Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0149871 (deep vein thrombosis)
 12,364 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Based on morphological features of the lymphatic microcirculation of the skin from healthy subjects, and from paraplegic patients who had no evidence of ilio-femoral venous thrombosis (thromboembolic disease: TED), the leg terminal lymphatic vessels from skin biopsies of five male paraplegic patients with acute traumatic spinal cord lesions and with documented TED were studied. Paraplegic patients with TED had lymph vessels with a dilated lumen surrounded by a rarefacted perivascular connective tissue characterized by dissociation and disruption of collagen and elastic fibres. The lymphatic wall was generally attenuated and some open junctions and channels delimited by endothelial protrusions were observed. The venous outflow obstruction caused by deep venous thrombosis accompanied by the absence of ambulatory venous pressure in the paretic leg determines skin microlymphatic dilatation, lymph stasis and changes in the interstitial connective tissues. These alterations may be considered to be the morphological aspect of the dystrophic alterations seen in the skin of legs from paraplegic patients with TED. The results are discussed in view of the correct rehabilitative medical treatment necessary, and adequate prophylaxis of TED.
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PMID:Morphological changes in the skin microlymphatics in recently injured paraplegic patients with ilio-femoral venous thrombosis. 747 43

Often called in to give his opinion on lymphoedema of the upper limb after radiosurgical treatment for breast cancer, the angiologist should be familiar with the anatomic lesions induced by the treatment. The surgical procedure varies from simple tumourectomy to complete mammectomy. Complications include infection followed by fibrosis and occlusion of the collecting lymphatic vessels. Axillary venous thrombosis is exceptional. Dissection of the lymph nodes interrupts lymph drainage of the homolateral limb leading to lymphoedema which is worsened by fibrosis, venous stasis and damage to the plexus. Ionization therapy causes multiple organ damage to viscera (lungs, pleura), skeleton (ribs, clavicle), myocardium and coronary arteries, mediastinal brachial plexus, skin fibrosis, arterial obliteration and venous narrowing and thrombosis. Chemotherapy causes thrombosis of the superficial veins after perfusion. Deep vein thrombosis is rare. These lesions rarely occur alone. The clinical course of the associated lesions is part of a major psychological context which must be taken into account. The angiologist should perform a careful clinical examination, detect and document possible recurrence, explore the vascular axes with echo-Doppler or plethysmography when needed in order to detect the venous lesions which occur in 50% of the cases. Lymphatic involvement in lymphoedema is clinically obvious and may not require further explorations. Treatment is difficult in cases with associated venous involvement. Strapping with or without pressure, manual lymphatic drainage, active mobilisation and elastic sleave after reduction are used. When detected early venous thrombosis is managed as other deep vein thrombosis. Arterial damage may appear late (delay more than 3 years) in rare cases.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Management by the angiologist of sequellae of radiosurgical treatment of breast cancer]. 765 Apr 44

A 70-year-old woman developed erythema and induration of the right chest wall, and swelling of her right arm. The provisional diagnosis was deep venous thrombosis and/or cellulitis of the right arm. Skin biopsy showed a poorly differentiated adenocarcinoma within lymphatic vessels, and immunohistochemical staining revealed this to be of breast origin. Inflammatory carcinoma or carcinoma erysipeloides represents < 1% of all cases of breast carcinoma. Our case illustrates the importance of considering this entity in the differential diagnosis of unilateral chest wall erythema and induration.
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PMID:Inflammatory breast carcinoma (carcinoma erysipeloides): an easily overlooked diagnosis. 828 33

Mechanical injury of soft tissues and bones of the lower extremity is followed by chronic edema at the site of trauma and distally to it. This complication affects almost every patient with a fracture of the lower limb. The question is whether posttraumatic edema is due to lymphatic obstruction, venous thrombosis or both, or a local cytokine and growth factor hyperactivity at the fracture site. The aim of study was to assess the venous and lymph outflow in patient with chronic postraumatic edema of the lower limbs. A group of 19 patients with chronic edema lasting for more than 3 months was evaluated. Limb circumference, tissue tone measurements, skin temperature and Doppler enhanced ultrasonography were all taken down for the 19 patients in the evaluated group. Limb circumference was measured at the following level: foot, ankle, calf and thigh. Results showed an increase of circumference in comparison with the healthy extremity at each evaluated level of: 1.20 +/- 1.65 cm, 1.63 +/- 1.41 cm, 1.40 +/- 1.72 cm and 0.30 +/- 1.90 cm. Local temperature increase compared to the healthy extremity was also noted (0.93 +/- 0.81 degree C and 0.37 +/- 0.21 degree C measured at ankle and calf level). Tissue tone measurements and tone index (a quotient of tone measurement values in the extremity with edema and in the healthy extremity) were also increased by 0.86 +/- 0.57, 0.85 +/- 0.34 and 0.86 +/- 0.28, when measured with 40 g, 110 g and 180 g weights respectively. In 17 cases (89.5%) lymphoscintigraphy demonstrated an increased lymphatic outflow compared to the contralateral extremity. A marked increase in the inguinal lymph nodes was also noted. In the remaining 2 cases (10.5%) extravasation of the contrast medium into the skin indicated lymph outflow disorders. Only in 5 cases (26.3%) ultrasonography indicated deep vein thrombosis. The obtained results indicate that the pathophysiology of chronic postraumatic edema is linked with an inflammatory and restorative reaction at the fracture site. Only in a limited number of cases deep vein thrombosis and damaged lymphatic vessels are responsible for postraumatic edema.
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PMID:[Post-traumatic lymphatic and venous drainage changes in persistent edema of lower extremities]. 1105 20

