bluuebunny/crossref_metadata_2025_split huggingface dataset:
Microvascular Evaluation by Laser—Dopper Flowmetry of the Effects of Centellase in the Treatment of Severe Venous Hypertension and Leg Ulcers
Authors: Belcaro G. 
Published: January 2017

A study of the microcirculation in patients with venous hyperterision and perimalleolar ulcers was used to evaluate the effects of medical treatment by Centellase 60. The evaluation of the resting flow and the observation of the venous response before and after treatment shows an interesting, positive effect of Centellase 60 in 25 patients with venous ulceration treated for 4 weeks. The decrease of the resting flow and the increased efficacy of the venous vasomotor response was both significant and associated with a significant decrease of the ulcerated areas. Laser-Doppler flowmetry was useful to demonstrate microcirculatory changes which were not revealed by standard techniques such as ambulatory venous pressure. It may be useful to reveal variations in venous hypertension produced by other treatments such as elastic compression or ‘venoactive’ drugs.
Graduated Compression Stockings in the Prevention of Postoperative Deep Vein Thrombosis: A Comparative Study of Pressure Profiles and Patient Compliance
Authors: Williamson M. , Thomas S. , Edwards A. , Johnson R. , Riggs J. , Lewis M. H. 
Published: January 2017

Graded support stockings are widely used in the prophylaxis of postoperative deep vein thrombosis (DVT). For many years (following the results of early trials) one brand has dominated the market. We now describe an assessment of an alternative brand. Fifty patients undergoing major abdominal surgery were provided with graduated support stockings postoperatively for the prophylaxis of DVT. Two different makes of stockings were used, one on each leg; the leg randomly determined by an odd or even year of birth. Data was collected from each patient in order to determine patient compliance. Patients experienced no significant difference in comfort between the two makes, although, on balance, product ‘A’ was found to be more comfortable. No pressure sores were caused by either stocking type and there was no clinical evidence of DVT in any of the 50 patients. However, there were two cases of pulmonary embolus. Samples of both stockings were tested in a materials testing laboratory, to determine the pressure gradients which they could be expected to apply in normal use, and the results of these tests suggest that there are major differences in the performance of the products concerned.
Improvement of Ambulatory Venous Hypertension by Narrowing of the Femoral Vein in Congenital Absence of Venous Valves
Authors: Partsch B. , Mayer W. , Partsch H. 
Published: January 2017

Objective: To assess the effect of femoral vein compression in a patient with congenital avalvulae. Design: Single patient study. Setting: Department of Dermatology; Teaching Hospital, Vienna, Austria. Patient: A single patient with the rare condition of congenital absence of venous valves. Interventions: Compression of the thigh using a thigh Main outcome measures: Ambulatory venous pressure Measurement. Results: The ambulatory venous pressure was reduced when the thigh calf pressure was increased in excess of 70 mmHg. Conclusion: Thigh compression in a patient with congenital absence of venous valves resulted in a temporary valve mechanism permitting orthograde flow during muscle systole, but inhibiting venous reflux.
Techniques of Sclerotherapy: A Method to Distend Leg Veins with the Patient in a Horizontal Position Prior to Needle Insertion
Authors: Bundens W. P. 
Published: January 2017

Objective: To demonstrate the efficacy of the use of a large contoured thigh cuff to distend varicose veins, with the patient in a horizontal position, prior to needle insertion for sclerotherapy. Design: Prospective study in varicose vein patients treated by injection-compression sclerotherapy. Setting: Outpatient Surgery Clinic, University of California San Diego, La Jolla, California. Patients: Patients presenting with varicose veins on the lower thigh and below. Interventions: Patients underwent injection-compression sclerotherapy. Needles insertion was done with the patient in a horizontal position after veins were distended using a large contoured thigh cuff. Main outcome measures: Successful vein distension and needle insertion. Results: Ninety-five percent of patients had adequate vein distension for needle insertion. Conclusion: Vein distension, prior to needle insertion for sclerotherapy can be achieved by using a large contoured thigh cuff.
Marjolin's Ulcer: A Report of Three Cases and Review of the Literature
Authors: Hassan S. A. , Cheatle T. R. , Fox J. A. 
Published: January 2017

