Chronic Venous Insufficiency - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

CHRONIC VENOUS

INSUFFICIENCY A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES

J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2004 by ICON Group International, Inc. Copyright 2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Chronic Venous Insufficiency: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-497-00257-4 1. Chronic Venous Insufficiency-Popular works. I. Title.

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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.

Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail: [email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International, Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on chronic venous insufficiency. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.

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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.

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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health

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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON CHRONIC VENOUS INSUFFICIENCY .......................................................... 3 Overview........................................................................................................................................ 3 Federally Funded Research on Chronic Venous Insufficiency....................................................... 3 E-Journals: PubMed Central ......................................................................................................... 8 The National Library of Medicine: PubMed .................................................................................. 8 CHAPTER 2. NUTRITION AND CHRONIC VENOUS INSUFFICIENCY ................................................ 47 Overview...................................................................................................................................... 47 Finding Nutrition Studies on Chronic Venous Insufficiency...................................................... 47 Federal Resources on Nutrition ................................................................................................... 49 Additional Web Resources ........................................................................................................... 49 CHAPTER 3. ALTERNATIVE MEDICINE AND CHRONIC VENOUS INSUFFICIENCY .......................... 51 Overview...................................................................................................................................... 51 National Center for Complementary and Alternative Medicine.................................................. 51 Additional Web Resources ........................................................................................................... 60 General References ....................................................................................................................... 62 CHAPTER 4. PATENTS ON CHRONIC VENOUS INSUFFICIENCY ...................................................... 63 Overview...................................................................................................................................... 63 Patent Applications on Chronic Venous Insufficiency ................................................................ 63 Keeping Current .......................................................................................................................... 65 CHAPTER 5. BOOKS ON CHRONIC VENOUS INSUFFICIENCY .......................................................... 67 Overview...................................................................................................................................... 67 Book Summaries: Online Booksellers........................................................................................... 67 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 71 Overview...................................................................................................................................... 71 NIH Guidelines............................................................................................................................ 71 NIH Databases............................................................................................................................. 73 Other Commercial Databases....................................................................................................... 75 APPENDIX B. PATIENT RESOURCES ................................................................................................. 77 Overview...................................................................................................................................... 77 Patient Guideline Sources............................................................................................................ 77 Finding Associations.................................................................................................................... 79 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 81 Overview...................................................................................................................................... 81 Preparation................................................................................................................................... 81 Finding a Local Medical Library.................................................................................................. 81 Medical Libraries in the U.S. and Canada ................................................................................... 81 ONLINE GLOSSARIES.................................................................................................................. 87 Online Dictionary Directories ..................................................................................................... 87 CHRONIC VENOUS INSUFFICIENCY DICTIONARY.......................................................... 89 INDEX .............................................................................................................................................. 115

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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with chronic venous insufficiency is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about chronic venous insufficiency, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to chronic venous insufficiency, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on chronic venous insufficiency. Abundant guidance is given on how to obtain free-ofcharge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to chronic venous insufficiency, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on chronic venous insufficiency. The Editors

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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.

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CHAPTER

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STUDIES ON INSUFFICIENCY

CHRONIC

VENOUS

Overview In this chapter, we will show you how to locate peer-reviewed references and studies on chronic venous insufficiency.

Federally Funded Research on Chronic Venous Insufficiency The U.S. Government supports a variety of research studies relating to chronic venous insufficiency. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to chronic venous insufficiency. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore chronic venous insufficiency. The following is typical of the type of information found when searching the CRISP database for chronic venous insufficiency: •

Project Title: AN IN-VITRO MODEL OF PRESSURE INDUCED FIBROBLAST AGING Principal Investigator & Institution: Stanley, Andrew C.; Surgery; University of Vermont & St Agric College 340 Waterman Building Burlington, Vt 05405

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Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).

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Timing: Fiscal Year 2002; Project Start 01-SEP-2002; Project End 31-AUG-2003 Summary: Chronic venous insufficiency (CVI) affects about 5-10% of the population >65 years old. In its worse form ulcerations develop. These ulcers are chronic, indolent and recur 70% of the time. The treatment of these ulcers is largely outpatient. It involves a variety of compression dressings and paste compression wraps (Unna's boot). Most ulcers require months of therapy before healing. The cost and morbidity suffered as a direct result of CVI is significant. The exact mechanism of the pathophysiologic process is elusive. Several theories have attempted to explain the process but none have resulted in significantly improving the therapy of the disease. All theories cite venous hypertension as the inciting factor which leads to tissue changes and the resultant ulceration. Recent studies have found fibroblasts isolated from the legs of patients suffering from CVI to be prematurely aged in comparison to fibroblast isolated from uninvolved dermal tissue of the same patients. These diseased fibroblasts had a much higher level of senescent cells. To better study the relationship between venous hypertension, CVI and premature aging, a specially constructed pressure incubator has been constructed. With this incubator, it is possible to culture cells at 200mmHg above atmospheric pressure. Preliminary evidence confirms the pressure/aging relationship in that populations of neonatal fibroblasts grown at 80mmHg and 120mmHg above atmospheric pressure had high rates of senescence after only 10-14 days of growth. With this incubator the pressure aging phenomenon can be better studied. After adjustments of pressure and length of time in culture, appropriate dose response data can be generated. With the use of B- galactosidase staining and quantification of fibronectin production senescence rates can be objectively studied. Next, the ability of pressurized fibroblasts to enter mitosis and increase DNA synthesis will be studied using flow cytometry. Finally, the potential to reverse this aging process will be studied by adding external growth factors and reversing conditions. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CYTOKINE BALANCE IN VENOUS THROMBOSIS Principal Investigator & Institution: Wakefield, Thomas W.; Surgery; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2002; Project Start 01-JUL-1999; Project End 30-JUN-2003 Summary: Venous thrombosis and thromboembolism remain a national health problem, occurring with an annual incidence of 250,000 cases and resulting in 300,00 to 600,00 hospitalizations and 50,000 deaths per year. The incidence has not changed over the past 30 years. Venous thrombosis leads to chronic venous insufficiency with as many as 500,000 patients affected with skin ulceration from venous insufficiency and 6 to 7 million patients with skin stasis changes. Our ongoing hypothesis is that chronic venous insufficiency results from an interplay between thrombosis and inflammation (initiated by thrombosis), and that the inflammatory response amplifies thrombosis. We have demonstrated the following: 1) the inflammatory response initially involves neutrophil extravasation into the vein wall followed by monocyte emigration; 2) signaling cytokines in the vein wall such as tumor necrosis factor (TNF) are important for this leukocyte movement; 3) inhibition of pro-inflammatory cytokines will lessen the inflammatory response. Additionally, we have also noted the presence of the antiinflammatory cytokine interleukin-10 (IL-10) in high quantity in the vein wall in response to venous thrombosis. Our new hypothesis is that venous thrombosis induced inflammation involves an imbalance between anti- inflammatory and pro-inflammatory cytokines favoring inflammatory and thrombotic amplification. In this proposal, we will investigate the interplay between the thrombus and vein wall once clot has formed. We