According to the authors, advantages of outpatient abdominoplasty performed with the patient under conscious sedation are decreased nausea and vomiting and greatly reduced risk of deep venous thrombosis. Sharp dissection without electrocautery, preservation of perforators, and a plane of dissection that preserves lymphatic vessels has provided rapid recovery, minimal need for postoperative narcotics, and a low complication rate.
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PMID:Outpatient abdominoplasty under conscious sedation. 1934 73

A patient presented with shortness of breath and pleuritic pain shortly after bilateral knee synovial injections with sodium hyaluronate (HA). He was discharged after a brief hospitalization without a diagnosis when no Doppler or radiologic evidence of deep vein thrombosis or pulmonary emboli was found. Radiologic studies found patchy ground glass opacities that were predominantly peripheral in disposition, with prominent septal lines in the lungs; a subsequent pulmonary function test showed a reduced diffusing capacity of the lung for carbon monoxide (D(LCO)). These results prompted a lung biopsy that revealed multiple emboli composed of HA and fibrin in medium size pulmonary arteries, enlarged lymphatic vessels, and a bone marrow embolus. This is the first report of HA emboli following therapeutic HA injections and demonstrates that pulmonary function tests can be used to infer the reduction in pulmonary vascular area consequent to pulmonary emboli, and so can contribute to the detection of pulmonary emboli in unusual presentations.
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PMID:Pulmonary emboli from therapeutic sodium hyaluronate. 2241 76

Dilation of lymphatic vessels may contribute to iatrogenic dissemination of cancer cells during surgery. We sought to determine whether neuraxial anesthesia reduces regional lymphatic flow. Using nuclear lymphoscintigraphy, 5 participants receiving spinal anesthesia for brachytherapy had lower extremity lymph flow at rest compared with flow under conditions of spinal anesthesia. Six limbs were analyzed. Four limbs were excluded because of failure to demonstrate lymph flow (1 patient, 2 limbs), colloid injection error (1 limb), and undiagnosed deep vein thrombosis (1 limb). All analyzed limbs showed reduced lymph flow washout from the pedal injection site (range 62%-100%) due to neuraxial anesthesia. Lymph flow was abolished in 3 limbs. We report proof-of-concept that neuraxial anesthesia reduces lymphatic flow through a likely mechanism of sympathectomy.
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PMID:Neuraxial Anesthesia Reduces Lymphatic Flow: Proof-of-Concept in First In-Human Study. 2763 40

We encountered a case in which we used a pedicled deep inferior epigastric perforator(DIEP) flap to repair a lymphatic leak. This case shows that such repairs can lead to the reconstruction of the lymphatic tract and prevent lymphatic leak recurrences. The present report describes a 45-year-old woman with ovarian cancer who underwent hysterectomy, bilateral salpingo-oophorectomy, pelvic lymphadenectomy, para-aortic lymphadenectomy, and omentectomy. She presented with a pelvic lymphocele with lower-extremity swelling. Lymphovenous anastomosis was performed and swelling of the lower extremity abated. However, because of the occurrence of deep vein thrombosis and the recurrence of swelling, we used a 6-cm-long and 14-cm-wideDIEP flap after lymphocele fenestration. The flap was de-epithelialized and fixed into the peritoneum, with the cutis side facing the leakage point. The postoperative course was uneventful, and no recurrence was observed. We obtained good results by providing abundant blood flow to abundant lymph tissue at the fenestration point. It is known that lymphatic vessels can spontaneously connect with each other. We hypothesize that the DIEP flap improved the edema in this case by regenerating the lymphatic network and improving flow into the bridging flap.
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PMID:Lymphatic tract reconstruction using a pedicled deep inferior epigastric perforator flap. 3025 59