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Query: UMLS:C0235886 (leg edema)
 674 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To investigate the early limb oedema after various types of arterial reconstructions 180 patients operated on due to occlusive or aneurysmatic arterial disease were followed by daily circumference measurements of the lower leg. For volume calculations circumference measurements were shown to be well correlated to water displacement volumetry. Femoro-popliteal bypass resulted regularly in a pronounced oedema, significantly more than in any of the other groups. Aortofemoral reconstruction did not lead to significant leg oedema, but all other reconstructions resulted in a volume increase in the symptomatic leg. Following distal reconstruction, patients with popliteal aneurysm and no ischaemia developed the same maximal volume increase as patients with severe ischaemia. Regarding all patients as one group the volume increase was not significantly correlated to the preoperative ankle blood pressure or ankle brachial pressure index. Only after various proximal reconstructions, with a limited postoperative oedema, there was a correlation between the degree of preoperative ischaemia and postoperative volume increase. A successful reconstruction was not necessary for the development of postoperative oedema. A failed distal reconstruction was followed by a significant oedema, although less pronounced than after a successful. Exploration of the vessels without reconstruction also led to a postoperative oedema. The findings indicate that the pathogenesis of postreconstructive oedema is multifactorial. The type of reconstruction is the most important predictive factor and degree of preoperative ischaemia and success of operation are contributing factors.
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PMID:Lower limb oedema after arterial reconstructive surgery. Influence of preoperative ischaemia, type of reconstruction and postoperative outcome. 280 Aug 74

Between 1976 and 1983, 28 patients with Kaposi's sarcoma were treated in the Department of Radiation and Clinical Oncology of the Hadassah University Hospital in Jerusalem. Most of the patients (16, i.e. 57%) were Jews of European origin. Eighteen (64.2%) of the patients presented with severe leg edema in addition to multifocal, disseminated skin lesions. Only one patient was free of clinical disease in the lower extremities. Large, ulcerated masses were seen in three patients. The affected limbs were immersed in a water bath and irradiated with two-opposing portals to a total dose of 3000 rads. Total disappearance of the skin lesions was achieved in 89% of the patients, although the limb edema regressed completely in only 56% of the patients.
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PMID:Megavoltage radiotherapy using water bolus in the treatment of Kaposi's sarcoma. 309 76

The plasma volume is determined by fluid influx through drinking and outflux by renal excretion. Both fluxes are regulated according to plasma volume and composition through arterial pressure, osmoreceptors and vascular stretch receptors. As to the remaining part of the extracellular volume, the interstitial space, there is no evidence that its volume (IFV), pressure or composition are sensed in such a way as to influence water intake or excretion. Nevertheless, IFV is clearly regulated, often pari passu with the regulation of plasma volume. However, there are many exceptions to parallel changes of the two compartments, indicating the existence of automatic, local mechanisms guarding the net transfer of fluid between plasma and interstitium. Thus, a rise in arterial and/or venous pressure, tending to increase capillary pressure and net filtration, is counteracted by changes in the "Starling forces": hydrostatic and colloid osmotic pressures of capillary blood and interstitial fluid. These "oedemapreventing mechanisms" (A. C. Guyton) may be listed as follows: Vascular mechanisms, modifying capillary pressure or interstitial fluid pressure (IFP). Increased transmural vascular pressure elicits precapillary constriction and thereby reduces the rise in capillary pressure. Counteracts formation of leg oedema in orthostasis. Venous expansion transmits pressure to the interstitium in encapsulated organs (brain, bone marrow, rat tail). Mechanisms secondary to increased net filtration, A rise in IFV will increase IFP, and thereby oppose further filtration. Favoured by lowcompliant interstitium. Reduction of interstitial COP through dilution and/or washout of interstitial proteins. A new steady state depends on increased lymph flow. Increased lymph flow permits a rise in net capillary filtration pressure. Low blood flow and high filtration fraction will increase local capillary COP.
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PMID:Distribution of body fluids: local mechanisms guarding interstitial fluid volume. 639 7

Water restriction is a slow and difficult way to treat dilutional hyponatremia during diuretic therapy of congestive heart failure. An i.v. infusion of 400-1 400 mmol hypertonic saline combined with repeated i.v. injections of loop diuretics was used instead in 9 cases (6 patients). In 4 cases with dominating left heart failure the serum sodium concentration increased and the heart failure was not aggravated as judged from pulmonary rales and body weight. Two of the five cases with dominating right heart failure responded in the same favourable way, but body weight increased 1-2 kg and hyponatremia reappeared in three. The only difference observed between responders and non-responders was that the responders were free from leg edema. This treatment of dilutional hyponatremia seems worth further cautious use in situations in which water restriction is troublesome, but it should probably be reserved for patients without severe right heart failure.
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PMID:Treatment of dilutional hyponatremia in congestive heart failure. 738 23