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will: 1) Evaluate the magnitude of expression, time course and cellular sources of the anti-inflammatory cytokine IL-10 and its receptor during venous thrombosis correlated to pro-inflammatory cytokines and determine their relationship to the thrombotic and inflammatory response without and with IL-10 neutralization; 2) Define the specific relationship between IL-10 and TNF in vitro and determine the interplay between these anti-inflammatory and pro-inflammatory cytokines in isolated monocytes derived from blood and both vein wall and thrombus during venous thrombosis; 3) Determine the effect of IL-10 over expression on the inflammatory and thrombotic response during venous thrombosis using both localized transient transfection of the IL-10 gene into the vein wall and systemic administration of rIL-10. This investigation should further our understanding of the balance between anti-inflammatory and pro-inflammatory activities of the vein wall produced by venous thrombosis, the manner in which these activities affect thrombus amplification and suggest therapeutic options to lessen inflammation and thrombosis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: FEASIBILITY EVALUATION OF A PROSTHETIC VENOUS VALUE Principal Investigator & Institution: Schmidt, Steven P.; Biomedical Research Associates, Inc. 44 Orchard Rd Akron, Oh 44313 Timing: Fiscal Year 2004; Project Start 01-JUL-2004; Project End 30-JUN-2005 Summary: (provided by applicant): The goal of this Phase I STTR proposal is to demonstrate the feasibility of a novel prosthetic venous valve design concept. One of the ultimate goals in vascular surgery is to develop a successful prosthetic venous valve to replace defective valves in patients with chronic venous insufficiency (CVI). More than 8 million Americans suffer from the debilitating consequences of CVI. Many surgeons believe that replacing the incompetent valves in these patients will improve their conditions. However, transplanted valves derived from upper limbs or from animals have had limited success and prior versions of artificial vein valves have failed from thrombosis or intimal hyperplasia in the challenging hemodynamic environment of the venous circulation. Thus, rectifying the underlying etiology of the disease in these patients remains unresolved and these patients are relegated to traditional conservative, compression therapies. The novel venous valve design concept that BioMedical Reseach Associates proposes for evaluation could well serve as the platform upon which a successful prosthetic venous valve prototype can be designed. This design concept has been conceived based upon observations of venous valves from normal subjects and has worked successfully in crude flow loop to prevent regurgitation. In this Phase I proposal, feasibility of the design concept will be rigorously assessed by inserting preliminary valve protoypes in an in vitro flow loop designed to mimic human venous physiology and comparing performances of these prototypes under physiologic flow conditions to benchmarked data derived from normal human subjects. The deliverable from this research will be the conclusion whether the design concept is feasible or not compared to native vein valves and, if the concept is feasible, directions that the Phase II research should take for design improvements. If the ultimately developed prototype remains patent and competent over time in vivo, a prosthetic venous valve could be manufactured that would significantly benefit this challenging population of patients. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: SHEAR STRESS & CELLULAR CONTROL OF CAPILLARY FUNCTION Principal Investigator & Institution: Williams, Donna A.; None; University of Missouri Columbia 310 Jesse Hall Columbia, Mo 65211 Timing: Fiscal Year 2002; Project Start 01-SEP-2001; Project End 31-JUL-2006 Summary: (provided by the applicant): Over 100 years ago Starling deduced that hydrostatic and protein osmotic pressures on either side of the capillary barrier control filtration and absorption. Until recently, the assumption has been that the barrier itself does not participate in fluid balance. With modem scientific methods it has become eminently clear that capillaries sense humoral and metabolic signals, which originate from distant organs or locally from tissues that surround the microcirculation. Consequently, a very different picture of a dynamic capillary barrier is coming to the forefront. The long-term goal of the N's laboratory focuses on mechanical stimulation of capillaries. The mechanical stimuli of interest are fluid shear stress and fluid acceleration, two forces imparted to the capillary wall by flowing blood. Measurements of hydraulic conductivity (Lp) will be performed on capillaries located in a living preparation of frog mesentery and cannulated individually with glass micropipettes. In this model, capillary pressure, surface area, network location, blood flow rate, and direction are known. In SPECIFIC AIM 1 we examine the new and exciting possibility that absolute values of capillary Lp relate directly to very SLOW rates of fluid acceleration through the capillary (30 to 50 ums-2). SPECIFIC AIM 2 focuses on the glycocalyx, a layer of glycoproteins located on the capillary lumenal surface, and its potential role in modulating the response of intact capillaries to fluid acceleration. Prostacyclin is one autocoid known to be released acutely (sec to min) upon stimulating cultured endothelial cells with a change in fluid shear stress. SPECIFIC AIM 3 focuses on cyclooxygenase activity (COX), prostacyclin, and the second messenger, adenosine 3'5'-cyclic monophosphate (cAMP) as essential for protecting the capillary barrier in the face of changes in blood flow. Finally, in SPECIFIC AIM 4, we propose two unique mechanisms for sensing fluid stimuli in vivo. Partial digestion of the glycocalyx will be combined with inhibition of COX. Capillaries will be challenged with SLOW (5 min) or ABRUPT (< 0.1 s) changes in fluid velocity to reveal lumenal versus whole cell mechanisms for sensing flow. Collectively, the results from these studies will be critical to our understanding of capillary barrier function, mechanotransduction in vivo, and whole body fluid balance. Chronic venous insufficiency, congestive heart failure, and lymphedema represent three human diseases where the capillary barrier is not functioning properly and mechanical stimulation of the microcirculation may exacerbate the problem. The work proposed here will impact directly on clinical research efforts focused on these costly and potentially life-threatening diseases. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: SKIN TEMPERATURE AND PERFUSION IN VENOUS DISEASE Principal Investigator & Institution: Kelechi, Teresa J.; None; Medical University of South Carolina P O Box 250854 Charleston, Sc 29425 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 29-SEP-2005 Summary: (provided by applicant): Venous ulcers pose a serious health threat to over 2 millions Americans who suffer from them. It is critical to study individuals with chronic venous insufficiency (CVI), a known culprit of ulcers, in hopes of finding ways to prevent them. The purpose of this study is to measure skin temperature and tissue perfusion of both lower legs of older adults with CVI. The medial aspect of both lower

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legs above the malleolus (most vulnerable to ulceration) will be measured with an infrared thermometer to evaluate skin temperature and a laser Doppler flowmeter to evaluate tissue perfusion. The aim is to establish norm data and describe the correlation between skin temperature and tissue perfusion. The descriptive comparative study will compare skin temperature and tissue perfusion in a sample of 52 subjects (26 with CVI and 26 without CVI) at least 50 years of age recruited from various outpatient and community settings. Data will be analyzed using ANOVA and correlations. The findings of this study will add to the scant knowledge base regarding skin temperature and tissue perfusion of lower leg skin affected by CVI. The data will reveal whether these two "vital signs," particularly skin temperature, can be incorporated in a prediction/prevention model of lower leg complications. It is hypothesized that when skin temperature and perfusion are outside of a normal range (elevated), there may be an increased likelihood of ulcer development. The data obtained will be incorporated into an intervention protocol to prevent venous leg complications. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: VENOUS ULCERS: TESTING EFFECTS OF COMPRESSION & POSITION Principal Investigator & Institution: Wipke-Tevis, Deidre D.; None; University of Missouri Columbia 310 Jesse Hall Columbia, Mo 65211 Timing: Fiscal Year 2002; Project Start 01-SEP-2001; Project End 31-MAY-2006 Summary: (provided by applicant): Chronic venous insufficiency causes changes in the skin microcirculation that result in hypoxia, impaired blood flow, edema, and painful venous ulcers. Nursing management of these ulcers is an ongoing challenge. Usual nursing interventions include compression bandages and frequent leg elevation. It is important for nurses to know how the combination of compression bandaging and leg elevation affect skin microcirculation. The objective of this revised New Investigator proposal is to determine the effect of leg/body position changes and compression bandaging on four key parameters of microvascular responsiveness and function. The specific aims are: Specific Aim 1) To measure baseline (supine) skin oxygen (02), skin carbon dioxide (C02), skin blood perfusion, and limb volume in the lower limbs of venous ulcer subjects and healthy adults; Specific Aim 2) To measure skin 02, skin C02, skin blood perfusion and limb volume in the lower limbs of venous ulcer subjects and healthy adults in response to leg/body position changes; Specific Aim 3) To measure skin 02, skin C02, skin blood perfusion, and limb volume in the lower limbs of venous ulcer subjects and healthy adults in response to leg/body position changes with compression bandaging; Specific Aim 4) To correlate skin blood perfusion estimated by laser Doppler flux with skin blood perfusion estimated by transcutaneous oximetry with inspired 02 in the lower limbs of venous ulcer subjects and healthy adults in response to changes in leg/body position with and without compression bandaging. A convenience sample of 64 venous ulcer and 64 healthy subjects will be recruited. Subjects will have skin 02, skin C02, and skin blood perfusion measured at the medial malleolar area and foot while lying supine, lying supine with legs elevated 300, and standing. The measures will be repeated with the subject wearing an elastic compression bandage. Limb volume will be measured after baseline 1, after the position protocol, at baseline 2, after the position/compression protocol, and after baseline 3. To answer Aim 1, a Hotellings T2 will be used. To answer Aims 2 and 3, a repeated measures ANOVA will be used. To answer Aim 4, correlations will be performed. These questions must be answered in order to develop a nursing intervention that prescribes optimal leg/body position and compression combinations that maximize healing.

