the end-stage structural and functional components of wet AMD and their connection to the fresh exudative lesion stage. The s...

  8. Predictive Factors in OCT Analysis for Visual Outcome in Exudative AMD

    OpenAIRE

    Maria-Andreea Gamulescu; Georgios Panagakis; Carmen Theek; Horst Helbig

    2012-01-01

    Background. Reliable predictive factors for therapy outcome may enable treating physicians to counsel their patients more efficiently concerning probability of improvement or time point of discontinuation of a certain therapy. Methods. This is a retrospective analysis of 87 patients with exudative age-related macular degeneration who received three monthly intravitreal ranibizumab injections. Visual acuity before initiation of intravitreal therapy and 4–6 weeks after last intravitreal injecti...

  9. Prevalence of extracranial venous abnormalities: results from a sample of 586 multiple sclerosis patients.

    Science.gov (United States)

    Simka, M; Latacz, P; Ludyga, T; Kazibudzki, M; Swierad, M; Janas, P; Piegza, J

    2011-01-01

    The aim of this study was to assess the prevalence of chronic cerebrospinal venous insufficiency in an unselected cohort of multiple sclerosis (MS) patients. A total of 586 patients with clinically defined MS underwent catheter venography of the internal jugular veins, brachiocephalic veins and azygos vein. The following findings were regarded as pathologic: no outflow, slowed outflow, reversal of flow direction, prestenotic dilation accompanied by impaired outflow, outflow through collaterals, intraluminal structures obstructing the vein, hypoplasia, agenesia or significant narrowing of the vein. Venous abnormalities were found in 563 patients (96.1%). Lesions in one vein were found in 43.5%, in two veins in 49.5%, and in three veins in 3.1% of patients. Venous pathologies in the right internal jugular vein were found in 64.0% of patients, in the left internal jugular vein in 81.7%, in the left brachiocephalic vein in 1.0%, and in the azygos vein in 4.9%. Venous pathologies were found to be highly associated with MS, yet the clinical relevance of this phenomenon remains to be established.

  10. Topical application of amelogenin extracellular matrix protein in non-healing venous ulcers

    Directory of Open Access Journals (Sweden)

    Burçin Abud

    2014-12-01

    Full Text Available Background and Design: Treatment of chronic venous ulcers of the lower extremity is still an important difficulty. The principal treatment of these ulcers includes compression therapy, local wound care and surgery. Unresponsiveness to these standard treatments is a frequent situation with negative effects on life quality and reductions in personal productivity. Therefore, there is a need for new applications to increase the effectiveness of treatment in treatment-resistant cases. In the present study, we retrospectively evaluated the results of topical application of amelogenin extracellular matrix protein in resistant venous ulcers. Materials and Methods: We analyzed the records of patients with treatment-resistant venous ulceration who were treated with amelogenin extracellular matrix protein between June 2011 and December 2012.. Results: 26 patients (21 male and 5 female with a total number of 28 ulcers (24 patients with 1 ulcer, 2 patients with two ulcers were evaluated. The patients were treated with topically applied amelogenin extracellular matrix protein and regional four bandage compression. Bandages were changed weekly. Each cure continued for six weeks. In fourteen patients (15 ulcers, we observed a complete healing by the end of the first cure. In another twelve cases (13 ulcers, the same period resulted with a reduction in wound diameter. We continued to the second cure for these patients. By the end of the second cure, complete healing was achieved in five cases (6 ulcers. Conclusion: Topical application of amelogenin extracellular matrix protein may be considered as an effective therapeutic choice for refractory venous ulcers.

  11. Central Venous Catheter-Related Hydrothorax

    Directory of Open Access Journals (Sweden)

    Se Hun Kim

    2015-11-01

    Full Text Available This report describes a case of 88-year-old women who developed central venous catheter-related bilateral hydrothorax, in which left pleural effusion, while right pleural effusion was being drained. The drainage prevented accumulation of fluid in the right pleural space, indicating that there was neither extravasation of infusion fluid nor connection between the two pleural cavities. The only explanation for bilateral hydrothorax in this case is lymphatic connections. Although vascular injuries by central venous catheter can cause catheter-related hydrothorax, it is most likely that the positioning of the tip of central venous catheter within the lymphatic duct opening in the right sub-clavian-jugular confluence or superior vena cava causes the catheter-related hydrothorax. Pericardial effusion can also result from retrograde lymphatic flow through the pulmonary lymphatic chains.

  12. Infections associated with the central venous catheters.

    Science.gov (United States)

    Drasković, Biljana; Fabri, Izabella; Benka, Anna Uram; Rakić, Goran

    2014-01-01

    Central venous catheters are of an essential importance to critically ill patients who require long-term venous access for various purposes. Their use made the treatment much easier, but still they are not harmless and are prone to numerous complications. Catheter infections represent the most significant complication in their use. The frequency of infections varies in different patient care settings, but their appearance mostly depends on the patient's health condition, catheter insertion time, localization of the catheter and type of the used catheter. Since they are one of the leading causes of nosocomial infections and related to significant number of morbidity and mortality in intensive care units, it is very important that maximal aseptic precautions are taken during the insertion and the maintenance period. Prevention of infection of the central venous catheters demands several measures that should be applied routinely.

  13. Classification of Non-Proliferative Diabetic Retinopathy Based on Segmented Exudates using K-Means Clustering

    Directory of Open Access Journals (Sweden)

    Handayani Tjandrasa

    2014-12-01

    Full Text Available Diabetic retinopathy is a severe complication retinal disease caused by advanced diabetes mellitus. Long suffering of this disease without threatment may cause blindness. Therefore, early detection of diabetic retinopathy is very important to prevent to become proliferative. One indication that a patient has diabetic retinopathy is the existence of hard exudates besides other indications such as microaneurysms and hemorrhages. In this study, the existence of hard exudates is applied to classify the moderate and severe grading of non-proliferative diabetic retinopathy in retinal fundus images. The hard exudates are segmented using K-means clustering. The segmented regions are extracted to obtain a feature vector which consists of the areas, the perimeters, the number of centroids and its standard deviation. Using three different classifiers, i.e. soft margin Support Vector Machine, Multilayer Perceptron, and Radial Basis Function Network, we achieve the accuracy of 89.29%, 91.07%, and 85.71% respectively, for 56 training data and 56 testing data of retinal images.

  14. [Effect of phosphorus deficiency on activity of acid phosphatase exuded by wheat roots].

    Science.gov (United States)

    Sun, Haiguo; Zhang, Fusuo

    2002-03-01

    The activity of acid phosphatase exuded by roots, the tissue location of the enzyme, and the relationship between the enzyme activity and phosphorus efficiency of wheat were studied. The results showed that the activity of acid phosphatase exuded by wheat 81(85)5-3-3-3 and NC37 under P-sufficiency treat were lower than those under P-deficiency, and the enzyme activity of the former variety was significantly higher than that of the latter. There was a significant difference in the enzyme activity among 12 wheat genotypes grown under P-deficiency treat. Acid phosphatase was exuded by epidermis cell of root, especially by epidermal cell of root apex. Thus, there was a linear relationship between the enzyme activity and the surface area of root or the number of root apexes. It implied that the enzyme activity was markedly related to the size of root system. The linear relationship between relative grain yield and acid phosphatase activity was significant. It indicates that the enzyme activity could be used as an early indicator to select P-efficient wheat genotypes.

  15. Phytochemical screening of the exudate of Aloe otallensis and its effect on Leishmania donovani

    Directory of Open Access Journals (Sweden)

    Zerihun Tesfaye Nigusse

    2016-06-01

    Full Text Available Objective: To evaluate the antileishmanial activity of methanolic extract of Aloe otallensis (A. otallensis on the promastigote stage of Leishmania donovani (L. donovani as compared to standard drugs and to screen its phytochemical constituents. Methods: Phytochemical screening was done by using the method mentioned by Evans and Trease on methanolic extract of the exudates of Aloe otallensis leaves. The extract was also evaluated for in vitro antileishmanial activity against L. donavani which is found from the Parasitology Unit of Black Lion Hospital. The result was compared to standard drugs of sodium stibogluconate, milfostin and paramomycin. Results: The extract has a good antileishmanial activity with an IC50 of 0.1230 μg/mL on L. donovani (AM 563. The experimental data showed that relatively it had better activity than paramomycin and milfostin but less activity than sodium stibogluconate. The data analyses were done by GraphPad Prism version 5 software after it was read by ELISA reader at the wave length of 650 nm. The phytochemical screening of the exudates of A. otallensis showed the presence of phenol, alkaloid and saponin. Conclusions: The methanol extract of the exudates of A. otallensis has a good antileishmaniasis activity and this may be attributed to phenol, alkaloid and saponin present in the plant. But it needs further analysis for the conformation of which constituent presents in high concentration to know which one has the strongest effect.

  16. Polycystic liver disease presenting with an exudative pleural effusion: a case report

    Directory of Open Access Journals (Sweden)

    Woolnough Kerry

    2012-04-01

    Full Text Available Abstract Introduction Polycystic liver disease is asymptomatic in 95% of patients. In the remaining 5% it causes symptoms due to the local mass effect of the polycystic liver. We describe the case of a patient who presented with symptoms of a pleural effusion and was also found to have polycystic liver disease. The effusion recurred despite repeated efforts at drainage and only resolved following surgical debridement of the cystic liver. Case presentation A 50-year-old Caucasian woman presented with a two-week history of increasing dyspnoea. An examination revealed a large right pleural effusion and gross hepatomegaly. An ultrasound confirmed a large polycystic liver and diagnostic thoracocentesis revealed an exudate, which was sterile to culture. The pleural effusion proved refractory to drainage and our patient underwent surgery to deroof the main hepatic cysts in an attempt to reduce the pressure on her right diaphragm. The histology was compatible with that of polycystic liver disease. No evidence of malignancy was found. After surgery, our patient had no recurrence of her effusion and, to date, has remained asymptomatic from her polycystic liver disease. Conclusion The case in this report illustrates that an exudative pleural effusion is a rare complication of polycystic liver disease. We feel that the mechanical effects of a large polycystic liver, and subsequent disruption of sub-diaphragmatic capillaries, resulted in a persistent exudative pleural effusion. Thus, surgical debulking of the hepatic cysts is required to manage these effusions.

  17. Disentangling the rhizosphere effect on nitrate reducers and denitrifiers: insight into the role of root exudates.

    Science.gov (United States)

    Henry, S; Texier, S; Hallet, S; Bru, D; Dambreville, C; Chèneby, D; Bizouard, F; Germon, J C; Philippot, L

    2008-11-01

    To determine to which extent root-derived carbon contributes to the effects of plants on nitrate reducers and denitrifiers, four solutions containing different proportions of sugar, organic acids and amino acids mimicking maize root exudates were added daily to soil microcosms at a concentration of 150 microg C g(-1) of soil. Water-amended soils were used as controls. After 1 month, the size and structure of the nitrate reducer and denitrifier communities were analysed using the narG and napA, and the nirK, nirS and nosZ genes as molecular markers respectively. Addition of artificial root exudates (ARE) did not strongly affect the structure or the density of nitrate reducer and denitrifier communities whereas potential nitrate reductase and denitrification activities were stimulated by the addition of root exudates. An effect of ARE composition was also observed on N(2)O production with an N(2)O:(N(2)O + N(2)) ratio of 0.3 in microcosms amended with ARE containing 80% of sugar and of 1 in microcosms amended with ARE containing 40% of sugar. Our study indicated that ARE stimulated nitrate reduction or denitrification activity with increases in the range of those observed with the whole plant. Furthermore, we demonstrated that the composition of the ARE affected the nature of the end-product of denitrification and could thus have a putative impact on greenhouse gas emissions.

