Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Lipodermatosclerosis of the lower extremity, with or without ulceration, is a common manifestation of severe venous disease and the result of sustained venous hypertension. The latter is generally a sequela of deep vein thrombosis. Factors that enhance clot formation or impair fibrinolysis contribute to the pathogenesis of venous disease. It is already established that faulty fibrinolysis may play a pathogenic role in patients with venous disease. We examined the possibility that patients with venous disease have abnormally low plasma levels of proteins C and S, two proteins whose deficiencies have been reported to cause an increased frequency of thromboembolic disease. Using immunologic and functional assays for plasma proteins C and S, we found that 4 (21%) of 19 patients with lipodermatosclerosis and leg ulcers had abnormally low levels of protein C or protein S. One of 7 patients with lipodermatosclerosis without ulceration had a profoundly depressed level of protein C and a history of cerebral stroke at a young age. Plasma levels of protein C were normal in five patients with arterial insufficiency severe enough to cause leg ulceration. We conclude that abnormally low plasma levels of proteins C and S may be found in patients with lipodermatosclerosis and venous ulceration. As with the abnormally low fibrinolytic activity in these patients, our findings indicate a possible propensity for increased thrombotic disease.
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PMID:Protein C and protein S plasma levels in patients with lipodermatosclerosis and venous ulceration. 203 43

Lipodermatosclerosis and chronic ulceration have been longstanding and vexing problems caused by chronic venous insufficiency (CVI). While traditional approaches have been mainly medical with the use of compression, bedrest, and elevation; operative therapy for CVI has now been shown to cause earlier healing with fewer ulcer recurrences. The development of subfascial endoscopic surgery (SEPS) promises a more elegant approach applicable to outpatient or day surgery. However, in a recent trial, early results showed a 22% ulcer recurrence at 30 months, which did not compare favorably with traditional approaches. We have used extrafascial perforator interruption for SEPS recurrence and have now modified our SEPS approach particularly for low-lying ulcers. This overview suggests use of a combination of SEPS with an extrafascial perforator division when skin change relates to retro or submalleolar perforating veins. Several procedures, rather than one intervention may be required in CVI to prevent or divert transmission of venous hypertension to areas of affected skin, including saphenous stripping, staged valveplasty and treatment of iliac occlusions.
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PMID:New approaches to an old and vexing problem: improving the results of SEPS: an overview. 1128 Jan 70