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Chronic Venous Insufficiency

Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “chronic venous insufficiency” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for chronic venous insufficiency in the PubMed Central database: •

Rational therapy of chronic venous insufficiency -- chances and limits of the therapeutic use of horse-chestnut seeds extract. by Ottillinger B, Greeske K.; 2001; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=61039

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with chronic venous insufficiency, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “chronic venous insufficiency” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for chronic venous insufficiency (hyperlinks lead to article summaries):

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Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.

With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print. 6 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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A comparison between descending phlebography and duplex Doppler investigation in the evaluation of reflux in chronic venous insufficiency: a challenge to phlebography as the "gold standard". Author(s): Neglen P, Raju S. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 1992 November; 16(5): 687-93. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1433655

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A comprehensive method of management for patients with chronic venous insufficiency and venous ulcers. Author(s): Seeley J. Source: Ostomy Wound Manage. 1992 October; 38(8): 45-6, 48. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1482524

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A conventional compression bandage lacks effect on subcutaneous blood flow when walking and during passive dependence in chronic venous insufficiency. Author(s): Kristensen JK, Sindrup JH, Jelstrup Petersen L, Peters K, Danielsen L. Source: Acta Dermato-Venereologica. 1991; 71(5): 450-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1684480

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A correlation of air plethysmography and color-flow-assisted duplex scanning in the quantification of chronic venous insufficiency. Author(s): Weingarten MS, Czeredarczuk M, Scovell S, Branas CC, Mignogna GM, Wolferth CC Jr. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 1996 November; 24(5): 750-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8918319

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A double-blind trial of calcium dobesilate in chronic venous insufficiency. Author(s): Casley-Smith JR. Source: Angiology. 1988 October; 39(10): 853-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3177951

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A new method for the assessment of tissue hemoglobin oxygenation in patients with chronic venous insufficiency. Author(s): Thum J, Caspary L, Creutzig A, Alexander K. Source: Microvascular Research. 1996 May; 51(3): 317-26. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8992231

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Abnormal arteriovenous shunts associated with chronic venous insufficiency. Author(s): Haimovici H. Source: The Journal of Cardiovascular Surgery. 1976 November-December; 17(6): 473-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=993248

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Absorption of the stable prostacyclin analogue iloprost through the ulcer base in chronic venous insufficiency. Author(s): Meyer J, Gunther C, Werner-Schlenzka H. Source: The British Journal of Dermatology. 1993 November; 129(5): 571-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7504505

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Acute and chronic venous insufficiency in the finger. Author(s): Kerstein MD, May CJ. Source: Angiology. 1976 April; 27(4): 265-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1053534

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Advances in venous surgery: SEPS and phlebectomy for chronic venous insufficiency. Author(s): Bergan JJ. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 2002 January; 28(1): 26-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11991265

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Air plethysmography in chronic venous insufficiency: clinical diagnosis and quantitative assessment. Author(s): Ting AC, Cheng SW, Wu LL, Cheung GC. Source: Angiology. 1999 October; 50(10): 831-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10535722

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Arterial and venous function in the lower leg in patients with chronic venous insufficiency. Author(s): Brakkee AJ, Kuiper JP. Source: Vasa. Zeitschrift Fur Gefasskrankheiten. Journal for Vascular Diseases. 1975; 4(4): 385-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1229645

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Ascending cinevenography in chronic venous insufficiency: a comparison with ambulatory venous pressure measurements. Author(s): Gray-Weale AC, de Burgh MM, Lippey E, Palme A. Source: The Australian and New Zealand Journal of Surgery. 1985 December; 55(6): 5659. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3868994

Studies

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Assessment of chronic venous insufficiency using dynamic venous pressure studies. Author(s): Randhawa GK, Dhillon JS, Kistner RL, Ferris EB 3rd. Source: American Journal of Surgery. 1984 August; 148(2): 203-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6465425

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Blood flux and venoarteriolar response of the skin in legs with chronic venous insufficiency measured at two different depths by using a double-wavelength laser Doppler technique. Author(s): Malanin K, Vilkko P, Kolari PJ. Source: Angiology. 1998 June; 49(6): 441-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9631889

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Calcium dobesilate for chronic venous insufficiency: a systematic review. Author(s): Ciapponi A, Laffaire E, Roque M. Source: Angiology. 2004 March-April; 55(2): 147-54. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15026869

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Canges in chemical, hematological and blood gases values in chronic venous insufficiency of the lower limbs. Author(s): Zelikovski A, Podlipski A, Sternberg A, Urca I. Source: Vasa. Zeitschrift Fur Gefasskrankheiten. Journal for Vascular Diseases. 1977; 6(1): 26-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=835327

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Capillary underperfusion in chronic venous insufficiency: a cause for leg ulceration? Author(s): Luetolf O, Bull RH, Bates DO, Mortimer PS. Source: The British Journal of Dermatology. 1993 March; 128(3): 249-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8471507

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Changes in cellular motility and cytoskeletal actin in fibroblasts from patients with chronic venous insufficiency and in neonatal fibroblasts in the presence of chronic wound fluid. Author(s): Raffetto JD, Mendez MV, Marien BJ, Byers HR, Phillips TJ, Park HY, Menzoian JO. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 2001 June; 33(6): 1233-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11389423

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Changes in venous lumen size and shape do not affect the accuracy of volume flow measurements in healthy volunteers and patients with primary chronic venous insufficiency. Author(s): Lurie F, Ogawa T, Kistner RL, Eklof B. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 2002 March; 35(3): 522-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11877702

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Changes of cytokeratin expression in the epidermis with chronic venous insufficiency. Author(s): Peschen M, Grenz H, Lahaye T, Brand-Saberi B, Simon JC, Schopf E, Vanscheidt W. Source: Vasa. Zeitschrift Fur Gefasskrankheiten. Journal for Vascular Diseases. 1997 May; 26(2): 76-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9174381