  18. Thermochemical Properties of Hydrophilic Polymers from Cashew and Khaya Exudates and Their Implications on Drug Delivery

    Directory of Open Access Journals (Sweden)

    Emmanuel O. Olorunsola

    2016-01-01

    Full Text Available Characterization of a polymer is essential for determining its suitability for a particular purpose. Thermochemical properties of cashew gum (CSG extracted from exudates of Anacardium occidentale L. and khaya gum (KYG extracted from exudates of Khaya senegalensis were determined and compared with those of acacia gum BP (ACG. The polymers were subjected to different thermal and chemical analyses. Exudates of CSG contained higher amount of hydrophilic polymer. The pH of 2% w/v gum dispersions was in the order KYG < CSG < ACG. Calcium was the predominant ion in CSG while potassium was predominant in KYG. The FTIR spectra of CSG and KYG were similar and slightly different from that of ACG. Acacia and khaya gums exhibited the same thermal behaviour which is different from that of CSG. X-ray diffraction revealed that the three gums are the same type of polymer, the major difference being the concentration of metal ions. This work suggests the application of cashew gum for formulation of basic and oxidizable drugs while using khaya gum for acidic drugs.

  19. The Extraction, Isolation and Identiifcation of Exudates from the Roots of Flaveria bidentis

    Institute of Scientific and Technical Information of China (English)

    YANG Xing; ZHANG Li-hui; SHI Cui-ping; SHANG Yan; ZHANG Jin-lin; HAN Jian-min; DONG Jin-gao

    2014-01-01

    Large amounts of Flaveria bidentis’s root culturing solution were obtained by using DFT (deep lfow technique) equipment and these solution which was vacuum concentrated (10, 20 mg mL-1) can have a certain inhibition on Triticum aestivum, Cucumis sativus, Raphanus sativus, Amaranthus retrolfexus, Setaria viridis, Chenopodium album, Echinochloa crusgalli and Chloris virgata. This outcome suggested some active compounds in the root exudates of Flaveria bidentis can inhibit the germination, seedling elongation and root length. The dichloromethane extract of root exudates was identiifcated by GC-MS, and 29 kinds of compounds, including esters, hydrocarbons, ketones, thiazole, amines, etc. were obtained and the phthalate n-octyl ester, phthalate 2-ethylhexyl ester were proved to be allelochemicals. The culturing solution of root exudates was separated through the resin column and silica gel column and a component inhibiting seedling height, root length and fresh weight of wheat was got. There were 6 kinds of organic compounds in this component including dioctyl phthalate, 1,2-phthalate, mono(2-ethylhexyl) ester by GC-MS.

  20. Naturally-assisted metal phytoextraction by Brassica carinata: Role ofroot exudates

    Energy Technology Data Exchange (ETDEWEB)

    Quartacci, Mike F., E-mail: mfquart@agr.unipi.i [Dipartimento di Chimica e Biotecnologie Agrarie, Universita di Pisa, Via del Borghetto 80, 56124 Pisa (Italy); Irtelli, Barbara [Dipartimento di Chimica e Biotecnologie Agrarie, Universita di Pisa, Via del Borghetto 80, 56124 Pisa (Italy); Gonnelli, Cristina; Gabbrielli, Roberto [Dipartimento di Biologia Vegetale, Sezione di Ecologia e Fisiologia Vegetale, Universita di Firenze, Via Micheli 1, 50121 Firenze (Italy); Navari-Izzo, Flavia [Dipartimento di Chimica e Biotecnologie Agrarie, Universita di Pisa, Via del Borghetto 80, 56124 Pisa (Italy)

    2009-10-15

    Due to relatively high chelant dosages and potential environmental risks it is necessary to explore different approaches in the remediation of metal-contaminated soils. The present study focussed on the removal of metals (As, Cd, Cu, Pb and Zn) from a multiple metal-contaminated soil by growing Brassica carinata plants in succession to spontaneous metallicolous populations of Pinus pinaster, Plantago lanceolata and Silene paradoxa. The results showed that the growth of the metallicolous populations increased the extractable metal levels in the soil, which resulted in a higher accumulation of metals in the above-ground parts of B. carinata. Root exudates of the three metallicolous species were analysed to elucidate their possible role in the enhanced metal availability. The presence of metals stimulated the exudation of organic and phenolic acids as well as flavonoids. It was suggested that root exudates played an important role in solubilising metals in soil and in favouring their uptake by roots. - Phytoextraction of metals is enhanced in Brassica carinata grown in succession to metallicolous populations of spontaneous species.

  1. Thermochemical Properties of Hydrophilic Polymers from Cashew and Khaya Exudates and Their Implications on Drug Delivery

    Science.gov (United States)

    Bhatia, Partap G.; Tytler, Babajide A.; Adikwu, Michael U.

    2016-01-01

    Characterization of a polymer is essential for determining its suitability for a particular purpose. Thermochemical properties of cashew gum (CSG) extracted from exudates of Anacardium occidentale L. and khaya gum (KYG) extracted from exudates of Khaya senegalensis were determined and compared with those of acacia gum BP (ACG). The polymers were subjected to different thermal and chemical analyses. Exudates of CSG contained higher amount of hydrophilic polymer. The pH of 2% w/v gum dispersions was in the order KYG < CSG < ACG. Calcium was the predominant ion in CSG while potassium was predominant in KYG. The FTIR spectra of CSG and KYG were similar and slightly different from that of ACG. Acacia and khaya gums exhibited the same thermal behaviour which is different from that of CSG. X-ray diffraction revealed that the three gums are the same type of polymer, the major difference being the concentration of metal ions. This work suggests the application of cashew gum for formulation of basic and oxidizable drugs while using khaya gum for acidic drugs. PMID:27990303

  2. Phytochemical screening of the exudate of Aloe otallensis and its effect on Leishmania donovani

    Institute of Scientific and Technical Information of China (English)

    Zerihun Tesfaye Nigusse; WoldeaAbebe Wondifraw; Sefinew MigbaruAbate

    2016-01-01

    Objective: To evaluate the antileishmanial activity of methanolic extract of Aloe otallensis (A. otallensis) on the promastigote stage of Leishmania donovani (L. donovani) as compared to standard drugs and to screen its phytochemical constituents. Methods: Phytochemical screening was done by using the method mentioned by Evans and Trease on methanolic extract of the exudates of Aloe otallensis leaves. The extract was also evaluated for in vitro antileishmanial activity against L. donavani which is found from the Parasitology Unit of Black Lion Hospital. The result was compared to standard drugs of sodium stibogluconate, milfostin and paramomycin. Results: The extract has a good antileishmanial activity with an IC50 of 0.1230 μg/mL on L. donovani (AM 563). The experimental data showed that relatively it had better activity than paramomycin and milfostin but less activity than sodium stibogluconate. The data analyses were done by GraphPad Prism version 5 software after it was read by ELISA reader at the wave length of 650 nm. The phytochemical screening of the exudates of A. otallensis showed the presence of phenol, alkaloid and saponin. Conclusions: The methanol extract of the exudates of A. otallensis has a good anti-leishmaniasis activity and this may be attributed to phenol, alkaloid and saponin present in the plant. But it needs further analysis for the conformation of which constituent presents in high concentration to know which one has the strongest effect.

  3. The Variation of Root Exudates from the Hyperaccumulator Sedum alfredii under Cadmium Stress: Metabonomics Analysis

    Science.gov (United States)

    Luo, Qing; Sun, Lina; Hu, Xiaomin; Zhou, Ruiren

    2014-01-01

    Hydroponic experiments were conducted to investigate the variation of root exudates from the hyperaccumulator Sedum alfredii under the stress of cadmium (Cd). S. alfredii was cultured for 4 days in the nutrient solution spiked with CdCl2 at concentrations of 0, 5, 10, 40, and 400 µM Cd after the pre-culture. The root exudates were collected and analyzed by GC-MS, and 62 compounds were identified. Of these compounds, the orthogonal partial least-squares discrimination analysis (OPLS-DA) showed that there were a distinct difference among the root exudates with different Cd treatments and 20 compounds resulting in this difference were found out. Changing tendencies in the relative content of these 20 compounds under the different Cd treatments were analyzed. These results indicated that trehalose, erythritol, naphthalene, d-pinitol and n-octacosane might be closely related to the Cd stabilization, phosphoric acid, tetradecanoic acid, oxalic acid, threonic acid and glycine could be attributed to the Cd mobilization, and mannitol, oleic acid, 3-hydroxybutanoic acid, fructose, octacosanol and ribitol could copy well with the Cd stress. PMID:25545686

  4. The variation of root exudates from the hyperaccumulator Sedum alfredii under cadmium stress: metabonomics analysis.

    Directory of Open Access Journals (Sweden)

    Qing Luo

    Full Text Available Hydroponic experiments were conducted to investigate the variation of root exudates from the hyperaccumulator Sedum alfredii under the stress of cadmium (Cd. S. alfredii was cultured for 4 days in the nutrient solution spiked with CdCl2 at concentrations of 0, 5, 10, 40, and 400 µM Cd after the pre-culture. The root exudates were collected and analyzed by GC-MS, and 62 compounds were identified. Of these compounds, the orthogonal partial least-squares discrimination analysis (OPLS-DA showed that there were a distinct difference among the root exudates with different Cd treatments and 20 compounds resulting in this difference were found out. Changing tendencies in the relative content of these 20 compounds under the different Cd treatments were analyzed. These results indicated that trehalose, erythritol, naphthalene, d-pinitol and n-octacosane might be closely related to the Cd stabilization, phosphoric acid, tetradecanoic acid, oxalic acid, threonic acid and glycine could be attributed to the Cd mobilization, and mannitol, oleic acid, 3-hydroxybutanoic acid, fructose, octacosanol and ribitol could copy well with the Cd stress.

  5. Automatic Exudate Detection from Non-dilated Diabetic Retinopathy Retinal Images Using Fuzzy C-means Clustering

    OpenAIRE

    Akara Sopharak; Sarah Barman; Bunyarit Uyyanonvara

    2009-01-01

    Exudates are the primary sign of Diabetic Retinopathy. Early detection can potentially reduce the risk of blindness. An automatic method to detect exudates from low-contrast digital images of retinopathy patients with non-dilated pupils using a Fuzzy C-Means (FCM) clustering is proposed. Contrast enhancement preprocessing is applied before four features, namely intensity, standard deviation on intensity, hue and a number of edge pixels, are extracted to supply as input parameters to coarse se...

  6. Complement C3 and High Risk of Venous Thromboembolism

    DEFF Research Database (Denmark)

    Nørgaard, Ina; Nielsen, Sune Fallgaard; Nordestgaard, Børge Grønne

    2016-01-01

    BACKGROUND: Complement activation may contribute to venous thromboembolism, including deep venous thrombosis and pulmonary embolism. We tested the hypothesis that high complement C3 concentrations are associated with high risk of venous thromboembolism in the general population. METHODS: We...... similar for deep venous thrombosis and pulmonary embolism separately. The multivariable-adjusted hazard ratio for venous thromboembolism for a 1-g/L increase in complement C3 was 2.43 (1.74-3.40). CONCLUSIONS: High concentrations of complement C3 were associated with high risk of venous thromboembolism...... included 80 517 individuals without venous thromboembolism from the Copenhagen General Population Study recruited in 2003-2012. Plasma complement C3 concentrations were measured at baseline, and venous thromboembolism (n = 1176) was ascertained through April 2013 in nationwide registries. No individuals...