Objective: To report three cases of Marjolin's ulcer and review the literature on the subject. Design: Case report. Setting: Edgware General Hospital, Edgware, Middlesex. Patients: Three patients presenting with Marjolin's ulcer. Interventions: Amputation (2 cases) and excision with skin grafting (1 case). Main outcome measures: Disease control. Results: Satisfactory control of disease in all three.
Endothelium-Derived Relaxing Factor Release from Normal and Varicose Human Saphenous Veins
Authors: Payne S. P. K. , Sayers R. D. , Watt P. A. C. , Bell P. R. F. , Thurston H. 
Published: January 2017

Objective: To evaluate the role of endothelium-derived relaxing factor (EDRF) in the regulation of smooth muscle tone in normal and varicose human saphenous veins. Design: An in vitro study of site-matched saphenous vein samples from patients undergoing varicose vein surgery or carotid endarterectomy. Setting: Department of Surgery, University of Leicester, Leicester Royal Infirmary. Patients: Nine patients undergoing varicose vein surgery and seven patients undergoing carotid endarterectomy. Measurements: Vein samples were contracted with noradrenaline and relaxation studies performed with acetylcholine (endothelium-dependent) and sodium nitroprusside (endothelium-independent). Results: There was no statistical difference in either smooth muscle contraction in response to noradrenaline or in endothelial-dependent relaxation in response to acetylcholine. All veins retained the ability to relax in response to nitroprusside. Conclusions: No evidence of a defect in either smooth muscle function or EDRF release has been found that may contribute to the aetiology of varicose veins.
Angiomatosis at the Saphenofemoral Junction
Authors: Lechter A. , Lopez G. , Theuzaba E. , Franco C. , Bayona G. 
Published: January 2017

Objective: To describe 12 patients with a vascular malformation found at the saphenofemoral junction during dissection of the inguinal region for surgery of varicose veins. Design: Retrospective study of cases found during the period from 1986 to 1991. Setting: University Hospital of the Military School of Medicine, Bogota, Colombia. Patients: Twelve patients, 11 unilateral and one bilateral, representing 0.5% of our total experience in surgery of varicose veins in 5 years. Interventions: Surgical resection of the angiomatous malformation. Main outcome measures: Clinical assessment of patients and histological examination of excised tissue. Results: The excised angiomatous tissue was found to contain irregular venous vessels, associated with lymphatic nodular structures and surrounded by adipose tissue. A satisfactory clinical outcome was obtained in patients where the angiomatous tissue could be excised. Conclusions: Vascular surgeons treating varicose veins should be aware of the possibility of finding vascular angiomatous malformation of the saphenofemoral junction. Surgical resection of these benign lesions results in a satisfactory clinical outcome.
Double-Blind Trial of the Efficacy of Troxerutin in Chronic Venous Insufficiency
Authors: Vin F. , Chabanel A. , Taccoen A. , Ducros J. , Gruffaz J. , Hutinel B. , Maillet P. , Samama M. 
Published: January 2017

Objective: To evaluate the efficacy of troxerutin in chronic venous insufficiency. Design: Randomized, double-blind, multicentre, prospective controlled trial. Setting: Hôtel Dieu Hospital and Notre Dame de Bon Secours Hospital, Paris, France. Patients: Sixty-nine patients with truncal varicose veins. Intervention: After a single-blind 15-day placebo run-in period, one group ( n = 34) received troxerutin 3500 mg daily for 2 months. The other group ( n = 35) received a placebo. Main outcome measures: Subjective symptoms, ankle circumference, venous refilling time with photoplethysmography, erythrocyte aggregation using the SEFAM aggregameter and fibrinogen level. Results: Leg aching ( p < 0.001) and venous function score ( p < 0.001) improvements were significantly higher in the troxerutin group (83% and −3.7) compared with the placebo group (23% and −0.7). A significant difference in favour of troxerutin was found for erythrocyte aggregation kinetic indexes ( p < 0.001) and dissociation threshold ( p < 0.01). Conclusions: This study confirmed the dual action of the drug: a parietal effect and a rheological effect.
Pathophysiology of Chronic Venous Insufficiency
Authors: Bauersachs J. , Fleming I. , Busse R. 
Published: January 2017