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Chronic venous insufficiency and venous leg ulceration. Author(s): Valencia IC, Falabella A, Kirsner RS, Eaglstein WH. Source: Journal of the American Academy of Dermatology. 2001 March; 44(3): 401-21; Quiz 422-4. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11209109

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Chronic venous insufficiency and venous ulceration. Author(s): Alguire PC, Mathes BM. Source: Journal of General Internal Medicine : Official Journal of the Society for Research and Education in Primary Care Internal Medicine. 1997 June; 12(6): 374-83. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9192256

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Chronic venous insufficiency disease. Its etiology. A new technique for vein valve transplantation. Author(s): Rai DB, Lerner R. Source: Int Surg. 1991 July-September; 76(3): 174-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1938208

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Chronic venous insufficiency in a Chinese population: an anatomic and functional study by continuous-wave Doppler and photoplethysmography. Author(s): Cheng SW, Wong J. Source: Annals of Vascular Surgery. 1995 May; 9(3): 274-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7632556

Studies

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Chronic venous insufficiency in persons with a history of injection drug use. Author(s): Pieper B, Templin T. Source: Research in Nursing & Health. 2001 October; 24(5): 423-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11746071

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Chronic venous insufficiency in post-thrombotic patients. Author(s): Blombery P, McGrath B. Source: Clinical Science (London, England : 1979). 2000 April; 98(4): 445-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10731479

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Chronic venous insufficiency is associated with increased platelet and monocyte activation and aggregation. Author(s): Powell CC, Rohrer MJ, Barnard MR, Peyton BD, Furman MI, Michelson AD. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 1999 November; 30(5): 844-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10550182

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Chronic venous insufficiency of the legs: pathogenesis of venous ulcers. Author(s): Tretbar LL. Source: J Enterostomal Ther. 1987 May-June; 14(3): 105-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3647049

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Chronic venous insufficiency of the lower extremity. Pathogenesis and surgical treatment. Author(s): Thurston OG, Williams HT. Source: Archives of Surgery (Chicago, Ill. : 1960). 1973 April; 106(4): 537-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4696727

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Chronic venous insufficiency. Author(s): Miller WL. Source: Cardiovasc Clin. 1992; 22(3): 67-80. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1600552

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Chronic venous insufficiency. Author(s): Miller WL. Source: Current Opinion in Cardiology. 1995 September; 10(5): 543-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7496065

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Chronic venous insufficiency. Author(s): Vernick SH, Shaw FD. Source: Archives of Physical Medicine and Rehabilitation. 1994 September; 75(9): 1023-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8085925

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Chronic venous insufficiency. Author(s): O'Donnell TF Jr, McEnroe CS, Heggerick P. Source: The Surgical Clinics of North America. 1990 February; 70(1): 159-80. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2406965

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Chronic venous insufficiency. Author(s): Lofgren EP. Source: Cardiovasc Clin. 1983; 13(2): 133-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6839319

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Chronic venous insufficiency. A common health problem in general practice in Greece. Author(s): Lionis C, Erevnidou K, Antonakis N, Argyriadou S, Vlachonikolis I, Katsamouris A; CVI Research Group. Source: International Angiology : a Journal of the International Union of Angiology. 2002 March; 21(1): 86-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11941279

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Chronic venous insufficiency. Breaking the cycle of ulceration. Author(s): Brainard NR, Ortiz L. Source: Adv Nurse Pract. 1999 July; 7(7): 57-60, 80. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10476105

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Chronic venous insufficiency. Discussion and case report of statis ulcer treatment. Author(s): Bernstein MZ. Source: J Am Podiatry Assoc. 1974 April; 64(4): 248-52. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4363562

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Chronic venous insufficiency: a challenge for the vascular laboratory. Author(s): Browse NL. Source: World Journal of Surgery. 1986 December; 10(6): 925-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3798939

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Chronic venous insufficiency: a focus on prevention of venous ulceration. Author(s): Capeheart JK. Source: Journal of Wound, Ostomy, and Continence Nursing : Official Publication of the Wound, Ostomy and Continence Nurses Society / Wocn. 1996 July; 23(4): 227-34. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8900677

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Chronic venous insufficiency: assessment with descending venography. Author(s): Morano JU, Raju S. Source: Radiology. 1990 February; 174(2): 441-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2296653

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Chronic venous insufficiency: clinical and duplex correlations. The Edinburgh Vein Study of venous disorders in the general population. Author(s): Ruckley CV, Evans CJ, Allan PL, Lee AJ, Fowkes FG. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 2002 September; 36(3): 520-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12218976

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Chronic venous insufficiency: dysregulation of collagen synthesis. Author(s): Sansilvestri-Morel P, Rupin A, Badier-Commander C, Fabiani JN, Verbeuren TJ. Source: Angiology. 2003 July-August; 54 Suppl 1: S13-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12934753

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Chronic venous insufficiency: mechanisms and management. Author(s): Ibrahim S, MacPherson DR, Goldhaber SZ. Source: American Heart Journal. 1996 October; 132(4): 856-60. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8831377

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Chronic venous insufficiency: the genetic influence. Author(s): Pistorius MA. Source: Angiology. 2003 July-August; 54 Suppl 1: S5-12. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12934752

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Chronic venous insufficiency--a well-known disorder with many question marks. Author(s): Norgren L. Source: Angiology. 1997 January; 48(1): 23-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8995339

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Chronic venous insufficiency--clinical and therapeutic approach. Author(s): Goitia HF, Dipietro A, Gatta F. Source: Angiology. 1986 January; 37(1): 8-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3946836

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Chronic venous insufficiency--epidemiology. Author(s): Staffa R. Source: Bratisl Lek Listy. 2002; 103(4-5): 166-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12413204

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Circulating leucocyte adhesion molecules in chronic venous insufficiency. Author(s): Ciuffetti G, Lombardini R, Pasqualini L, Vaudo G, Lupattelli G. Source: Vasa. Zeitschrift Fur Gefasskrankheiten. Journal for Vascular Diseases. 1999 August; 28(3): 156-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10483318

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Classification of chronic venous insufficiency. Author(s): Mayer W, Partsch H. Source: Current Problems in Dermatology. 1999; 27: 81-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10547730

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Classification of chronic venous insufficiency: a review. Author(s): Antignani PL. Source: Angiology. 2001 August; 52 Suppl 1: S17-26. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11510593

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Clinical and hemodynamic significance of the greater saphenous vein diameter in chronic venous insufficiency. Author(s): Navarro TP, Delis KT, Ribeiro AP. Source: Archives of Surgery (Chicago, Ill. : 1960). 2002 November; 137(11): 1233-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12413308

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Clinical evaluation of the efficacy and safety of calcium dobesilate in patients with chronic venous insufficiency of the lower limbs. Author(s): Arceo A, Berber A, Trevino C. Source: Angiology. 2002 September-October; 53(5): 539-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12365860

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Clinical histochemical and immunohistochemical investigation of the capillary basal membrane in chronic venous insufficiency. Author(s): Peschen M, Zeiske D, Laaff H, Weiss JM, Schopf E, Vanscheidt W. Source: Acta Dermato-Venereologica. 1996 November; 76(6): 433-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8982404

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Clinical presentation and anatomic distribution of chronic venous insufficiency of the lower limb in a typical Mediterranean population. Author(s): Giannoukas AD, Tsetis D, Ioannou C, Kostas T, Kafetzakis A, Petinarakis I, Kardoulas D, Touloupakis E, Katsamouris A. Source: International Angiology : a Journal of the International Union of Angiology. 2002 June; 21(2): 187-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12110782