  7. Effect of Pingyangmycin on human venous malformation endothelial cells

    Institute of Scientific and Technical Information of China (English)

    Yi Fang Zhao; Zhi Jun Sun; Yu Lin Jia; Jun Jia; Ya Meng Si; Ji Hong Zhao; Wen Feng Zhang

    2008-01-01

    @@ Purpose: Venous malformations are common vascular anomalies with a propensity of the head and neck. Intralesional injection of Pingyangmycin (PYM, bleomycin A5 hydrochloride) is a widely used sclerotherapy method for the treatment of venous malformation.

  8. Imaging characteristics of two patients with isolated cortical venous thrombosis

    Institute of Scientific and Technical Information of China (English)

    Shunchang Han; Hui Zhang; Guoguang Fan; Baohai Sun

    2008-01-01

    BACKGROUND:Over the past twenty years, improvements in neuroimaging have greatly improved the ability to diagnose cerebral venous sinus thrombosis, as well as isolated cortical venous thrombosis. Neuroimaging allows for variations to be detected in the cortical vein and venous sinus. Diagnosis of thromboses in the venous system should not depend entirely on angiography of undeveloped veins or venous sinus. Currently, the combination of magnetic resonance imaging and magnetic resonance venography is the gold standard for diagnosing cerebral venous sinus thrombosis, rather than digital subtraction angiography. This article summarizes clinical manifestations, results from computed tomography and magnetic resonance imaging in two cases of isolated cortical venous thrombosis, analyzed relevant literature, and discussed the clinical and imaging characteristics of isolated cortical venous thromboses.

  9. Lay Stress on Study of Venous Thromboembolism

    Institute of Scientific and Technical Information of China (English)

    刘泽霖

    2002-01-01

    @@ Venous thromboembolism (VTE) including deep vein thrombosis(DVT) and pulmonary embolism(PE).Its occurs in about 1 per 1 000 individuals per years.Thrombosis is a serious disorder. It may be fatal by PE (case fatality rate of venous thrombosis is estimated at 1% to 2%)(Figure 1 ). A substantial proportion of these deaths occur in the postoperative period, and many events are fatal before diagnosis can be made and therapy initiated. Just as well, the prophylactic treatment of thrombosis is focused on preventing first events and recurrences through adequate knowledge about risks and risk factors.

  10. Assessment of Venous Thrombosis in Animal Models.

    Science.gov (United States)

    Grover, Steven P; Evans, Colin E; Patel, Ashish S; Modarai, Bijan; Saha, Prakash; Smith, Alberto

    2016-02-01

    Deep vein thrombosis and common complications, including pulmonary embolism and post-thrombotic syndrome, represent a major source of morbidity and mortality worldwide. Experimental models of venous thrombosis have provided considerable insight into the cellular and molecular mechanisms that regulate thrombus formation and subsequent resolution. Here, we critically appraise the ex vivo and in vivo techniques used to assess venous thrombosis in these models. Particular attention is paid to imaging modalities, including magnetic resonance imaging, micro-computed tomography, and high-frequency ultrasound that facilitate longitudinal assessment of thrombus size and composition.

  11. Contribution of Individual Chemoreceptors to Sinorhizobium meliloti Chemotaxis Towards Amino Acids of Host and Nonhost Seed Exudates.

    Science.gov (United States)

    Webb, Benjamin A; Helm, Richard F; Scharf, Birgit E

    2016-03-01

    Plant seeds and roots exude a spectrum of molecules into the soil that attract bacteria to the spermosphere and rhizosphere, respectively. The alfalfa symbiont Sinorhizobium meliloti utilizes eight chemoreceptors (McpT to McpZ and IcpA) to mediate chemotaxis. Using a modified hydrogel capillary chemotaxis assay that allows data quantification and larger throughput screening, we defined the role of S. meliloti chemoreceptors in sensing its host, Medicago sativa, and a closely related nonhost, Medicago arabica. S. meliloti wild type and most single-deletion strains displayed comparable chemotaxis responses to host or nonhost seed exudate. However, while the mcpZ mutant responded like wild type to M. sativa exudate, its reaction to M. arabica exudate was reduced by 80%. Even though the amino acid (AA) amounts released by both plant species were similar, synthetic AA mixtures that matched exudate profiles contributed differentially to the S. meliloti wild-type response to M. sativa (23%) and M. arabica (37%) exudates, with McpU identified as the most important chemoreceptor for AA. Our results show that S. meliloti is equally attracted to host and nonhost legumes; however, AA play a greater role in attraction to M. arabica than to M. sativa, with McpZ being specifically important in sensing M. arabica.

  12. Isolation and identification of Desmodium root exudates from drought tolerant species used as intercrops against Striga hermonthica.

    Science.gov (United States)

    Hooper, A M; Caulfield, J C; Hao, B; Pickett, J A; Midega, C A O; Khan, Z R

    2015-09-01

    Plants from the genus Desmodium, in particular D. uncinatum, are used on sub-Saharan small-holder farms as intercrops to inhibit parasitism of cereal crops by Striga hermonthica and Striga asiatica via an allelopathic mechanism. The search for Desmodium species which are adapted to more arid conditions, and which show resilience to increased drought stress, previously identified D. intortum, D. incanum and D. ramosissimum as potential drought tolerant intercrops. Their potential as intercrops was assessed for resource poor areas of rain-fed cereal production where drought conditions can persist through normal meteorological activity, or where drought may have increasing impact through climate change. The chemical composition of the root exudates were characterised and the whole exudate biological activity was shown to be active in pot experiments for inhibition of Striga parasitism on maize. Furthermore, rain fed plot experiments showed the drought tolerant Desmodium intercrops to be effective for Striga inhibition. This work demonstrates the allelopathic nature of the new drought tolerant intercrops through activity of root exudates and the major compounds seen in the exudates are characterised as being C-glycosylflavonoid. In young plants, the exudates show large qualitative differences but as the plants mature, there is a high degree of convergence of the C-glycosylflavonoid exudate chemical profile amongst active Desmodium intercrops that confers biological activity. This defines the material for examining the mechanism for Striga inhibition.

  13. Viperid Envenomation Wound Exudate Contributes to Increased Vascular Permeability via a DAMPs/TLR-4 Mediated Pathway

    Science.gov (United States)

    Rucavado, Alexandra; Nicolau, Carolina A.; Escalante, Teresa; Kim, Junho; Herrera, Cristina; Gutiérrez, José María; Fox, Jay W.

    2016-01-01

    Viperid snakebite envenomation is characterized by inflammatory events including increase in vascular permeability. A copious exudate is generated in tissue injected with venom, whose proteomics analysis has provided insights into the mechanisms of venom-induced tissue damage. Hereby it is reported that wound exudate itself has the ability to induce increase in vascular permeability in the skin of mice. Proteomics analysis of exudate revealed the presence of cytokines and chemokines, together with abundant damage associated molecular pattern molecules (DAMPs) resulting from both proteolysis of extracellular matrix and cellular lysis. Moreover, significant differences in the amounts of cytokines/chemokines and DAMPs were detected between exudates collected 1 h and 24 h after envenomation, thus highlighting a complex temporal dynamic in the composition of exudate. Pretreatment of mice with Eritoran, an antagonist of Toll-like receptor 4 (TLR4), significantly reduced the exudate-induced increase in vascular permeability, thus suggesting that DAMPs might be acting through this receptor. It is hypothesized that an “Envenomation-induced DAMPs cycle of tissue damage” may be operating in viperid snakebite envenomation through which venom-induced tissue damage generates a variety of DAMPs which may further expand tissue alterations. PMID:27886127

  14. Effect of root exudates of different resistant varieties of cucumber on fusarium wilt and preliminary studies on their resistance mechanism

    Institute of Scientific and Technical Information of China (English)

    Benli HUANG; Yundong XU; Ye WU; Shunqi ZHANG; Xuchao CHEN

    2008-01-01

    This study investigated the effect of root exudates of cucumber varieties, Jinyan 4 (susceptible variety), Jinchun 4 (resistant variety) and Yinnan Black seed squash on fusa-rium wilt. The results showed that fusarium wilt occurrence of plants treated with the root exudate of Jinyan 4 was earlier. The infection rate was significantly higher 15 days after inoculation, but similar to the control 20 days after inocula-tion. In contrast, the infection rate of plants treated with the root exudate of Jinchun 4 was significantly lower than that of the control. The plant height and fresh weight of Jinyan 4 treated with its own root exudate were lower than those of the control, and the root vigor decreased but the conductance increased. There was no significant effect of the root exudates from Jinchun 4 and Black seed squash on plant height and fresh mass of Jinyan 4. We found that the root exudate of susceptible cucumber variety stimulated the growth of Fusarium oxysporum pathogen, in contrast, that of resistance variety and Black seed squash suppressed the growth.

  15. Patterns of organic acids exuded by pioneering fungi from a glacier forefield are affected by carbohydrate sources

    Science.gov (United States)

    Brunner, Ivano; Goren, Asena; Schlumpf, Alessandro

    2014-01-01

    Bare soils in the area of retreating glaciers are ideal environments to study the role of microorganisms in the early soil formation and in processes of mineral weathering. The aim of our study was to investigate whether the source of carbohydrate would influence the patterns of organic acids exuded by fungal species. Three pioneering fungus species, isolated from fine granitic sediments in front of the Damma glacier from the central Swiss Alps, have previously been found to have the capability to exude organic acids and dissolve granite powder. In batch experiments, various carbohydrates, including glucose, cellulose, pectin, pollen, and cell remnants of cyanobacteria, fungi, and algae, were applied as carbohydrate sources and the patterns of exuded organic acids recorded. The results showed that two fungi, the zygomycete fungus Mucor hiemalis and the ascomycete fungus Penicillium chrysogenum, released a significantly higher amount of organic acids in dependence on specific carbohydrate sources. Pollen and algae as carbohydrate sources triggered significantly the exudation of malate in M. hiemalis, and pollen and cellulose that of oxalate in P. chrysogenum. We conclude that the occurrence of complex carbohydrate sources in nutrient-deficient deglaciated soils may positively influence the exudation of organic acids of fungi. In particular, pollen and remnants of other microorganisms can trigger the exudation of organic acids of fungi in order to promote the weathering of minerals and to make nutrients available that would otherwise be trapped in that cryospheric environment.

  16. Risk factors for a first and recurrent venous thrombosis

    OpenAIRE

    Flinterman, Linda Elisabeth

    2013-01-01

    The aim of this thesis was to identify new risk factors for first and recurrent venous thrombosis of both the upper and lower extremity, and assess the incidence of recurrence and mortality after a first venous thrombosis. An overview was provided of the current literature on risk factors and treatment for a first venous thrombosis of the upper extremity (chapter 2). We investigated the association between levels of coagulation factors, blood group and a first venous thrombosis of the upper e...