Objective: To review the physiological mechanisms determining venous return to the heart and the pathophysiological events culminating in chronic venous insufficiency (CVI), focusing primarily on the role of alterations in nitric oxide (NO) production by the vascular endothelium. Background: Congenital valve incompetence, thrombotic damage or venous outflow obstruction result in the development of chronic venous hypertension which frequently leads to ulceration. One major aetiological factor of trophic changes in the skin of patients with CVI is the phenomenon of leucocyte trapping. Hypothesis: It has been suggested that endothelial dysfunction, effectively resulting in a decrease in cellular levels of NO, is a key event in the initiation of enhanced adhesion molecule expression. Data: P-selectin, monocyte chemoattractant protein-1 and vascular cell adhesion molecule-1 expression can be enhanced by attenuating endothelial NO production. The mechanism by which NO alters the expression of genes encoding these adhesion molecules would appear to involve an interaction with transcription factors, in particular NF*** xB. Conclusion: Impaired endothelial NO synthesis associated with CVI may enhance the expression of adhesion molecules and chemotactic factors and lead to leucocyte adhesion and extravasation.
Laser Doppler Flux in the Venous Wall
Authors: Belcaro G. , Nicolaides A. N. , Laurora G. , Cesarone M. R. , De Sanctis M. T. , Incande L. , Ricci A. 
Published: January 2017

Objectives: To evaluate in vivo the perfusion of the venous wall in normal veins, varicose veins and in femoral veins of post-phlebitic limbs recording wall flux with laser Doppler flowmetry. As there is some evidence that both structure and microcirculatory dynamic responses are altered in the abnormal vein wall, we also aimed to study the response of vein wall perfusion to locally induced vasodilatation following papaverine infusion. Design: Open prospective study in patients with venous insufficiency and in patients undergoing coronary revascularization with a normal venous system. Setting: Cardiovascular Institute, Chieti University, Pierangeli Clinic, Italy and Irvine Laboratory, St Mary's Hospital, London, UK. Patients: Twenty-four normal long saphenous veins and 11 common femoral veins (35 normal veins, 35 subjects) and 42 varicose veins (42 patients). Measurements: Venous wall flux was measured on the external surface of normal long saphenous veins and common femoral veins. Measurements were also made on varicose veins before ligation of the sapheno-femoral junction. All measurements were made when at least three-quarters of the adventitia and periadventitia tissue were still intact for a length of 3 cm. Results: Flux in the normal vein wall was higher ( t = 5.88; p<0.05) than in varicose veins and in veins of post-phlebitic limbs. There was no difference in flux between varicose veins and post-phlebitic veins. After intravenous papaverine injection in a subgroup of eight normal and eight varicose veins, in the wall of normal veins there was a significant increase in flux (from 8.5 (SD 5.1) units to 13.2 (SD 3.8) units; p<0.05) which was not observed in varicose veins. Conclusions: A higher vein wall perfusion was observed in normal veins compared with varicose veins and post-phlebitic limb veins. Greater vascular reactivity to intraluminal papaverine injection was observed in normal veins.
Angioscopic External Valvuloplasty in the Treatment of Varicose Veins
Authors: Satokawa H. , Hoshino S. , Igari T. , Takase S. , Ogawa T. 
Published: January 2017

Objective: To report on the surgical treatment of varicose veins by angioscopic valvuloplasty to preserve the long saphenous vein (LSV) and the efficacy of this method compared with conventional stripping and high ligation. Methods: A total of 306 limbs in 187 patients with reflux at the sapheno-femoral junction to below knee level were operated on using intraoperative angioscopy to diagnose valve insufficiency. Angioscopic external valvuloplasty was attempted for the subterminal valves in the LSV by three techniques: total plication of the dilated annulus by running polypropylene sutures (technique 1), plication by autogenous femorofascial sleeve or Dacron-reinforced silicone (technique 2), and plication of the commissure with shortening of the cusps from outside the vein wall (technique 3). Partial stripping or segmental ligation was performed for varicose veins below knee level and the incompetent perforating veins were treated simultaneously by suprafascial ligation. Results: The subterminal valves were classified as follows: valves with elongated and atrophic cusps – type I, 136 (44%); valves with expanded and depressed commissures with cusp changes – type II, 108 (35%); valves that had cusps with other deformities – type III, 38 (13%); and absence of valves between the saphenofemoral junction and mid-thigh level, 24 limbs (8%). Valvuloplasty of the LSV was successfully performed in 62 limbs (20%). There were two cases with occlusion of the LSV (3%) and four with recurrence of varicose veins (6%) at 2–89 (mean 55, SD 21) months follow-up. Conclusions: Angioscopic external valvuloplasty is effective in the treatment of varicose veins to preserve the LSV. Further data are needed for complete evaluation of this procedure.
Anatomical Distribution of Chronic Venous Insufficiency in a Chinese Population
Authors: Ting A. C. W. , Cheng S. W. K. , Wu L. L. H. , Cheung G. C. Y. 
Published: January 2017