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Clinical results of deep venous valvular repair for chronic venous insufficiency. Author(s): Jamieson WG, Chinnick B. Source: Canadian Journal of Surgery. Journal Canadien De Chirurgie. 1997 August; 40(4): 294-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9267299

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Clinical revision series 6. Chronic venous insufficiency. Author(s): Shreeve C. Source: Nurs Mirror. 1985 June 12; 160(24): 28. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3848927

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Coagulation and fibrinolysis in chronic venous insufficiency. Author(s): Blomgren L, Johansson G, Siegbahn A, Bergqvist D. Source: Vasa. Zeitschrift Fur Gefasskrankheiten. Journal for Vascular Diseases. 2001 July; 30(3): 184-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11582948

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Comparative evaluation of duplex-derived parameters in patients with chronic venous insufficiency: correlation with clinical manifestations. Author(s): Yamaki T, Nozaki M, Fujiwara O, Yoshida E. Source: Journal of the American College of Surgeons. 2002 December; 195(6): 822-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12495315

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Comparison of IL-10 levels in chronic venous insufficiency ulcers and autologous donor tissue. Author(s): Lundberg JE, Roth TP, Dunn RM, Doyle JW. Source: Archives of Dermatological Research. 1998 December; 290(12): 669-73. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9879836

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Compression stockings and rubber floor mats: do they benefit workers with chronic venous insufficiency and a standing profession? Author(s): Krijnen RM, de Boer EM, Ader HJ, Osinga DS, Bruynzeel DP. Source: Journal of Occupational and Environmental Medicine / American College of Occupational and Environmental Medicine. 1997 September; 39(9): 889-94. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9322173

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Congestive heart failure associated with chronic venous insufficiency and leg ulcers secondary to an arteriovenous fistula caused by a shotgun wound 15 years ago. Author(s): Erdol C, Baykan M, Gokce M, Celik S, Sari A, Uzun Z, Altun G, Ozcan F. Source: Vasa. Zeitschrift Fur Gefasskrankheiten. Journal for Vascular Diseases. 2002 May; 31(2): 125-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12099144

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Contact sensitization in chronic venous insufficiency: modern wound dressings. Author(s): Gallenkemper G, Rabe E, Bauer R. Source: Contact Dermatitis. 1998 May; 38(5): 274-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9667445

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Correlation of clinical findings with venous hemodynamics in 386 patients with chronic venous insufficiency. Author(s): McEnroe CS, O'Donnell TF Jr, Mackey WC. Source: American Journal of Surgery. 1988 August; 156(2): 148-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3400816

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Correlation of venous noninvasive tests with the Society for Vascular Surgery/International Society for Cardiovascular Surgery clinical classification of chronic venous insufficiency. Author(s): Iafrati MD, Welch H, O'Donnell TF, Belkin M, Umphrey S, McLaughlin R. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 1994 June; 19(6): 1001-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8201700

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Could gut-liver function derangements cause chronic venous insufficiency? Author(s): Cordts PR, Kaminski MV, Raju S, Clark MR, Woo KM. Source: Vascular Surgery. 2001 March-April; 35(2): 107-14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11668378

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Cutaneous inflammation limited to the region of the ulcer in chronic venous insufficiency. Author(s): Hahn J, Junger M, Friedrich B, Zuder D, Steins A, Hahn M, Klyscz T. Source: Vasa. Zeitschrift Fur Gefasskrankheiten. Journal for Vascular Diseases. 1997 November; 26(4): 277-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9409177

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Cutaneous microcirculation in skin lesions associated with chronic venous insufficiency. Author(s): Stucker M, Schobe MC, Hoffmann K, Schultz-Ehrenburg U. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 1995 October; 21(10): 877-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7551745

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Cytokines in progressing stages of chronic venous insufficiency. Author(s): Peschen M. Source: Current Problems in Dermatology. 1999; 27: 13-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10547723

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Dermal tissue fibrosis in patients with chronic venous insufficiency is associated with increased transforming growth factor-beta1 gene expression and protein production. Author(s): Pappas PJ, You R, Rameshwar P, Gorti R, DeFouw DO, Phillips CK, Padberg FT Jr, Silva MB Jr, Simonian GT, Hobson RW 2nd, Duran WN. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 1999 December; 30(6): 1129-45. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10587400

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Detection of outflow obstruction in chronic venous insufficiency. Author(s): Neglen P, Raju S. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 1993 March; 17(3): 583-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8445756

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Development and validation of a disease-specific questionnaire on the quality of life of patients with chronic venous insufficiency. Author(s): Augustin M, Dieterle W, Zschocke I, Brill C, Trefzer D, Peschen M, Schopf E, Vanscheidt W. Source: Vasa. Zeitschrift Fur Gefasskrankheiten. Journal for Vascular Diseases. 1997 November; 26(4): 291-301. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9409180

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Development of endoscopic dissection of perforating veins and fasciotomy for treatment of chronic venous insufficiency. Author(s): Hauer G, Bergan JJ, Werner A, Mitterhusen M, Nasralla F. Source: Annals of Vascular Surgery. 1999 July; 13(4): 357-64. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10398731

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Diagnosis of chronic venous insufficiency. Author(s): Kistner RL. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 1986 January; 3(1): 185-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3510326

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Differences between intracutaneous and transcutaneous skin oxygen tension in chronic venous insufficiency. Author(s): Roszinski S, Schmeller W. Source: The Journal of Cardiovascular Surgery. 1995 August; 36(4): 407-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7593157

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Diminished mononuclear cell function is associated with chronic venous insufficiency. Author(s): Pappas PJ, Teehan EP, Fallek SR, Garcia A, Araki CT, Back TL, Duran WN, Hobson RW 2nd. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 1995 November; 22(5): 580-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7494359

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Disturbed vasomotion in chronic venous insufficiency. Author(s): Stucker M, Steinbrugge J, Memmel U, Avermaete A, Altmeyer P. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 2003 September; 38(3): 522-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12947271

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Does air plethysmography correlate with duplex scanning in patients with chronic venous insufficiency? Author(s): van Bemmelen PS, Mattos MA, Hodgson KJ, Barkmeier LD, Ramsey DE, Faught WE, Sumner DS. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 1993 November; 18(5): 796-807. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8230566

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Does thigh compression improve venous hemodynamics in chronic venous insufficiency? Author(s): Partsch H, Menzinger G, Borst-Krafek B, Groiss E. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 2002 November; 36(5): 948-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12422092

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Does total hip arthroplasty predispose to chronic venous insufficiency? Author(s): Warwick D, Perez J, Vickery C, Bannister G. Source: The Journal of Arthroplasty. 1996 August; 11(5): 529-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8872571

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Double-blind, double-dummy, randomized, multi-centre clinical assessment of the efficacy, tolerability and dose-effect relationship of sulodexide in chronic venous insufficiency. Author(s): Saviano M, Maleti O, Liguori L. Source: Current Medical Research and Opinion. 1993; 13(2): 96-108. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8325047

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Doxium 500 in chronic venous insufficiency: a double-blind placebo controlled multicentre study. Author(s): Widmer L, Biland L, Barras JP. Source: International Angiology : a Journal of the International Union of Angiology. 1990 April-June; 9(2): 105-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2254672