  17. Intravitreal bevacizumab combined with plaque brachytherapy reduces melanoma tumor volume and enhances resolution of exudative detachment

    Directory of Open Access Journals (Sweden)

    Houston SK

    2013-01-01

    Full Text Available Samuel K Houston,1 Nisha V Shah,1 Christina Decatur,1 Marcela Lonngi,1 William Feuer,1 Arnold M Markoe,2 Timothy G Murray1–31Department of Ophthalmology, 2Department of Radiation Oncology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, 3Murray Ocular Oncology and Retina, Miami, FL, USABackground: The purpose of this study was to evaluate intravitreal bevacizumab as an adjuvant treatment to plaque brachytherapy in the treatment of choroidal melanoma.Methods: This was a retrospective, consecutive study of 124 patients treated from 2007 to 2009 for choroidal melanoma with plaque brachytherapy. Patients were treated with I-125 plaque brachytherapy with 2 mm margins and 85 Gy to the tumor apex. Consecutive patients were injected intravitreally with 2.5 mg/0.1 mL bevacizumab at a site away from the primary tumor and immediately following plaque removal. Choroidal melanomas were observed using indirect ophthalmoscopy, wide-angle photography, and ultrasound. The main outcome measures were tumor volume, resolution of exudative retinal detachment, and visual acuity.Results: One hundred and twenty-four patients met our inclusion criteria and were included in the analysis. The mean patient age was 65.7 years, and the mean apical tumor height was 4.0 ± 2.7 mm and basal diameter was 12.7 ± 3.0 mm. Mean follow-up was 24 months. Prior to treatment, 100% of tumors had exudative retinal detachment, and pretreatment visual acuity was 20/55 (median 20/40. Tumor control was 100%, metastasis was 0% at last follow-up, and 89.8% had complete resolution of exudative retinal detachment, with a mean time to resolution of 3.36 months. At one month, 43% had complete resolution of exudative retinal detachment, which increased to 73% at 4 months. Visual acuity was 20/62 (median 20/40 at 4 months, with stabilization to 20/57 (median 20/40 at 8 months, 20/56 (median 20/30 at 12 months, and 20/68 (median 20/50 at 24 months. Tumor

  18. Interaction of root exudates with the mineral soil constituents and their effect on mineral weathering

    Science.gov (United States)

    Mimmo, T.; Terzano, R.; Medici, L.; Lettino, A.; Fiore, S.; Tomasi, N.; Pinton, R.; Cesco, S.

    2012-04-01

    Plants release significant amounts of high and low molecular weight organic compounds into the rhizosphere. Among these exudates organic acids (e.g. citric acid, malic acid, oxalic acid), phenolic compounds (e.g. flavonoids), amino acids and siderophores of microbial and/or plant origin strongly influence and modify the biogeochemical cycles of several elements, thus causing changes in their availability for plant nutrition. One class of these elements is composed by the trace elements; some of them are essential for plants even if in small concentrations and are considered micronutrients, such as Fe, Zn, Mn. Their solubility and bioavailability can be influenced, among other factors, by the presence in soil solution of low molecular weight root exudates acting as organic complexing agents that can contribute to the mineral weathering and therefore, to their mobilization in the soil solution. The mobilized elements, in function of the element and of its concentration, can be either important nutrients or toxic elements for plants. The objective of this study was to assess the influence of several root exudates (citric acid, malic acid, oxalic acid, genistein, quercetin and siderophores) on the mineralogy of two different soils (an agricultural calcareous soil and an acidic polluted soil) and to evaluate possible synergic or competitive behaviors. X-ray diffraction (XRD) coupled with Electron Probe Micro Analysis (EPMA) was used to identify the crystalline and amorphous phases which were subjected to mineral alteration when exposed to the action of root exudates. Solubilization of trace metals such as Cu, Zn, Ni, Cr, Pb, Cd as well as of major elements such as Si, Al, Fe and Mn was assessed by means of Inductively Coupled Plasma Optical Emission Spectroscopy (ICP-OES). Soil microorganisms have proven to decrease mineral weathering by reducing the concentration of active root exudates in solution. Results obtained are an important cornerstone to better understand the

  19. Comparison of skin and muscle biopsies before and after pentoxifylline treatment in patients with leg ulcers due to deep venous incompetence.

    Science.gov (United States)

    Angelides, N S; von der Ahe, C W; Themistocleus, P

    1991-01-01

    The aim of this study was to understand the possible mechanisms by which deep venous insufficiency and venous hypertension are associated with trophic skin changes and ulceration and to explain the therapeutic effect of Pentoxifylline in patients with leg ulcers due to deep venous incompetence. Twenty patients were included in this pilot study. They were graded into two groups: group 1, included 10 patients (5 F and 5 M) with deep venous incompetence and normal arteries; group 2, included 10 patients (1 F and 9 M) with deep venous incompetence and moderate arterial disease. Skin and muscle biopsies were carried out before and after the oral administration of 1,200 mg of Pentoxifylline daily (400 mg t.d.s). The following parameters were investigated by means of light microscopy and immunofluorescence tests: engorgement of venous stroma; decrease of intimal elastica; hyaline degeneration; floccular degeneration; pericapillary fibrin deposits and fibrin degradation products; inflammation and fat necrosis; myofibril degeneration; fibrous scar; regeneration and reconstitution of muscle fibres. The results indicated that local inflammation at the ulcer's area cause accumulation of white blood cells in the capillaries and the interstitial fluid, where there is also accumulation of fibrinogen. These changes may lead to chronic tissue ischaemia and ulceration. The known favourable effect of Pentoxifylline on red cells and leucocyte function as well as its lowering effect on plasma fibrinogen level, may be responsible for the observed therapeutic effect of Pentoxifylline on venous leg ulcers.

  20. Differential inactivation of seed exudate stimulation of Pythium ultimum sporangium germination by Enterobacter cloacae influences biological control efficacy on different plant species.

    Science.gov (United States)

    Kageyama, Koji; Nelson, Eric B

    2003-02-01

    This study was initiated to understand whether differential biological control efficacy of Enterobacter cloacae on various plant species is due to differences in the ability of E. cloacae to inactivate the stimulatory activity of seed exudates to Pythium ultimum sporangium germination. In biological control assays, E. cloacae was effective in controlling Pythium damping-off when placed on the seeds of carrot, cotton, cucumber, lettuce, radish, tomato, and wheat but failed to protect corn and pea from damping-off. Seeds from plants such as corn and pea had high rates of exudation, whereas cotton and cucumber seeds had much lower rates of exudation. Patterns of seed exudation and the release of P. ultimum sporangium germination stimulants varied among the plants tested. Seed exudates of plants such as carrot, corn, lettuce, pea, radish, and wheat were generally more stimulatory to P. ultimum than were the exudates of cotton, cucumber, sunflower, and tomato. However, this was not directly related to the ability of E. cloacae to inactivate the stimulatory activity of the exudate and reduce P. ultimum sporangium germination. In the spermosphere, E. cloacae readily reduced the stimulatory activity of seed exudates from all plant species except corn and pea. Our data have shown that the inability of E. cloacae to protect corn and pea seeds from Pythium damping-off is directly related to its ability to inactivate the stimulatory activity of seed exudates. On all other plants tested, E. cloacae was effective in suppressing damping-off and inactivating the stimulatory activity of seed exudates.

  1. Physical activity, immobilization and the risk of venous thrombosis

    NARCIS (Netherlands)

    Stralen, Karlijn Janneke van

    2008-01-01

    Deep venous thrombosis is a common disease. Already in 1856 it was suggested that immobilization could cause venous thrombosis. However, so far little research has shown whether exercise or ambulation could decrease the risk of venous thrombosis. We performed a historical review regarding the role o

  2. Use of Rhizosphere Metabolomics to Investigate Exudation of Phenolics by Arabidopsis Roots

    Science.gov (United States)

    Lee, Yong Jian; Rai, Amit; Reuben, Sheela; Nesati, Victor; Almeida, Reinaldo; Swarup, Sanjay

    2013-04-01

    The rhizosphere is a specialised micro-niche for bacteria that have an active exchange of signals and nutrients with the host plant. Nearly 20% of photosynthates are released as root exudates, which consist of primary metabolites and products of secondary metabolism which are largely phenolic in nature. Previously, using rhizosphere metabolomics, we showed that nearly 50% of organic carbon in the exudates is in the form of phenolic compounds, of which the largest fraction is from the phenylpropanoid synthesis pathway. Using Arabidopsis as a model, we have demonstrated that a biased rhizosphere can be created using plants with varying levels of phenylpropanoids due to mutations in the biosynthetic or regulatory genes. These phenylpropanoids levels are reflected in the exudates, and exudates from lines with regulatory gene mutations, tt8 and ttg, have higher levels of phenylpropanoids, whereas biosynthetic mutant line, tt4, has very low and undetectable levels of phenylpropanoids. The biased rhizosphere of tt8 and ttg lines provides a nutritional advantage to rhizobacteria that can utilize these phenylpropanoids such as quercetin. With such a strategy to increase the competitiveness of plant growth-promoting rhizobacteria (PGPR) such as Pseudomonas putida, this system can be applied to improve plant performance. In order to better understand the metabolic basis of the nutritional advantage behind the competitiveness of the favoured P. putida, we elucidated its quercetin utilization pathway. We have recently cloned the gene for quercetin oxidoreductase (QuoA) and expressed it in transgenic Arabidopsis lines to alter the plant phenylpropanoid metabolism, using a gain of function approach. Since phenylpropanoid biosynthesis in plants involve formation of quercetin from naringenin, we envisaged that QuoA expression in plants will provide us with a genetic tool to "reverse" this biosynthetic step. This perturbation led to a decrease in flavonoids and an increase in lignin

  3. Lymphatic and venous function in lipoedema.

    Science.gov (United States)

    Harwood, C A; Bull, R H; Evans, J; Mortimer, P S

    1996-01-01

    Lipoedema is a common but infrequently recognized condition causing bilateral enlargement of the legs in women. Although generally considered to be the result of an abnormal deposition of subcutaneous fat with associated oedema, the precise mechanisms responsible for oedema formation have yet to be fully established. In order to evaluate the possible role of lymphatic or venous dysfunction in the pathogenesis of lipoedema, 10 patients were investigated by photoplethysmography (venous function) and quantitative lymphoscintigraphy (lymphatic function). The results were compared with those from patients with primary lymphoedema and those from healthy volunteers. The results demonstrated minor abnormalities of venous function in only two patients. One patient had moderately impaired lymphatic function in both legs and seven patients had a marginal degree of impairment in one or both legs. However, in none of these cases did the impairment attain the low levels seen in true lymphoedema. Lipoedema appears to be a distinct clinical entity best classified as a lipodystrophy rather than a direct consequence of any primary venous or lymphatic insufficiency.

  4. Nonclinical aspects of venous thrombosis in pregnancy.

    Science.gov (United States)

    Struble, Evi; Harrouk, Wafa; DeFelice, Albert; Tesfamariam, Belay

    2015-09-01

    Pregnancy is a hypercoagulable state which carries an excess risk of maternal venous thrombosis. Endothelial injury, alterations in blood flow and activation of the coagulation pathway are proposed to contribute to the hypercoagulability. The risk for thrombosis may be accentuated by certain drugs and device implants that directly or indirectly affect the coagulation pathway. To help ensure that these interventions do not result in adverse maternal or fetal outcomes during pregnancy, gravid experimental animals can be exposed to such treatments at various stages of gestation and over a dosage range that would identify hazards and inform risk assessment. Circulating soluble biomarkers can also be evaluated for enhancing the assessment of any increased risk of venous thrombosis during pregnancy. In addition to traditional in vivo animal testing, efforts are under way to incorporate reliable non-animal methods in the assessment of embryofetal toxicity and thrombogenic effects. This review summarizes hemostatic balance during pregnancy in animal species, embryofetal development, biomarkers of venous thrombosis, and alterations caused by drug-induced venous thrombosis.

  5. [Femoral venous catheter: an unusual complication].

    Science.gov (United States)

    Garcia, P; Mora, A; Trambert, P; Maler, E; Courant, P

    2000-08-01

    We report an erratic course of a venous femoral catheter which was in the abdominal cavity in a patient with an haemoperitoneum and an hepatic injury. This complication led to an inefficiency of the transfusion and a worsening of the haemoperitoneum.