Objective: To study the anatomical distribution of chronic venous insufficiency (CVI) in a Chinese population by means of duplex scanning. Procedures: A total of 582 limbs in 291 patients with primary venous insufficiency were classified clinically into three different groups according to SVS/ISCVS criteria and evaluated prospectively with duplex scanning. Results: One hundred and thirty-one limbs were classified into group I (CEAP clinical class 0), 291 into group II (CEAP clinical classes 1 and 2) and 160 into group III (CEAP clinical classes 3–6). Mixed deep and superficial venous incompetence was found in 70% and 83% of limbs in groups II and III, respectively. Reflux was also demonstrated in 73% of group I limbs. Conclusions: Most of our patients had mixed deep and superficial venous incompetence. The prevalence of deep venous incompetence in this population, in which deep vein thrombosis is rare, suggests a pattern of venous incompetence other than postphlebitic deep vein valvular dysfunction. The prevalence of reflux in the asymptomatic contralateral limbs implies a bilateral predisposition to venous reflux and thus a possible developmental origin of CVI.
The Relationship between Ultrasonic Ambulatory Venous Pressure and Residual Volume Fraction in Primary Venous Insufficiency
Authors: Zamboni P. , Quaglio D. , Cisno C. , Marchetti F. , Cisno L. , Marcellino M. G. 
Published: January 2017

Objective: To study the relationship between two non-invasive methods for determining ambulatory venous pressure (AVP) in primary chronic venous insufficiency of the lower limbs. Design: Comparison between ultrasonic AVP (US-AVP) and residual volume fraction (RVF) determined by means of air plethysmography (APG). Setting: Department of Surgery and Vascular Laboratory, University of Ferrara, Italy. Patients: Twenty-one subjects affected by primary chronic venous insufficiency (CVI). Main outcome measure: A comparison of the AVP values extrapolated from the change in ultrasonic diameter of the saphenous vein after exercise and from RVF values. Ultrasonographic extrapolation was also made by the means of the software Venometer and compared with manual assessment. Results: Linear regression analysis demonstrated that US-AVP values were significantly correlated with RVF values ( r = 0.86 and p<0.0001). Assessment by Venometer as compared with manual calculation showed a high degree of correlation ( r = 0.98), p<0.0001). Conclusions: The two methods for non-invasive assessment of AVP appear to be closely and significantly correlated. The Venometer allows reliable and rapid extrapolation of AVP values.
Endostripping: A New Minimally Invasive Technique for Limited Stripping of the Greater Saphenous Vein
Authors: Shamiyeh A. , Schrenk P. , Rieger R. , Wayand W. 
Published: January 2017

Objective: To describe a new technique for limited stripping (in the thigh) of the greater saphenous vein (GSV) to avoid painful postoperative haematomas. Design: Pilot study. Setting: General Hospital Linz, Second Surgical Department, Linz, Austria. Patients: Sixteen patients undergoing primary varicose vein surgery for varices on the long saphenous vein. CEAP clinical stage: C2 ( n = 12), C3 ( n = 4). Intervention: Removal of the GSV from the thigh by endoscopic dissection with electrocautery division of the main tributaries. Phlebectomy for varices in GSV tributaries. Main outcome measures: Clinical assessment of the extent of haematomas and cosmetic appearance. Results: Fifteen of 16 operations were completed as intended without any technical problem. In one case conversion to conventional stripping was required due to adhesion of the saphenous vein to a previous operation scar in the thigh. The median total operation time for one limb was 57 min. A postoperative haematoma occurred in only one patient. There was no additional postoperative complication. Conclusion: Endostripping is a new technique for stripping of the GSV and reduces postoperative haematoma. It can be performed in a reasonable operation time and is safe. The value of this technique should be assessed in clinical trials.
Fluspirilene in Schizophrenia
Authors: Cottrell W M , Magnus Ralph V 
Published: January 2017

Forty patients have been treated for two months with fluspirilene, a new injectable diphenylbutylpiperidine administered intramuscularly once per week. Chronic cases improved satisfactorily and acute cases did rather better, particularly in relation to delusions. When the average dose was low ( 5.4 mg) extra-pyramidal effects were uncommon, but if 12 mg was given, more side-effects were encountered. Two patients on fluspirilene 4 mg weekly had dystonic reactions. If marked hypertension was present, the systolic pressure fell by about 60 mm Hg.
A Practical Regimen for Weight Reduction in Family Practice
Authors: Alien G S 
Published: January 2017