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Duplex assessment of venous reflux and chronic venous insufficiency: the significance of deep venous reflux. Author(s): Welch HJ, Young CM, Semegran AB, Iafrati MD, Mackey WC, O'Donnell TF Jr. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 1996 November; 24(5): 755-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8918320

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Duplex-derived valve closure times fail to correlate with reflux flow volumes in patients with chronic venous insufficiency. Author(s): Rodriguez AA, Whitehead CM, McLaughlin RL, Umphrey SE, Welch HJ, O'Donnell TF. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 1996 April; 23(4): 606-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8627895

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Dysregulated L-selectin expression on lymphocytes in patients with chronic venous insufficiency. Author(s): Junger M, Friedrich B, Hahn J, Klyscz T, Muller CA, Schmid-Schonbein GW. Source: Clinical Hemorheology and Microcirculation. 2001; 25(1): 21-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11790867

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Early clinical outcomes after subfascial endoscopic perforator surgery (SEPS) and saphenous vein surgery in chronic venous insufficiency. Author(s): Lee DW, Chan AC, Lam YH, Wong SK, Fung TM, Mui LM, Ng EK, Chung SC. Source: Surgical Endoscopy. 2001 July; 15(7): 737-40. Epub 2001 April 03. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11591980

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Edema control in the management of disabling chronic venous insufficiency. Author(s): Lippmann HI, Fishman LM, Farrar RH, Bernstein RK, Zybert PA. Source: Archives of Physical Medicine and Rehabilitation. 1994 April; 75(4): 436-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8172504

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Effect of leg elevation on the skin microcirculation in chronic venous insufficiency. Author(s): Abu-Own A, Scurr JH, Coleridge Smith PD. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 1994 November; 20(5): 705-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7966805

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Endoscopic subfascial perforating vein ligation: its complementary role in the surgical management of chronic venous insufficiency. Author(s): Padberg FT Jr. Source: Annals of Vascular Surgery. 1999 May; 13(3): 343-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10347271

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Epidemiology of chronic venous insufficiency. Author(s): De Backer G. Source: Angiology. 1997 July; 48(7): 569-76. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9242154

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Evaluation of therapeutic compression stockings in the treatment of chronic venous insufficiency. Author(s): Motykie GD, Caprini JA, Arcelus JI, Reyna JJ, Overom E, Mokhtee D. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 1999 February; 25(2): 116-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10037516

Studies

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Experimental models to investigate inflammatory processes in chronic venous insufficiency. Author(s): Korthuis RJ, Unthank JL. Source: Microcirculation (New York, N.Y. : 1994). 2000; 7(6 Pt 2): S13-22. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11151966

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Expression of adhesion molecules and cytokines on saphenous veins in chronic venous insufficiency. Author(s): Takase S, Bergan JJ, Schmid-Schonbein G. Source: Annals of Vascular Surgery. 2000 September; 14(5): 427-35. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10990550

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Expression of the adhesion molecules ICAM-1, VCAM-1, LFA-1 and VLA-4 in the skin is modulated in progressing stages of chronic venous insufficiency. Author(s): Peschen M, Lahaye T, Hennig B, Weyl A, Simon JC, Vanscheidt W. Source: Acta Dermato-Venereologica. 1999 January; 79(1): 27-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10086854

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Fasciotomy, chronic venous insufficiency, and the calf muscle pump. Author(s): Bermudez K, Knudson MM, Morabito D, Kessel O. Source: Archives of Surgery (Chicago, Ill. : 1960). 1998 December; 133(12): 1356-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9865656

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Femoral and iliofemoral thrombectomy to prevent chronic venous insufficiency. Follow-up of 18 patients. Author(s): de Araujo Bessa JC. Source: The Journal of Cardiovascular Surgery. 1986 July-August; 27(4): 443-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3722247

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Femoral vein reconstruction in the management of chronic venous insufficiency. A 14-year experience. Author(s): Ferris EB, Kistner RL. Source: Archives of Surgery (Chicago, Ill. : 1960). 1982 December; 117(12): 1571-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7149977

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Foot transcapillary filtration in patients with severe chronic venous insufficiency. Author(s): Kolari PJ, Pekanmaki K. Source: Vasa. Zeitschrift Fur Gefasskrankheiten. Journal for Vascular Diseases. 1988; 17(2): 92-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3407319

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Frequency of toenail onychomycosis in patients with cutaneous manifestations of chronic venous insufficiency. Author(s): Del Mar M, De Ocariz S, Arenas R, Ranero-Juarez GA, Farrera-Esponda F, Monroy-Ramos E. Source: International Journal of Dermatology. 2001 January; 40(1): 18-25. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11277948

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Functional evaluation of chronic venous insufficiency by foot volumetry. Author(s): Norgren L. Source: Acta Chir Scand Suppl. 1974; 444: 1-48. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4528574

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Genetic alterations in chronic venous insufficiency. Author(s): Taheri SA, Weaver TA, Schultz RO. Source: International Angiology : a Journal of the International Union of Angiology. 1993 March; 12(1): 1-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8376904

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Guidelines for testing drugs for chronic venous insufficiency. Author(s): Martin M. Source: Vasa. Zeitschrift Fur Gefasskrankheiten. Journal for Vascular Diseases. 2001 February; 30(1): 76. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11284096

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Guidelines for testing drugs for chronic venous insufficiency. Author(s): Vanscheidt W, Heidrich H, Junger M, Rabe E; Phlebology Study Group of the Austrian Society of Dermatology; German Society of Angiology; German Society of Phlebology; Swiss Society of Phlebology. Source: Vasa. Zeitschrift Fur Gefasskrankheiten. Journal for Vascular Diseases. 2000 November; 29(4): 274-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11141651

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Haemostatic factors and risk of varicose veins and chronic venous insufficiency: Edinburgh Vein Study. Author(s): Lee AJ, Lowe GD, Rumley A, Ruckley CV, Fowkes FG. Source: Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis. 2000 December; 11(8): 775-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11132657

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Healing of venous ulcers in an ambulatory care program: the roles of chronic venous insufficiency and patient compliance. Author(s): Erickson CA, Lanza DJ, Karp DL, Edwards JW, Seabrook GR, Cambria RA, Freischlag JA, Towne JB. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 1995 November; 22(5): 629-36. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7494367

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Hemodynamic assessment of chronic venous insufficiency. Author(s): Alam S, Sakurai T, Yano T, Shionoya S, Hirai M. Source: Jpn J Surg. 1991 March; 21(2): 154-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2051660

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Hemodynamics in the lower limbs of healthy women and women with chronic venous insufficiency. Author(s): Korzhova VV, Kulakov VI. Source: Hum Physiol. 1979 November-December; 5(5): 822-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=551065

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Hemorheological profile in chronic venous insufficiency after surgery. Author(s): Azaceta G, Romero S, Moreno JA, Vaquerizo A, Olave T, Lorente C, Azcona JM, Gutierrez M. Source: Haemostasis. 1999; 29(4): 219-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10702703

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Home use of impulse compression of the foot and compression stockings in the treatment of chronic venous insufficiency. Author(s): Arcelus JI, Caprini JA, Sehgal LR, Reyna JJ. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 2001 November; 34(5): 805-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11700479

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Hyperaemic response in the skin microcirculation of patients with chronic venous insufficiency. Author(s): Shami SK, Cheatle TR, Chittenden SJ, Scurr JH, Coleridge Smith PD. Source: The British Journal of Surgery. 1993 April; 80(4): 433-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8495302