Although leg oedema is believed to contribute to the pathogenesis of lipodermatosclerosis and leg ulcer, little is known about the cutaneous distribution of water in lipodermatosclerosis. In lipodermatosclerosis accompanied by leg ulceration, a subepidermal low echogenic band is seen in the high-frequency echograms of the skin at the boundary of the wound. Since skin echogenicity is inversely related to the amount of water contained, it has been assumed that the subepidermal low echogenic band corresponds to oedema in the papillary dermis. In this study we evaluated dermal oedema in lipodermatosclerosis by quantifying changes of skin echogenicity in 20 patients with lipodermatosclerosis and 20 age- and sex-matched controls. In order for us to evaluate the influence of the upright posture on skin water content, echogenicity was determined three times a day in various regions of the lower and upper extremities. Next morning, after ultrasound examination of the ankle skin, a compressive stocking was applied for 12 h and then the measurements of echogenicity were repeated. At any time of the day, ankle and calf skin was less echogenic in lipodermatosclerosis than in the control. The low echogenic area was confined to the subepidermal region. During the day the low echogenic area expanded in patients with lipodermatosclerosis. This phenomenon was reversed by leg compression. These results indicate that in lipodermatosclerosis oedema is located mainly in the papillary skin. An upright position causes aggravation of oedema, whereas application of compression protects against accumulation of water in the skin during the day.
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PMID:Dermal oedema in lipodermatosclerosis: distribution, effects of posture and compressive theraphy evaluated by high-frequency ultrasonography. 760 39

We report the case of a patient with an idiopathic syndrome of inappropriate secretion of ADH for more than 6 years. Water restriction was effective only during hospital care but was socially difficult to maintain at home, so that the patient presented frequent symptoms of water intoxication. Normal natremia was also obtained with a high salt intake (9 g/day) but this induced leg edema mild dyspnea and gastric intolerance. The patient was however successfully treated for more than 5 years without any side effects with oral urea (30 g/day) allowing her a normal fluid intake (1-1.5 liters/day). Oral urea, even during long periods, is a safe and effective therapeutic approach for patients with chronic SIADH which is not controlled by water restriction alone.
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PMID:5-year treatment of the chronic syndrome of inappropriate secretion of ADH with oral urea. 845 86

The influence of microwave and hot water immersion hyperthermia on lymphedema and lymphedematous skin of the leg in 12 patients was studied using circumference and volumetric measurements, immunohistochemistry and "quantitative" lymphoscintigraphy. Whereas heating was associated with a reduction in the girth and volume of the leg, lymph flow as assessed by lymphoscintigraphy was unchanged. Neither absorption of the radiolabeled nanocolloid from the injection site nor the rate of tracer accumulation in the inguinal lymph nodes was significantly altered by heat therapy. Histologically, the lymphedematous skin after heat treatment showed near resolution of perivascular cellular infiltration, disappearance of "lymph lakes" and dilatation of blood capillaries. Labeling of skin migrating immune cells with monoclonal antibodies confirmed subsidence of dermal cellular infiltration; nonetheless, there was nonspecific stimulation of resident epidermal immune cells, endothelial cells, macrophages, lymphocytes and keratinocytes by intense expression of class II and other antigens. There seemed to be a direct relationship between the subsidence of dermal inflammation and a decrease in leg edema. We suspect that subsidence of local inflammation in the lymphedematous limb with alteration in the extracellular protein matrix after regional heating accounts for the reduction in peripheral edema.
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PMID:The influence of local hyperthermia on lymphedema and lymphedematous skin of the human leg. 846 23