  6. The aetiology of deep venous thrombosis.

    Science.gov (United States)

    Malone, P C; Agutter, P S

    2006-09-01

    Most ideas about the pathogenesis of deep venous thrombosis (DVT) are dominated by a 'consensus model' first articulated around 1962. This model invokes 'Virchow's triad' and attributes thrombogenesis in veins to some combination of 'hypercoagulability', 'stasis' and 'intimal injury'. This arose as a by-product of studies on the mechanisms of haemostasis and bleeding diatheses that were at best only indirectly relevant to thrombosis, and there are reasons for doubting the causal significance of 'hypercoagulability' and 'stasis' in the aetiology of DVT. Proponents of the consensus model make little reference to a substantial literature, mostly historical, that: (a) emphasizes the significance of the venous valve pockets (VVP) and blood rheology in DVT pathogenesis; and (b) describes morphological features specific to venous thrombi that a valid aetiological model must explain. This literature provides the basis for an alternative hypothesis of DVT aetiology, published some 30 years ago, which has been experimentally corroborated and is compatible with recent cell and molecular biological studies of the venous endothelium. We review this alternative hypothesis, considering its potential value for future research on DVT and embolism, and its significance for clinical practice.

  7. Diagnosing deep venous thrombosis in primary care

    NARCIS (Netherlands)

    Oudega, Rudolphus

    2005-01-01

    In patients suspected of deep venous thrombosis (DVT) in primary care, it is a challenge to discriminate the patients with DVT from those without DVT. The risk of missing the diagnosis and the risk of unnecessary referral and treatment with a potential harmful therapy has to be balanced by the prima

  8. Microalbuminuria and Risk of Venous Thromboembolism

    NARCIS (Netherlands)

    Mahmoodi, Bakhtawar K.; Gansevoort, Ron T.; Veeger, Nic J. G. M.; Matthews, Abigail G.; Navis, Gerjan; Hillege, Hans L.; van der Meer, Jan

    2009-01-01

    Context Microalbuminuria (albuminuria 30-300 mg per 24-hour urine collection) is a well-known risk marker for arterial thromboembolism. It is assumed that microalbuminuria reflects generalized endothelial dysfunction. Hence, microalbuminuria may also predispose for venous thromboembolism (VTE). Obje

  9. Arterial and Venous Thrombosis in Cancer Patients

    Directory of Open Access Journals (Sweden)

    Andrew D. Blann

    2011-01-01

    Full Text Available The most frequent ultimate cause of death is myocardial arrest. In many cases this is due to myocardial hypoxia, generally arising from failure of the coronary macro- and microcirculation to deliver enough oxygenated red cells to the cardiomyocytes. The principle reason for this is occlusive thrombosis, either by isolated circulating thrombi, or by rupture of upstream plaque. However, an additionally serious pathology causing potentially fatal stress to the heart is extra-cardiac disease, such as pulmonary hypertension. A primary cause of the latter is pulmonary embolus, considered to be a venous thromboembolism. Whilst the thrombotic scenario has for decades been the dominating paradigm in cardiovascular disease, these issues have, until recently, been infrequently considered in cancer. However, there is now a developing view that cancer is also a thrombotic disease, and notably a disease predominantly of the venous circulation, manifesting as deep vein thrombosis and pulmonary embolism. Indeed, for many, a venous thromboembolism is one of the first symptoms of a developing cancer. Furthermore, many of the standard chemotherapies in cancer are prothrombotic. Accordingly, thromboprophylaxis in cancer with heparins or oral anticoagulation (such as Warfarin, especially in high risk groups (such as those who are immobile and on high dose chemotherapy, may be an important therapy. The objective of this communication is to summarise current views on the epidemiology and pathophysiology of arterial and venous thrombosis in cancer.

  10. Treatment of Cancer-Associated Venous Thrombosis

    NARCIS (Netherlands)

    G.L. van Sluis; H.R. Buller

    2009-01-01

    Venous thromboembolism (VTE) is an important complication in cancer patients, which is associated with bad outcome. Increased recurrence rates and bleeding complications as compared to non-cancer patients during the treatment of VTE, require special attention. This review aims to summarize the avail

  11. CLINICAL CO RELATION BETWEEN ARTERIAL VERSUS VENOUS AMMONIA LEVELS IN HEPATIC ENCEPHLOPATHY IN CIRRHOSIS OF LIVER

    Directory of Open Access Journals (Sweden)

    Manjunath

    2014-05-01

    Full Text Available : INTRODUCTION: Hepatic encephalopathy is a reversible neuropsychiatry state that complicates liver disease. Pathogenesis of Hepatic Encephalopathy in chronic liver is function is widely accepted to be due to failure of hepatic clearance of toxins products from gut exact toxin involved remains controversial but ammonia is thought to be an important factor. Ammonia levels help both in diagnosis and serve as a guide in treatment. Diagnosis of Hepatic Encephalopathy can be done based on clinical criteria and the severity of Hepatic Encephalopathy can be graded by West Haven Criteria. This criterion is the simplest grading of Hepatic Encephalopathy based on clinical findings. AIMS AND OBJECTIVES: To correlate between Ammonia levels and clinical severity of Hepatic Encephalopathy in Cirrhosis of liver and correlate between Arterial versus venous ammonia levels with severity of Hepatic Encephalopathy. RESULTS: Male patients had higher incidence than females. Severity of hepatic encephalopathy was graded by West Haven grading. Arterial total ammonia and venous ammonia was correlated with the clinical severity of HE. Of the 50 patients 3 had grade 1, 18 had grade 2, 22 had grade 3 and 7 had grade 4. Arterial and venous ammonia levels co related with severity of HE. The highest level of arterial ammonia was seen in grade 3 and grade 4.It was seen that other lab parameters also increased with severity of HE. But were not significant. Serum albumin was inversely co related with severity of HE. CONCLUSIONS: Arterial total ammonia correlated better with the severity of Hepatic Encephalopathy as compared to venous ammonia levels. Venous total ammonia did not correlate with severity of Hepatic Encephalopathy and with arterial ammonia levels.

  12. Cerebral venous thrombosis presenting with cerebellar ataxia and cortical blindness.

    Science.gov (United States)

    Ben Sassi, Samia; Mizouni, Habiba; Nabli, Fatma; Kallel, Lamia; Kefi, Mounir; Hentati, Fayçal

    2010-01-01

    Venous infarction in the cerebellum has been reported only rarely, probably because of the abundant venous collateral drainage in this region. Bilateral occipital infarction is a rare cause of visual loss in cerebral venous thrombosis. We describe a 50-year-old woman with a history of ulcerative colitis who developed acute cerebellar ataxia and cortical blindness. She had bilateral cerebellar and occipital lesions related to sigmoid venous thrombosis and achieved complete recovery with anticoagulation therapy. Cerebral venous thrombosis should be considered in cases of simultaneous cerebellar and occipital vascular lesions.

  13. Association between thrombophilia and seated immobility venous thromboembolism.

    Science.gov (United States)

    Siniarski, Aleksander; Wypasek, Ewa; Fijorek, Kamil; Gajos, Grzegorz; Undas, Anetta

    2014-03-01

    Prolonged work and recreation-related seated immobility increases the risk of venous thromboembolism (VTE). Little is known about links of thrombophilia and prolonged immobility. We sought to determine factors associated with the occurrence of seated immobility venous thromboembolism (SIT). Four hundred and ninety-three consecutive outpatients with a history of first-ever VTE, aged up to 65 years were referred for evaluation of suspected thrombophilia. Exclusion criteria were provoked VTE unless family history of VTE was positive, arterial thrombosis, cancer, infection and chronic inflammatory diseases. The prolonged immobility group was defined as being seated at least 8 h daily and at least 3 h daily without getting up, or 10 h daily and 2 h daily without getting up, or 12 h daily and 1 h daily without getting up during 12 weeks prior to VTE onset. SIT was observed in 115 patients (24.5%). Inherited thrombophilia was more common among SIT patients than in the remainder [Odds ratio (OR) 3.98, 95% confidence interval (CI) 2.55-6.25], with a major impact of factor V Leiden mutation (FVL) (OR 4.86, 95% CI 2.95-8.05). In multivariate analysis, FVL (OR 5.43, 95% CI 3.23-9.15), trauma (OR 2.55, 95% CI 1.30-4.99), current smoking (OR 1.68, 95% CI 1.06-2.67) and varices (OR 2.08, 95% CI 1.27-3.40) were independent predictors of SIT. Moreover, FVL (OR 4.05, 95% CI 2.12-7.76), prothrombin G20210A variant (OR 3.84, 95% CI 1.47-10.05) and computer use (OR 2.84, 95% CI 1.43-5.63) were independent predictors of unprovoked VTE in the SIT group. Inherited thrombophilia, current smoking and varices characterize patients with SIT.

  14. Advances in diagnosis and treatment of cerebral venous system diseases

    Directory of Open Access Journals (Sweden)

    Xiao-yun LIU

    2016-11-01

    Full Text Available Cerebral venous system diseases include cerebral venous thrombosis (CVT, venous sinus stenosis, carotid cavernous fistula (CCF, intracranial arteriovenous malformation (AVM and so on. In recent years, due to the rapid development of neuroimaging and interventional technology, more and more cerebral venous system diseases have been timely diagnosed and treated, such as magnetic resonance black-blood thrombus imaging (MRBTI in the diagnosis of CVT, stenting in the treatment of venous sinus stenosis, micro coil plus Onyx glue or covered stents in the treatment of CCF, which allow us to make a deeper recognition of cerebral venous system diseases. Therefore, this paper will introduce the latest diagnosis and treatment of cerebral venous system diseases. DOI: 10.3969/j.issn.1672-6731.2016.11.006

  15. Exudation of organic acids by Lupinus albus and Lupinus angustifolius as affected by phosphorus supply

    Science.gov (United States)

    Hentschel, Werner; Wiche, Oliver

    2016-04-01

    In phytomining and phytoremediation research mixed cultures of bioenergy crops with legumes hold promise to enhance availability of trace metals and metalloids in the soil plant system. This is due to the ability of certain legumes to mobilize trace elements during acquisition of nutrients making these elements available for co-cultured species. The legumes achieve this element mobilization by exudating carboxylates and enzymes as well as by lowering the pH value in the rhizosphere. The aim of our research was to determine characteristics and differences in the exudation of Lupinus albus and Lupinus angustifolius regarding to quantitative as to qualitative aspects. Especially the affection by phosphorus (P) supply was a point of interest. Thus we conducted laboratory batch experiments, wherein the plants were grown over four weeks under controlled light, moisture and nutritional conditions on sand as substrate. Half of the plants were supplied with 12 mg P per kg substrate, the other half were cultivated under a total lack of P. After cultivation the plants were transferred from the cultivation substrate into a 0,05 mmolṡL-1 CaCl2 solution. After two hours the plants were removed, moist and dry mass off shoots and roots were measured together with the root length (Tennants' method). Concentrations of exudated carboxylates in the CaCl2 solution were determined via IC (column: Metrosept OrganicAcids, eluent 0.5 molṡL-1 H2SO4 + 15% acetone, pH=3; 0.5 mLṡmin-1). As a result four different organic acids were identified (citric acid, fumaric acid, tartaric acid, malic acid) in concentration ranges of 0.15 mgṡL-1 (fumaric acid) to 9.21 mgṡL-1 (citric acid). Lupinus angustifolius showed a higher exudation rate (in nmol per cm root length per hour) than Lupinus albus in the presence of phosphorus (e.g. regarding citric acid: 1.99 vs 0.64 nmolṡ(gṡh)-1). However, as the root complexity and length of L. albus were far higher than of L. angustifolius, the total

  16. Genetic Determinism of Sensitivity to Corynespora cassiicola Exudates in Rubber Tree (Hevea brasiliensis).

    Science.gov (United States)

    Tran, Dinh Minh; Clément-Demange, André; Déon, Marine; Garcia, Dominique; Le Guen, Vincent; Clément-Vidal, Anne; Soumahoro, Mouman; Masson, Aurélien; Label, Philippe; Le, Mau Tuy; Pujade-Renaud, Valérie

    2016-01-01

    An indirect phenotyping method was developed in order to estimate the susceptibility of rubber tree clonal varieties to Corynespora Leaf Fall (CLF) disease caused by the ascomycete Corynespora cassiicola. This method consists in quantifying the impact of fungal exudates on detached leaves by measuring the induced electrolyte leakage (EL%). The tested exudates were either crude culture filtrates from diverse C. cassiicola isolates or the purified cassiicolin (Cas1), a small secreted effector protein produced by the aggressive isolate CCP. The test was found to be quantitative, with the EL% response proportional to toxin concentration. For eight clones tested with two aggressive isolates, the EL% response to the filtrates positively correlated to the response induced by conidial inoculation. The toxicity test applied to 18 clones using 13 toxinic treatments evidenced an important variability among clones and treatments, with a significant additional clone x treatment interaction effect. A genetic linkage map was built using 306 microsatellite markers, from the F1 population of the PB260 x RRIM600 family. Phenotyping of the population for sensitivity to the purified Cas1 effector and to culture filtrates from seven C. cassiicola isolates revealed a polygenic determinism, with six QTL detected on five chromosomes and percentages of explained phenotypic variance varying from 11 to 17%. Two common QTL were identified for the CCP filtrate and the purified cassiicolin, suggesting that Cas1 may be the main effector of CCP filtrate toxicity. The CCP filtrate clearly contrasted with all other filtrates. The toxicity test based on Electrolyte Leakage Measurement offers the opportunity to assess the sensitivity of rubber genotypes to C. cassiicola exudates or purified effectors for genetic investigations and early selection, without risk of spreading the fungus in plantations. However, the power of this test for predicting field susceptibility of rubber clones to CLF will have

  17. Sinorhizobium meliloti chemoreceptor McpU mediates chemotaxis toward host plant exudates through direct proline sensing.