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Immunohistochemical investigation of dermal capillaries in chronic venous insufficiency. Author(s): Vanscheidt W, Laaff H, Weiss JM, Schopf E. Source: Acta Dermato-Venereologica. 1991; 71(1): 17-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1676207

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Immunohistochemical investigation of pericytes in chronic venous insufficiency. Author(s): Laaff H, Vandscheidt W, Weiss JM, Schaefer HE, Schoepf E. Source: Vasa. Zeitschrift Fur Gefasskrankheiten. Journal for Vascular Diseases. 1991; 20(4): 323-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1776342

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Improved hemodynamic effectiveness and associated clinical correlations of a new intermittent pneumatic compression system in patients with chronic venous insufficiency. Author(s): Kakkos SK, Szendro G, Griffin M, Sabetai MM, Nicolaides AN. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 2001 November; 34(5): 915-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11700495

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In situ hemodynamics of perforating veins in chronic venous insufficiency. Author(s): Delis KT, Husmann M, Kalodiki E, Wolfe JH, Nicolaides AN. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 2001 April; 33(4): 773-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11296331

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Increased arterial inflow in extremities with chronic venous insufficiency: an important and unappreciated hemodynamic parameter. Author(s): Skladany M, Schanzer H. Source: Surgery. 1996 July; 120(1): 30-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8693419

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Increased collagen IV layer in the basal membrane area of the capillaries in severe chronic venous insufficiency. Author(s): Neumann HA, Van den Broek MJ. Source: Vasa. Zeitschrift Fur Gefasskrankheiten. Journal for Vascular Diseases. 1991; 20(1): 26-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2031396

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Increased expression of platelet-derived growth factor receptor alpha and beta and vascular endothelial growth factor in the skin of patients with chronic venous insufficiency. Author(s): Peschen M, Grenz H, Brand-Saberi B, Bunaes M, Simon JC, Schopf E, Vanscheidt W. Source: Archives of Dermatological Research. 1998 June; 290(6): 291-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9705159

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Increased white cell trapping in the dependent legs of patients with chronic venous insufficiency. Author(s): Thomas PR, Nash GB, Dormandy JA. Source: Journal Des Maladies Vasculaires. 1991; 16(1): 35-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2010704

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Increasing erythrocyte aggregability with the progressive grades of chronic venous insufficiency: importance and mechanisms. Author(s): Zuccarelli F, Taccoen A, Razavian M, Chabanel A. Source: The Journal of Cardiovascular Surgery. 1995 August; 36(4): 387-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7593153

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Inelastic versus elastic leg compression in chronic venous insufficiency: a comparison of limb size and venous hemodynamics. Author(s): Spence RK, Cahall E. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 1996 November; 24(5): 783-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8918324

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Inflammatory mechanisms involving neutrophils in chronic venous insufficiency of lower limbs. Author(s): Stvrtinova V, Jahnova E, Weissova S, Horvathova M, Ferencik M. Source: Bratisl Lek Listy. 2001; 102(5): 235-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11725375

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Influence of compression in sclerotherapy for the treatment of chronic venous insufficiency. Author(s): Fegan WG. Source: The Journal of Cardiovascular Surgery. 1966 September-October; 7(5): 339-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5925306

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Influence of medical compression stockings on venolymphatic drainage in phlebologically healthy test persons and patients with chronic venous insufficiency. Author(s): Lentner A, Wienert V. Source: Int J Microcirc Clin Exp. 1996 November-December; 16(6): 320-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9049711

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Intermittent pneumatic compression in chronic venous insufficiency favorably affects fibrinolytic potential and platelet activation. Author(s): Kessler CM, Hirsch DR, Jacobs H, MacDougall R, Goldhaber SZ. Source: Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis. 1996 June; 7(4): 437-46. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8839995

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Investigation of chronic venous insufficiency: A consensus statement (France, March 5-9, 1997). Author(s): Nicolaides AN; Cardiovascular Disease Educational and Research Trust; European Society of Vascular Surgery; ,The International Angiology Scientific Activity Congress Organization; International Union of Angiology; Union Internationale de Phlebologie at the Abbaye des Vaux de Cernay. Source: Circulation. 2000 November 14; 102(20): E126-63. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11076834

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Leucocyte activity in chronic venous insufficiency. Author(s): Ciuffetti G, Mannarino E, Paltriccia R, Malagigi V, Sergi F, Paulisch P, Pasqualini L, Lupattelli G. Source: International Angiology : a Journal of the International Union of Angiology. 1994 December; 13(4): 312-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7790751

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Low intensity negative electric current in the treatment of ulcers of the leg due to chronic venous insufficiency. Preliminary report of three cases. Author(s): Assimacopoulos D. Source: American Journal of Surgery. 1968 May; 115(5): 683-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5300518

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Low molecular weight heparin in the symptomatic treatment of chronic venous insufficiency. Controlled double blind study vs calcium heparin. Author(s): Sannazzari P. Source: Panminerva Medica. 1989 July-September; 31(3): 127-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2557572

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Lower leg subcutaneous blood flow during walking and passive dependency in chronic venous insufficiency. Author(s): Peters K, Sindrup JH, Petersen LJ, Olivarius F, Danielsen L, Kristensen JK. Source: The British Journal of Dermatology. 1991 February; 124(2): 177-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2004002

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Lupus anticoagulant in patients with chronic venous insufficiency. Author(s): Fink AM, Kottas-Heldenberg A, Bayer PM, Bednar R, Steiner A. Source: Acta Dermato-Venereologica. 2003; 83(4): 287-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12926801

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Magnetic resonance imaging and computed tomography in advanced chronic venous insufficiency. Author(s): List-Hellwig E, Meents H. Source: Current Problems in Dermatology. 1999; 27: 109-13. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10547734

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Management of chronic venous insufficiency in the lower extremities. Author(s): Eckstam EE. Source: Wis Med J. 1970 August; 69(8): 194-6. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5506878

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Methods of evaluation and quantification of microangiopathy in high perfusion microangiopathy (chronic venous insufficiency and diabetic microangiopathy). Author(s): DeSanctis MT, Cesarone MR, Incandela L, Belcaro G, Acerbi G. Source: Journal of Cardiovascular Pharmacology and Therapeutics. 2002 January; 7 Suppl 1: S3-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12011965

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Methods of evaluation and quantification of microangiopathy in high perfusion microangiopathy (chronic venous insufficiency and diabetic microangiopathy). Author(s): Cesarone MR, De Sanctis MT, Incandela L, Belcaro G, Griffin M, Cacchio M. Source: Angiology. 2001 October; 52 Suppl 2: S3-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11666120

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Microangiopathy in chronic venous insufficiency: quantitative assessment by capillary microscopy. Author(s): Howlader MH, Smith PD. Source: European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery. 2003 September; 26(3): 325-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14509899

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Microangiopathy in the pathogenesis of chronic venous insufficiency. Author(s): Junger M, Hahn M, Klyscz T, Steins A. Source: Current Problems in Dermatology. 1999; 27: 124-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10547736

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Microangiopathy of cutaneous blood and lymphatic capillaries in chronic venous insufficiency (CVI). Author(s): Franzeck UK, Haselbach P, Speiser D, Bollinger A. Source: Yale J Biol Med. 1993 January-February; 66(1): 37-46. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8256463

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Microangiopathy of the skin and the effect of leg compression in patients with chronic venous insufficiency. Author(s): Abu-Own A, Shami SK, Chittenden SJ, Farrah J, Scurr JH, Smith PD. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 1994 June; 19(6): 1074-83. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8201709