The effectiveness of a weight reduction programme consisting of motivation of the patient, use of an anorectic drug (Tenuate, 25 mg), and diet and exercise was assessed in 110 obese patients in a 12 week, double-blind, placebo-controlled study. The differences in weight loss with continuous therapy (Tenuate) vs placebo and with intermittent therapy (Tenuateplacebo-Tenuate) vs placebo were statistically significant (p = 0·0001 and p = 0·0004 respectively). No deleterious effects on blood pressure, pulse rate, ECG, and chest x-ray were seen. Only 1 of the original 174 patients dropped out of the study because of side-effects.
Comparison of Efficacy of Amoxapine and Imipramine in a Multi-Clinic Double-Blind Study Using the WHO Schedule for a Standard Assessment of Patients with Depressive Disorders
Authors: Takahashi Ryo , Sakuma Akira , Hara Toshio , Kazamatsuri Hajime , Mori Atsuyoshi , Saito Yoichi , Murasaki Mitsukuni , Oguchi Toru , Sakurai Yukihiko , Yuzuriha Taro , Takemura Michio , Kurokawa Hidezo , Kurita Hiroshi 
Published: January 2017

A multi-clinic double-blind controlled study on amoxapine in comparison with imipramine, using the WHO Schedule for a Standard Assessment of Patients with Depressive Disorders, was performed and the data were analyzed with 111 patients. The assessment of severity of illness and overall improvement indicated clearly the superiority of the antidepressive effect of amoxapine to that of imipramine. The onset of antidepressive effect of amoxapine was clearly more rapid than that of imipramine, and in more than half of the patients in the amoxapine group the improvement was seen within four days following the drug administration, Amoxapine was superior to imipramine in terms of safety and usefulness. The side-effects due to amoxapine appeared less frequently and were less serious than with imipramine. The difference between amoxapine and imipramine was especially remarkable for hypotensive effect. The antidepressive effect of amoxapine was superior to that of imipramine for almost all symptoms and signs. Amoxapine displayed an especially remarkable effect on psychomotor retardation, depressive feeling, anxiety and tension, somatic complaints and sleep disturbance.
Magnapen Treatment of Infections in the Elderly
Authors: Middleton R S W , Sinha H K 
Published: January 2017

Magnapen is a combination of two well-proven semi-synthetic penicillins which together offer the theoretical advantages of a broad spectrum of activity, good bioavailability and a low incidence of side-effects. It is of particular value in treating infections in the elderly. In this study the theory is borne out in practice in a population presenting special problems for which this combination seems particularly appropriate. Ninety-six patients have been treated with a course of Magnapen syrup. Of the total entered into the study, 73% of patients were clinically cured following therapy, with a further 19% improved. Clinical failure occurred in 8% of patients. Fifty-two patients were bacteriologically assessable, forty-seven of whom (90%) had infecting organisms cleared by therapy. Side-effects occurred in four patients (4%), one of whom had to discontinue therapy.
A Multicentre Double-Blind Comparison of Oxaprozin Aspirin Therapy on Rheumatoid Arthritis
Authors: Hubsher Jerome A , Ballard Ian M , Walker Barry R , Gold Jerome A 
Published: January 2017

Preliminary clinical studies showed that oxaprozin (4,5 Diphenyl-2-oxazolepropionic acid) has anti-inflammatory and analgesic properties with a plasma half-life of about 40 hours. Consequently, a multicentre, double-blind parallel trial was conducted for 12 weeks at thirteen investigator sites, utilizing 212 patients with classic rheumatoid arthritis and comparing oxaprozin 600 mg/day, oxaprozin 1200 mg/day and aspirin 3900 mg/day. Both the oxaprozin and aspirin-treated patients had statistically significant improvement from baseline periods, in most key categories evaluated. Oxaprozin administered twice a day (b.i.d.) was as effective as aspirin administered four times a day (q.i.d.) and caused significantly less tinnitus (p < 0.001). Fewer patients receiving high dose oxaprozin (2%) dropped out of the study because of unsatisfactory response than did those receiving aspirin (10%). There were no clinically significant laboratory abnormalities in the gastro-intestinal, renal, hepatic or haematological parameters monitored. This study suggests that oxaprozin is effective and well tolerated in the treatment of rheumatoid arthritis.