    Science.gov (United States)

    Webb, Benjamin A; Hildreth, Sherry; Helm, Richard F; Scharf, Birgit E

    2014-06-01

    Bacterial chemotaxis is an important attribute that aids in establishing symbiosis between rhizobia and their legume hosts. Plant roots and seeds exude a spectrum of molecules into the soil to attract their bacterial symbionts. The alfalfa symbiont Sinorhizobium meliloti possesses eight chemoreceptors to sense its environment and mediate chemotaxis toward its host. The methyl accepting chemotaxis protein McpU is one of the more abundant S. meliloti chemoreceptors and an important sensor for the potent attractant proline. We established a dominant role of McpU in sensing molecules exuded by alfalfa seeds. Mass spectrometry analysis determined that a single germinating seed exudes 3.72 nmol of proline, producing a millimolar concentration near the seed surface which can be detected by the chemosensory system of S. meliloti. Complementation analysis of the mcpU deletion strain verified McpU as the key proline sensor. A structure-based homology search identified tandem Cache (calcium channels and chemotaxis receptors) domains in the periplasmic region of McpU. Conserved residues Asp-155 and Asp-182 of the N-terminal Cache domain were determined to be important for proline sensing by evaluating mutant strains in capillary and swim plate assays. Differential scanning fluorimetry revealed interaction of the isolated periplasmic region of McpU (McpU40-284) with proline and the importance of Asp-182 in this interaction. Using isothermal titration calorimetry, we determined that proline binds with a Kd (dissociation constant) of 104 μM to McpU40-284, while binding was abolished when Asp-182 was substituted by Glu. Our results show that McpU is mediating chemotaxis toward host plants by direct proline sensing.

  18. Gelation of Soy Milk with Hagfish Exudate Creates a Flocculated and Fibrous Emulsion- and Particle Gel.

    Directory of Open Access Journals (Sweden)

    Lukas Böni

    Full Text Available Hagfish slime is an ultra dilute, elastic and cohesive hydrogel that deploys within milliseconds in cold seawater from a glandularly secreted exudate. The slime is made of long keratin-like fibers and mucin-like glycoproteins that span a network which entraps water and acts as a defense mechanism against predators. Unlike other hydrogels, the slime only confines water physically and is very susceptible to mechanical stress, which makes it unsuitable for many processing operations and potential applications. Despite its huge potential, little work has been done to improve and functionalize the properties of this hydrogel. To address this shortcoming, hagfish exudate was mixed with a soy protein isolate suspension (4% w/v and with a soy emulsion (commercial soy milk to form a more stable structure and combine the functionalities of a suspension and emulsion with those of the hydrogel. Hagfish exudate interacted strongly with the soy systems, showing a markedly increased viscoelasticity and water retention. Hagfish mucin was found to induce a depletion and bridging mechanism, which caused the emulsion and suspension to flocculate, making "soy slime", a cohesive and cold-set emulsion- and particle gel. The flocculation network increases viscoelasticity and substantially contributes to liquid retention by entrapping liquid in the additional confinements between aggregated particles and protein fibers. Because the mucin-induced flocculation resembles the salt- or acid-induced flocculation in tofu curd production, the soy slime was cooked for comparison. The cooked soy slime was similar to conventional cooked tofu, but possessed a long-range cohesiveness from the fibers. The fibrous, cold-set, and curd-like structure of the soy slime represents a novel way for a cold coagulation and fiber incorporation into a suspension or emulsion. This mechanism could be used to efficiently gel functionalized emulsions or produce novel tofu-like structured food

  19. Genetic Determinism of Sensitivity to Corynespora cassiicola Exudates in Rubber Tree (Hevea brasiliensis)

    Science.gov (United States)

    Tran, Dinh Minh; Clément-Demange, André; Déon, Marine; Garcia, Dominique; Le Guen, Vincent; Clément-Vidal, Anne; Soumahoro, Mouman; Masson, Aurélien; Label, Philippe; Le, Mau Tuy; Pujade-Renaud, Valérie

    2016-01-01

    An indirect phenotyping method was developed in order to estimate the susceptibility of rubber tree clonal varieties to Corynespora Leaf Fall (CLF) disease caused by the ascomycete Corynespora cassiicola. This method consists in quantifying the impact of fungal exudates on detached leaves by measuring the induced electrolyte leakage (EL%). The tested exudates were either crude culture filtrates from diverse C. cassiicola isolates or the purified cassiicolin (Cas1), a small secreted effector protein produced by the aggressive isolate CCP. The test was found to be quantitative, with the EL% response proportional to toxin concentration. For eight clones tested with two aggressive isolates, the EL% response to the filtrates positively correlated to the response induced by conidial inoculation. The toxicity test applied to 18 clones using 13 toxinic treatments evidenced an important variability among clones and treatments, with a significant additional clone x treatment interaction effect. A genetic linkage map was built using 306 microsatellite markers, from the F1 population of the PB260 x RRIM600 family. Phenotyping of the population for sensitivity to the purified Cas1 effector and to culture filtrates from seven C. cassiicola isolates revealed a polygenic determinism, with six QTL detected on five chromosomes and percentages of explained phenotypic variance varying from 11 to 17%. Two common QTL were identified for the CCP filtrate and the purified cassiicolin, suggesting that Cas1 may be the main effector of CCP filtrate toxicity. The CCP filtrate clearly contrasted with all other filtrates. The toxicity test based on Electrolyte Leakage Measurement offers the opportunity to assess the sensitivity of rubber genotypes to C. cassiicola exudates or purified effectors for genetic investigations and early selection, without risk of spreading the fungus in plantations. However, the power of this test for predicting field susceptibility of rubber clones to CLF will have

  20. An analysis of quantitative measurements of drainage exudate using negative suction in 96 microtia ear reconstructions.

    Science.gov (United States)

    Xu, Zhicheng; Zhang, Ruhong; Zhang, Qun; Xu, Feng

    2012-01-01

    Negative suction drainage is commonly used for the prevention of seromas or hematomas in auricular reconstruction surgery; however, there are few reports regarding the quantitative measurement of negative suction and its relation to disposed time, patient age or microtia type. In the present study, the authors recorded the volume of suction exudate in microtia reconstruction and elaborate on the relevant details of controlling negative suction. A negative suction drainage system was applied in 96 microtia patients between 2007 and 2010. Two small polyethylene drains were inserted adjacent to the concha and the scapha, respectively. The volume of exudate was recorded for three days after surgery and was analyzed according to disposed time, patient age and microtia type. The drains were removed on the third postoperative day, when only a small amount of exudate remained. A significant change in drainage was observed over three days postoperatively, and the quantity decreased progressively on the third postoperative day. Comparison of age groups showed that the volume of drainage from adults was greater than that from children or adolescents in the first two postoperative days, regardless of whether the drains were inserted in the scapha or concha. No statistical differences were found on the third postoperative day. A comparison of drain types revealed no statistically significant differences between scapha and concha drains three days postoperatively. The analysis demonstrated that drainage quantity is related to disposed time and patient age, but not to microtia type. The authors recommend removal of suction drains on the third postoperative day. Moreover, individualized negative suction treatment according to age or microtia type provides a safe and consistent approach to achieving acceptable results and fewer complications.

  1. Root Exudates, Rhizosphere Zn Fractions, and Zn Accumulation of Ryegrass at Different Soil Zn Levels

    Institute of Scientific and Technical Information of China (English)

    XU Wei-Hong; LIU Huai; MA Qi-Fu; XIONG Zhi-Ting

    2007-01-01

    A glasshouse experiment was conducted using a root-bag technique to study the root exudates, rhizosphere Zn fractions, and Zn concentrations and accumulations of two ryegrass cultivars (Lolium perenne L. cvs. Airs and Tede) at different soil Zn levels (0, 2, 4, 8, and 16 mmol kg-1 soil). Results indicated that plant growth of the two cultivars was not adversely affected at soil Zn level≤8 mmol kg-1. Plants accumulated more Zn as soil Zn levels increased, and Zn concentrations of shoots were about 540 /μg g-1 in Aris and 583.9μg g-1 in Tede in response to 16 mmol Zn kg-1 soil. Zn ratios of shoots to roots across the soil Zn levels were higher in Tede than in Airs, corresponding with higher rhizosphere available Zn fractions (exchangeable, bound to manganese oxides, and bound to organic matter) in Airs than in Tede. Low-molecular-weight (LMW) organic acids (oxalic, tartaric, malic, and succinic acids) and amino acids (proline, threonine, glutamic acid, and aspartic acid, etc.) were detected in root exudates, and the concentrations of LMW organic acids and amino acids increased with addition of 4 mmol Zn kg-1 soil compared with zero Zn addition. Higher rhizosphere concentrations of oxalic acid, glutamic acid, alanine, phenylalanine, leucine, and proline in Tede than in Airs likely resulted in increased Zn uptake from the soil by Tede than by Airs. The results suggested that genotypic differences in Zn accumulations were mainly because of different root exudates and rhizosphere Zn fractions.