The aim of this study was to compare the efficacy of two posologies of hydroxyethylrutosides (HR) as maintenance dose for the reduction of leg oedema. The increase in leg volume induced by standing motionless for one hour was measured in 12 healthy young male volunteers by a highly sensitive water displacement method. The volume increase (approx. 87.8 units) was found to be very reproducible after a one-week placebo run-in period. The mean value after 3-weeks treatment at 1000 mg/day HR was reduced to 85.2 +/- 8.7 units. The subjects were then randomised to 3 groups and further measurements were made after additional 3, 5, 6 and 7 weeks. On placebo, the values returned to baseline within 5-6 weeks. On 500 mg/day, the values continued to oscillate around the values at randomisation (i.e., the effect was maintained). On continuing the dose unchanged at 1000 mg/day, the volume increases continued to fall progressively to 79.1 +/- 7.7 at the end of the further 7 weeks. After analysis of all mean volume changes relative to the values at time of randomisation, it was found that the 1000 mg/day dose showed a significant greater antioedematous effect than placebo (p = 0.0001) or 500 mg/day (p = 0.0028). Also the 500 mg/day dose was superior to placebo (p = 0.0328). We conclude that, after initial treatment for 3 weeks with 1000 mg/day, a dose of 500 mg/day is adequate to maintain the resultant anti-oedematous effect.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Time course of the anti-oedematous effect of different dose regimens of O-(beta-hydroxyethyl) rutosides in healthy volunteers. 848 63

We tested 80 spinal cord injury or lesion patients admitted to Department of Rehabilitation Medicine of Chang Gung Memorial hospital from Jan, 1994 to Aug, 1994, in order to assess the effectiveness of compression stockings of different pressures. The study group consisted of patients who, after leaving bed for 4 hours, had a volume change in the lower extremities greater than 50 c.c., as measured by a specially designed water bucket. One of the lower limb was used as the control group and the other limb was used as the experimental group. Different stocking compression pressure, 12 mmHg 20 mmHg, and 30 mmHg, were used for the experimental limb. No placebo stocking was used in the control group. Change in the lower limb volume and degree of comfort after leaving bed for 4 hours were measured. The experimental results reveal that wearing stocking with compression pressure, 12 mmHg, 20 mmHg, 30 mmHg, had therapeutic effects (P < 0.01). The therapeutic effects of the 12 mmHg stocking was less than the 20 mmHg and 30 mmHg stocking. There was no significant difference between the therapeutic effects of the 20 mmHg and 30 mmHg stocking. As for the degree of comfort, 12 mmHg was better than 20 mmHg, and 20 mmHg better than 30 mmHg. When choosing the type of compression stocking to treat lower leg edema in spinal cord injury or lesion patients, we suggest starting with 20 mmHg compression pressure stockings would be a better choice, as they are cheaper, more comfortable to wear and can provide the same therapeutic effects as 30 mmHg compression stockings.
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PMID:[A comparison of compression stockings of different pressures with lower leg edema in spinal cord injury or lesions patients]. 867 44

The aim of this study was to investigate, if the the combined treatment of compression stockings and drug treatment with oxerutins (O-(beta-hydroxyethyl)-rutosides, Venoruton) provides additional benefit for patients with chronic venous insufficiency (CVI) compared to compression treatment alone. Oxerutins belong to the group of oedema protective agents and possess anti-exudative and membrane protective activity. A total of 133 female patients with CVI grade II participated in this double-blind, randomised, multi-centre, parallel-group study with two treatment groups. The whole study lasted for 19 weeks, and consisted of a one week placebo run-in phase, 12 weeks treatment phase, followed by a 6 weeks treatment-free follow-up period. All patients received a basis compression therapy that consisted of standard compression stockings. In order to standardise initial fitting of stockings in this multi-centre setting, stockings were fitted after one week of standard diuretics starting at baseline and then stockings were worn for the following 11 weeks. Patients were randomised to receive oxerutins (2 x 500 mg daily) or matching placebo. Leg volumes (water displacement) and associated subjective symptoms (visula analogue scale) were measured during a placebo run-in period at enrolment (week - 1) and half a week later (week - 1/2), at baseline week 0), at 4, 8, 12 weeks on treatment, and again after a 3- and 6-weeks treatment-free follow-up. The primary efficacy criterion, the area under the baseline from week 0 to week 18 (AUB0-18) of leg volume changes, as measurement of the global change of leg oedema during the study, resulted in a superior reduction of -5589 ml.d for the combined treatment with oxerutins compared to -2101 ml.d for placebo (p = 0.012). The mean change of leg volume compared to baseline after 12 weeks of treatment was -63.9 ml for stockings and oxerutins, and -32.9 ml for the patients who received stockings and placebo (p < 0.05). Oxerutins showed a prolonged effect in the follow-up phase compared to placebo, with mean AUB values for week 12 to week 18 of -1769 ml.d versus -133 ml.d (p < 0.01). The study demonstrated that the combined therapy of compression stockings and drug treatment with oxerutins is significantly superior in reducing leg oedema resulting from chronic venous insufficiency compared to compression treatment alone.
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PMID:Investigation of the efficacy of oxerutins compared to placebo in patients with chronic venous insufficiency treated with compression stockings. 873 30


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