  2. Urinary albumin excretion rate: a risk factor for retinal hard exudates in macular region in type 2 diabetic patients

    Institute of Scientific and Technical Information of China (English)

    Wang Shaocheng; Lin Siyong; Cao Xi; Zheng Yuezhong; Wang Jinyang; Lu Na; Yang Jinkui

    2014-01-01

    Background The various risk factors for retinal hard exudates are still poorly understood in type 2 diabetic patients.The aim of this study was to determine the association between urinary albumin excretion rate (UAER) and hard exudates in macular region in north Chinese patients.Methods A total of 272 patients (272 eyes) were enrolled for this study,including 154 subjects from group 1 (mild hard exudates),91 subjects from group 2 (moderate hard exudates) and 27 subjects from group 3 (severe hard exudates) confirmed using colour fundus photography,optical coherence tomography (OCT) as well as slit-lamp biomicroscopy with 78 diopter (D) lens.Each participant underwent a comprehensive assessment that included biochemical,clinical characteristics test and detailed ophthalmic evaluation.One-way analysis of variance (ANOVA) test and chi-square test were performed to analyze the fasting blood glucose (FBG),glycated hemoglobin (HbA1c),total cholesterol (TC),low density lipoprotein (LDL),high density lipoprotein (HDL),triglycerides (TG),full blood counts,urinary albumin excretion rate (UAER),blood creatinine (CREA),duration of diabetes,body mass index (BMI),systolic blood pressures (SBP) and diastolic blood pressures (DBP) between groups.Ordinal logistic regression analysis was further performed in order to eliminating the possible confounding factors.Results Three groups were matched in terms of age and gender.Risk factors which showed significant difference between groups include FBG (P <0.001),HbA1c (P <0.001),LDL (P <0.001),UAER (P <0.001),duration of diabetes (P=0.001),TC (P=0.005),SBP (P=0.026),CREA (P=0.004) and haemoglobin (Hb) (P=0.012).There was no significant difference between groups for the TG,HDL,DBP,platelet,total white blood cells and BMI.Using ordinal Logistic regression analyses,of all the variables,HbA1c,LDL and UAER which were independent risk factor for hard exudates showed a significantly odds ratio of 1.25,3.07,and 1.39,respectively

  3. Contribution of methylated exudate flavonoids to the anti-inflammatory activity of Grindelia robusta.

    Science.gov (United States)

    Krenn, Liselotte; Wollenweber, Eckhard; Steyrleuthner, Katja; Görick, Cornelia; Melzig, Matthias F

    2009-07-01

    The flavonoid pattern of an acetonic extract of Grindelia robusta Nutt. was investigated in detail. The flavonoids were enriched by CC. In addition to twelve known methylated exudate flavonols four compounds were identified for the first time in G. robusta. Several substances of the flavonoid complex, among them the main compounds quercetin-3-methylether and 6-OH-kaempferol-3,6-dimethylether, were tested for their activity to inhibit neutrophil elastase. Quercetin-3-methylether was shown to be most active with an IC(50) of 19 microM, thus obviously contributing to the anti-inflammatory activity of the drug.

  4. Solid phase extraction and metabolic profiling of exudates from living copepods

    DEFF Research Database (Denmark)

    Selander, Erik; Heuschele, Jan; Nylund, Göran M.;

    2016-01-01

    Copepods are ubiquitous in aquatic habitats. They exude bioactive compounds that mediate mate finding or induce defensive traits in prey organisms. However, little is known about the chemical nature of the copepod exometabolome that contributes to the chemical landscape in pelagic habitats. Here we....... Copepodamide G, known to induce defensive responses in phytoplankton, was among the ten compounds of highest relative abundance in both male and female extracts. The presence of copepodamide G shows that the method can be used to capture and analyze chemical signals from living source organisms. We conclude...

  5. Role of root exudates in dissolution of Cd containing iron oxides

    Science.gov (United States)

    Rosenfeld, C.; Martinez, C. E.

    2011-12-01

    Dissolved organic matter (DOM) in the rhizosphere contains organic acids, amino acids and more complex organic molecules that can substantially impact the solubility of soil solid phases. Plant roots and soil microorganisms contribute a large fraction of these organic compounds to DOM, potentially accelerating the transfer of solid phase elements into solution. In highly contaminated soils, heavy metals such as Cd are commonly found coprecipitated with common minerals (e.g. iron oxides). Introducing or changing vegetation on these contaminated soils may increase DOM levels in the soil pore fluids and thus enhance the biological and chemical weathering of soil minerals. Here, we investigate the role of root exudates on mineral dissolution and Cd mobility in contaminated soils. We hypothesize that plant exudates containing nitrogen and sulfur functional groups will dissolve Cd-containing mineral phases to a greater extent than exudates containing only oxygen functional groups, resulting in higher Cd concentrations in solution. Two different iron oxide mineral phases were utilized in a laboratory-scale model study system investigating the effects of low molecular weight, oxygen-, nitrogen-, and sulfur-containing organic compounds on mineral dissolution. Goethite (α-FeOOH) was synthesized in the laboratory with 0, 2.4, 5, and 100 theoretical mol% Cd, and franklinite (ZnFe2O4) was prepared with 0, 10, and 25 theoretical mol% Cd. Phase identity of all minerals was verified with X-ray diffraction (XRD). All minerals were reacted with 0.01 mM solutions containing one of four different organic ligands (oxalic acid, citric acid, histidine or cysteine) and aliquots of these solutions were sampled periodically over 40 days. Results from solution samples suggest that oxalic acid, citric acid, and histidine consistently increase mineral dissolution relative to the control (no organic compound present) while cysteine consistently inhibits dissolution relative to the control in

  6. A case of von Hippel-Lindau disease with exudative maculopathy

    Directory of Open Access Journals (Sweden)

    Basel T Ba′arah

    2009-01-01

    Full Text Available Von Hippel-Lindau (VHL disease is a rare multisystem familial tumor syndrome of autosomal dominant inheritance. Hallmark lesions include retinal, cerebellum and spinal cord hemangioblastomas, renal cell carcinomas, adrenal pheochromocytomas, angiomatous or cystic lesions of the kidneys, pancreas, and epididymis. We report a case of VHL disease in a 26-year-old patient who presented with exudative macular edema. Ocular and systemic studies revealed the presence of retinal and central nervous system hemangioblastomas, adrenal pheochromocytoma, multiple pancreatic, and kidney cysts. The retinal angiomas were successfully treated with argon laser photocoagulation and cryotherapy.

  7. Metabolism and root exudation of organic acid anions under aluminium stress

    OpenAIRE

    Eduardo D Mariano; Jorge, Renato A; Keltjens, Willem G.; Menossi, Marcelo

    2005-01-01

    Numerous plant species can release organic acid anions (OA) from their roots in response to toxic aluminium (Al) ions present in the rooting medium. Hypothetically OA complex Al in the root apoplast and/or rhizosphere and thus avoid its interaction with root cellular components and its entry in the root symplast. Two temporal patterns of root OA exudation are observed. In pattern I, OA release is rapidly activated after the contact of the root with Al ions while in pattern II there is a lag p...

  8. Organic matter exudation by Emiliania huxleyi under simulated future ocean conditions

    Directory of Open Access Journals (Sweden)

    A. Engel

    2012-01-01

    Full Text Available Emiliania huxleyi (strain B 92/11 was exposed to different growth, CO2 and temperature conditions in phosphorous controlled chemostats, to investigate effects on organic carbon exudation, and partitioning between the pools of particulate organic carbon (POC and dissolved organic carbon (DOC. 14C incubation measurements for primary production (PP and for extracellular release (ER were performed. Chemical analysis included amount and composition of high molecular weight dissolved combined carbohydrates (>1 kDa, HMW-dCCHO, particulate combined carbohydrates (pCCHO and the carbon content of transparent exopolymer particles (TEP-C. Applied CO2 and temperature conditions were 300, 550 and 900 μatm pCO2 at 14 °C, and additionally 900 μatm pCO2 at 18 °C simulating a greenhouse ocean scenario. A reduction in growth rate from μ =0.3 d−1 to μ =0.1 d−1 induced the most profound effect on the performance of E. huxleyi, relative to the effect of elevated CO2 and temperature. At μ =0.3 d−1, PP was significantly higher at elevated CO2 and temperature. DO14C production correlated to PO14C production in all cultures, resulting in similar percentages of extracellular release (DO14C/PP × 100; PER of averaged 3.74 ± 0.94%. At μ =0.1 d−1, PO14C decreased significantly, while exudation of DO14C increased, thus leading to a stronger partitioning from the particulate to the dissolved pool. Maximum PER of 16.3 ± 2.3% were observed at μ =0.1 d−1 at greenhouse conditions. Concentrations of HMW-dCCHO and pCCHO were generally higher at μ =0.1 d−1 compared to μ =0.3 d−1. At μ =0.3 d−1, pCCHO concentration increased significantly along with elevated CO2 and temperature. Despite of high PER, the percentage of HMW-dCCHO was smallest at greenhouse conditions. However, highest TEP-formation was observed under greenhouse conditions, together with a pronounced increase in pCCHO concentration, suggesting a stronger partitioning of PP from DOC to POC

  9. Vitrectomy for circumscribed choroidal hemangioma with exudative retinal detachment refractory to transpupillary thermotherapy

    Directory of Open Access Journals (Sweden)

    Shukla Dhananjay

    2007-01-01

    Full Text Available We report successful surgical management of a circumscribed choroidal hemangioma with exudative retinal detachment refractory to transpupillary thermotherapy (TTT. A 33-year-old man with symptomatic serous macular detachment in the left eye (Snellen acuity: 20/200 secondary to a paramacular choroidal hemangioma was treated with TTT. The nonresponsive detachment was subsequently managed by vitrectomy, endophotocoagulation and silicon-oil tamponade. It resulted in complete resolution of the tumor and the detachment. Silicon oil was removed at four months. Visual acuity improved to 20/80 by the last follow-up visit at 10 months without any recurrence.

  10. [Medial venous catheter or midline (MVC)].

    Science.gov (United States)

    Carrero Caballero, Ma Carmen; Montealegre Sanz, María; Cubero Pérez, Ma Antonia

    2014-01-01

    Current clinical practice is characterised for importance of the patient's quality of life and the need to reduce the costs of their treatment. We search intravenous therapy alternatives that meet the needs of the patient, reducing the complications associated with the use of venous catheters. Scientific evidence shows that there are midline venous catheters that offer patients and professionals the possibility of extending the duration of infusion therapy, using more venous compatibility materials, and with less risk of infection. The Midlines are becoming in a safe an efficient device for intravenous therapy, continuous and intermittent infusion, provided the necessary care by expert nurses. Midline catheters are peripheral venous access devices between 3 to 10 inches in length (8 to 25 cm). Midlines are usually placed in an upper arm vein, such as the brachial or cephalic, and the distal extreme ends below the level of the axillary line. Midlines catheters implanted in the cephalic or deep basilica veins get more blood flow. This large blood volume justifies the lower risk of mechanical or chemical phlebitis. Midlines are routinely used for two to six weeks. Due that the extrem of these catheters does not extend beyond the axillary line, there are limitations for its use: type of infused drugs, velocity of infusion, etc. In general, solutions that have pH 5 to 9, or an osmolarity less than 500 mOsm are appropriate for infusion through a Midline. Its use is recommended in case of treatments over 7 days with low irritant capacity fluids. According to the Infusion Nurses Society's standards of practice, Midline catheters are appropriate for all intravenous fluids that would normally be administered through a short peripheral IV Importantly, due that the catheter does not pass through the central veins, Midlines can be placed without a chest X-ray to confirm placement. For certain situations, Midlines are suitable for acute units and even for care home settings

  11. Risk factors for venous thrombosis associated with peripherally inserted central venous catheters.

    Science.gov (United States)

    Pan, Longfang; Zhao, Qianru; Yang, Xiangmei

    2014-01-01

    To evaluate the risk factors associated with an increased risk of symptomatic peripherally inserted central venous catheter (PICC)-related venous thrombosis. Retrospective analyses identified 2313 patients who received PICCs from 1 January 2012 to 31 December 2013. All 11 patients with symptomatic PICC-related venous thrombosis (thrombosis group) and 148 who did not have thromboses (non-thrombosis group) were selected randomly. The medical information of 159 patients (age, body mass index (BMI), diagnosis, smoking history, nutritional risk score, platelet count, leucocyte count as well as levels of D-dimer, fibrinogen, and degradation products of fibrin) were collected. Logistic regression analysis was undertaken to determine the risk factors for thrombosis. Of 2313 patients, 11 (0.47%) were found to have symptomatic PICC-related venous thrombosis by color Doppler ultrasound. Being bedridden for a long time (odds ratio [(OR]), 17.774; P=0.0017), D-dimer >5 mg/L (36.651; 0.0025) and suffering from one comorbidity (8.39; 0.0265) or more comorbidities (13.705; 0.0083) were the major risk factors for PICC-catheter related venous thrombosis by stepwise logistic regression analysis. Among 159 patients, the prevalence of PICC-associated venous thrombosis in those with ≥1 risk factor was 10.34% (12/116), in those with ≥2 risk factors was 20.41% (10/49), and in those with >3 risk factors was 26.67% (4/15). Being bedridden >72 h, having increased levels of D-dimer (>5 mg/L) and suffering from comorbidities were independent risk factors of PICC-related venous thrombosis.

  12. Gene expression regulation in the plant growth promoting Bacillus atrophaeus UCMB-5137 stimulated by maize root exudates.

    Science.gov (United States)

    Mwita, Liberata; Chan, Wai Yin; Pretorius, Theresa; Lyantagaye, Sylvester L; Lapa, Svitlana V; Avdeeva, Lilia V; Reva, Oleg N

    2016-09-15

    Despite successful use of Plant Growth Promoting Rhizobacteria (PGPR) in agriculture, little is known about specific mechanisms of gene regulation facilitating the effective communication between bacteria and plants during plant colonization. Active PGPR strain Bacillus atrophaeus UCMB-5137 was studied in this research. RNA sequencing profiles were generated in experiments where root exudate stimulations were used to mimic interactions between bacteria and plants. It was found that the gene regulation in B. atrophaeus UCMB-5137 in response to the root exudate stimuli differed from the reported gene regulation at similar conditions in B. amyloliquefaciens FZB42, which was considered as a paradigm PGPR. This difference was explained by hypersensitivity of UCMB-5137 to the root exudate stimuli impelling it to a sessile root colonization behavior through the CcpA-CodY-AbrB regulation. It was found that the transcriptional factor DegU also could play an important role in gene regulations during plant colonization. A significant stress caused by the root exudates on in vitro cultivated B. atrophaeus UCMB-5137 was noticed and discussed. Multiple cases of conflicted gene regulations showed scantiness of our knowledge on the regulatory network in Bacillus. Some of these conflicted regulations could be explained by interference of non-coding RNA (ncRNA). Search through differential expressed intergenic regions revealed 49 putative loci of ncRNA regulated by the root exudate stimuli. Possible target mRNA were predicted and a general regulatory network of B. atrophaeus UCMB-5137 genome was designed.

  13. Enhanced hyphal growth of arbuscular mycorrhizae by root exudates derived from high R/FR treated Lotus japonicus.

    Science.gov (United States)

    Nagata, Maki; Yamamoto, Naoya; Miyamoto, Taro; Shimomura, Aya; Arima, Susumu; Hirsch, Ann M; Suzuki, Akihiro

    2016-06-02

    Red/Far Red (R/FR) sensing positively influences the arbuscular mycorrhizal (AM) symbiosis of both legume and nonlegume plants through jasmonic acid (JA) and strigolactone signaling. We previously reported that root exudates obtained from high R/FR-grown plants contained more strigolactone than low R/FR-grown plants. To determine whether JA and JA derivatives were secreted from roots, we investigated the expression levels of JA-responsive genes in L. japonicus Miyakojima MG20 plants treated with root exudates prepared from either high or low R/FR light-treated plants. The root exudates from high R/FR light-treated plants were found to enhance the expression levels of JA-responsive genes significantly. Moreover, exogenous JA increased AM fungal hyphal elongation as did the root exudates derived from high R/FR-grown L. japonicus plants. We conclude that increased JA accumulation and secretion into root exudates from high R/FR light-grown plants is the best explanation for increased colonization and enhanced mycorrhization under these conditions.

  14. Status of Exudative Pleural Effusion in Adults of South Khorasan Province, Northeast Iran: Pleural Tuberculosis Tending toward Elderly

    Directory of Open Access Journals (Sweden)

    Sayyed Gholam Reza Mortazavi-Moghaddam

    2016-07-01

    Full Text Available The causes and situation of exudative pleural effusion vary from one area to another. A cross-sectional study was conducted on 327 patients with exudative pleural effusion in South Khorasan province (Iran. The patients were older than 12 years and comprised 172 (52.6% males and 155 (47.4% females. The study commenced in 2007 with seven years duration. The Light’s criteria were used to define exudative effusion. Procedures including pleural fluid analysis, microbiological study, pleural biopsy, and systemic investigations were conducted to determine the special cause of pleural effusion. The mean age of the patients was 63.4±18.4 years. Malignancies, tuberculosis, and parapneumonia pleural exudation were diagnosed in 125 (38.2%, 48 (14.7%, and 45 (13.8% cases, respectively. Among malignant effusions, metastasis from lung cancer made 48 (38.4% of the cases. The origin of metastasis was not determined in 44 (35.2% patients. The mean age of patients was not significantly different between malignant (66.9±14.3 years and tuberculosis (63.9±19.7 years cases (P=0.16. The older age of tuberculosis patients could be a new discussion point on the overall impression created on the subject of tuberculosis pleural exudation (TB-PLE occurring in young people.

  15. Low strigolactone root exudation: a novel mechanism of broomrape (Orobanche and Phelipanche spp.) resistance available for faba bean breeding.

    Science.gov (United States)

    Fernández-Aparicio, Mónica; Kisugi, Takaya; Xie, Xiaonan; Rubiales, Diego; Yoneyama, Koichi

    2014-07-23

    Faba bean yield is severely constrained in the Mediterranean region and Middle East by the parasitic weeds Orobanche crenata, O. foetida, and Phelipanche aegyptiaca. Seed germination of these weeds is triggered upon recognition of host root exudates. Only recently faba bean accessions have been identified with resistance based in low induction of parasitic seed germination, but the underlying mechanism was not identified. Strigolactones are a group of terpenoid lactones involved in the host recognition by parasitic plants. Our LC-MS/MS analysis of root exudates of the susceptible accession Prothabon detected orobanchol, orobanchyl acetate, and a novel germination stimulant. A time course analysis indicated that their concentration increased with plant age. However, low or undetectable amounts of these germination stimulants were detected in root exudates of the resistant lines Quijote and Navio at all plant ages. A time course analysis of seed germination induced by root exudates of each faba bean accession indicated important differences in the ability to stimulate parasitic germination. Results presented here show that resistance to parasitic weeds based on low strigolactone exudation does exist within faba bean germplasm. Therefore, selection for this trait is feasible in a breeding program. The remarkable fact that low induction of germination is similarly operative against O. crenata, O. foetida, and P. aegyptiaca reinforces the value of this resistance.

  16. Status of Exudative Pleural Effusion in Adults of South Khorasan Province, Northeast Iran: Pleural Tuberculosis Tending toward Elderly

    Science.gov (United States)

    Mortazavi-Moghaddam, Sayyed Gholam Reza; Sharifzadeh, Gholam Reza; Rezvani, Mohammad Reza

    2016-01-01

    The causes and situation of exudative pleural effusion vary from one area to another. A cross-sectional study was conducted on 327 patients with exudative pleural effusion in South Khorasan province (Iran). The patients were older than 12 years and comprised 172 (52.6%) males and 155 (47.4%) females. The study commenced in 2007 with seven years duration. The Light’s criteria were used to define exudative effusion. Procedures including pleural fluid analysis, microbiological study, pleural biopsy, and systemic investigations were conducted to determine the special cause of pleural effusion. The mean age of the patients was 63.4±18.4 years. Malignancies, tuberculosis, and parapneumonia pleural exudation were diagnosed in 125 (38.2%), 48 (14.7%), and 45 (13.8%) cases, respectively. Among malignant effusions, metastasis from lung cancer made 48 (38.4%) of the cases. The origin of metastasis was not determined in 44 (35.2%) patients. The mean age of patients was not significantly different between malignant (66.9±14.3 years) and tuberculosis (63.9±19.7 years) cases (P=0.16). The older age of tuberculosis patients could be a new discussion point on the overall impression created on the subject of tuberculosis pleural exudation (TB-PLE) occurring in young people. PMID:27365554

  17. Venous Thromboembolism in Patients With Thrombocytopenia

    DEFF Research Database (Denmark)

    Baelum, Jens Kristian; Moe, Espen Ellingsen; Nybo, Mads

    2017-01-01

    . OBJECTIVES: To identify VTE risk factors and describe treatment and outcome (bleeding episodes and mortality) in patients with thrombocytopenia. PATIENTS/METHODS: Patients with thrombocytopenia (platelet count ... with anticoagulants. There was no difference in bleeding incidence between cases and controls. CONCLUSIONS: Several known VTE risk factors also seems to apply in patients with thrombocytopenia. Also, patients with thrombocytopenia may be VTE risk stratified based on platelet count and comorbidities. Finally, patients......BACKGROUND: Venous thromboembolism (VTE) is a frequent and potentially lethal condition. Venous thrombi are mainly constituted of fibrin and red blood cells, but platelets also play an important role in VTE formation. Information about VTE in patients with thrombocytopenia is, however, missing...

  18. Deep venous thrombosis of the upper extremity

    DEFF Research Database (Denmark)

    Klitfod, Lotte; Broholm, R; Baekgaard, N

    2013-01-01

    to the condition. Malignancy and therapeutic interventions are major risk factors for the secondary deep vein thrombosis in combination with the patient's characteristics, comorbidities and prior history of deep vein thrombosis. Complications: recurrent deep venous thrombosis, pulmonary embolism and Post......Upper extremity deep venous thrombosis (UEDVT) occurs either spontaneously, as a consequence of strenuous upper limb activity (also known as the Paget-Schroetter syndrome) or secondary to an underlying cause. Primary and secondary UEDVT differs in long-term sequelae and mortality. This review...... will focus on the clinical presentation, risk factors, diagnosis, and treatment strategies of UEDVT. In the period from January to October 2012 an electronic literature search was performed in the PubMed/MEDLINE database, and 27 publications were included. Clinical presentation: swelling, pain and functional...

  19. External jugular venous aneurysm: A clinical curiosity

    Science.gov (United States)

    Mohanty, Debajyoti; Jain, Bhupendra Kumar; Garg, Pankaj Kumar; Tandon, Anupama

    2013-01-01

    Jugular venous aneurysm is an extremely rare condition. The patients presented with a painless swelling in the neck that appears while coughing, straining, bending, or breath holding. Detection of a soft and compressible swelling in the course of an external jugular vein (EJV) superficial to the sternomastoid muscle, non-filling on compression of the EJV during Valsalva maneuver clinches the diagnosis of EJV aneurysm. Color Doppler ultrasound allows precise delineation of the lesion and is considered the gold standard for confirming the diagnosis. Surgical excision is indicated mostly for cosmetic reasons and symptomatic aneurysms. We, herein, report a patient with saccular external jugular venous aneurysm to highlight the typical clinical presentation and diagnosis of this rare entity. PMID:23633867

  20. [Venous thromboembolism in patients with cancer].

    Science.gov (United States)

    Lecumberri, Ramón; Feliu, Jesús; Rocha, Eduardo

    2006-06-03

    The association between neoplastic diseases and venous thromboembolism (VTE) is known since long time ago. The nature of this association is bidirectional. On one hand, cancer increases the incidence of venous thrombosis and, on the other hand, the hemostatic system does play a key role in the tumorigenesis process. However, despite recent advances in the field, prophylaxis and treatment of VTE in cancer patients is still a challenge, due to the complexity of this type of patients. This review is focused on some important points regarding management of VTE in cancer patients such as physiopathology, epidemiology, search for hidden malignancy, prognostic impact, prophylaxis in the medical and surgical setting, or initial and long-term treatment.