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Microcirculation in chronic venous insufficiency. Author(s): Gschwandtner ME, Ehringer H. Source: Vascular Medicine (London, England). 2001; 6(3): 169-79. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11789972

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Microcirculatory dysfunction in chronic venous insufficiency (CVI). Author(s): Junger M, Steins A, Hahn M, Hafner HM. Source: Microcirculation (New York, N.Y. : 1994). 2000; 7(6 Pt 2): S3-12. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11151969

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Microcirculatory inflammation in chronic venous insufficiency: current status and future directions. Author(s): Duran W, Pappas PJ, Schmid-Schonbein GW. Source: Microcirculation (New York, N.Y. : 1994). 2000; 7(6 Pt 2): S49-58. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11151972

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Microvascular changes in chronic venous insufficiency--a review. Author(s): Leu AJ, Leu HJ, Franzeck UK, Bollinger A. Source: Cardiovascular Surgery (London, England). 1995 June; 3(3): 237-45. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7655836

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Mid-term results of endoscopic perforator vein interruption for chronic venous insufficiency: lessons learned from the North American subfascial endoscopic perforator surgery registry. The North American Study Group. Author(s): Gloviczki P, Bergan JJ, Rhodes JM, Canton LG, Harmsen S, Ilstrup DM. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 1999 March; 29(3): 489-502. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10069914

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Modern management of chronic venous insufficiency. Author(s): Bradbury AW. Source: Asian J Surg. 2003 July; 26(3): 129-32. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12925285

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Modulation of urokinase-type and tissue-type plasminogen activator occurs at an early stage of progressing stages of chronic venous insufficiency. Author(s): Peschen M, Rogers AA, Chen WY, Vanscheidt W. Source: Acta Dermato-Venereologica. 2000 May; 80(3): 162-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10954203

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Morphological changes of dermal blood and lymphatic vessels in chronic venous insufficiency of the leg. Author(s): Scelsi R, Scelsi L, Cortinovis R, Poggi P. Source: International Angiology : a Journal of the International Union of Angiology. 1994 December; 13(4): 308-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7790750

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Morphology of chronic venous insufficiency--light and electron microscopic examinations. Author(s): Leu HJ. Source: Vasa. Zeitschrift Fur Gefasskrankheiten. Journal for Vascular Diseases. 1991; 20(4): 330-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1776343

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Morphometric assessment of the dermal microcirculation in patients with chronic venous insufficiency. Author(s): Pappas PJ, DeFouw DO, Venezio LM, Gorti R, Padberg FT Jr, Silva MB Jr, Goldberg MC, Duran WN, Hobson RW 2nd. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 1997 November; 26(5): 784-95. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9372816

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Neutrophil activation and mediators of inflammation in chronic venous insufficiency. Author(s): Smith PD. Source: Journal of Vascular Research. 1999; 36 Suppl 1: 24-36. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10474048

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New advances in the understanding of the pathophysiology of chronic venous insufficiency. Author(s): Schmid-Schonbein GW, Takase S, Bergan JJ. Source: Angiology. 2001 August; 52 Suppl 1: S27-34. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11510594

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Non-elastic compression: an alternative in management of chronic venous insufficiency. Author(s): Bergan JJ, Sparks SR. Source: Journal of Wound, Ostomy, and Continence Nursing : Official Publication of the Wound, Ostomy and Continence Nurses Society / Wocn. 2000 March; 27(2): 83-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10729177

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Noninvasive evaluation of chronic venous insufficiency. Use of foot mercury straingauge plethysmography. Author(s): Schanzer H, Lande L, Premus G, Peirce EC 2nd. Source: Archives of Surgery (Chicago, Ill. : 1960). 1984 September; 119(9): 1013-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6477112

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Non-invasive functional investigation of chronic venous insufficiency with special reference to foot volumetry. Author(s): Norgren L. Source: Acta Chir Scand Suppl. 1988; 544: 39-43. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3051825

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On the conditions for the venous return from the lower leg in healthy subjects and in patients with chronic venous insufficiency. Author(s): Arnoldi CC. Source: Angiology. 1966 March; 17(3): 153-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5909810

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Optimal therapy for advanced chronic venous insufficiency. Author(s): Tawes RL, Barron ML, Coello AA, Joyce DH, Kolvenbach R. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 2003 March; 37(3): 545-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12618690

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Pathogenesis of chronic venous insufficiency and possible effects of compression and pentoxifylline. Author(s): Coleridge Smith PD. Source: Yale J Biol Med. 1993 January-February; 66(1): 47-59. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8256464

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Patterns of epidermal growth factor receptor, basic fibroblast growth factor and transforming growth factor-beta3 expression in skin with chronic venous insufficiency. Author(s): Peschen M, Grenz H, Grothe C, Schopf E, Vanscheidt W. Source: European Journal of Dermatology : Ejd. 1998 July-August; 8(5): 334-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9683865

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Patterns of venous reflux in limbs with skin changes associated with chronic venous insufficiency. Author(s): Lees TA, Lambert D. Source: The British Journal of Surgery. 1993 June; 80(6): 725-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8330157

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Peripheral nerve function in chronic venous insufficiency. Author(s): Shami SK, Shields DA, Farrah J, Scurr JH, Coleridge Smith PD. Source: Eur J Vasc Surg. 1993 March; 7(2): 195-200. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8462710

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Peripheral neuropathy in chronic venous insufficiency. Author(s): Reinhardt F, Wetzel T, Vetten S, Radespiel-Troger M, Hilz MJ, Heuss D, Neundorfer B. Source: Muscle & Nerve. 2000 June; 23(6): 883-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10842263

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Pharmaco-epidemiology of the treatment of chronic venous insufficiency in general medicine. Author(s): Allaert FA, Causse C. Source: International Angiology : a Journal of the International Union of Angiology. 2002 June; 21(2 Suppl 1): 12-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12515975

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Phlebodynamic effect of Doxium in chronic venous insufficiency. Author(s): Urai L, Kolonics I, Natly G. Source: Ther Hung. 1985; 33(3): 136-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3842009

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Physical basis of external supports in chronic venous insufficiency. Author(s): Lippmann HI, Briere JP. Source: Archives of Physical Medicine and Rehabilitation. 1971 December; 52(12): 555-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5136440

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Physiologic similarities between extremities with varicose veins and with chronic venous insufficiency utilizing air plethysmography. Author(s): Cordts PR, Hartono C, LaMorte WW, Menzoian JO. Source: American Journal of Surgery. 1992 September; 164(3): 260-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1415926

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Plasma human atrial natriuretic peptide under compression therapy in patients with chronic venous insufficiency with or without cardiac insufficiency. Author(s): Galm O, Jansen-Genzel W, von Helden J, Wienert V. Source: Vasa. Zeitschrift Fur Gefasskrankheiten. Journal for Vascular Diseases. 1996; 25(1): 48-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8851264

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Platelet-monocyte aggregates in patients with chronic venous insufficiency remain elevated following correction of reflux. Author(s): Rohrer MJ, Claytor RB, Garnette CS, Powell CC, Barnard MR, Furman MI, Michelson AD. Source: Cardiovascular Surgery (London, England). 2002 October; 10(5): 464-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12379404

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Plethysmographic studies of venous distensibility and emptying rate in normal legs and legs with chronic venous insufficiency. Author(s): Gundersen J, Haeger K, Lindell SE. Source: Zentralbl Phlebol. 1971; 10(3): 170-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5093627

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Popliteal vein entrapment presenting as deep venous thrombosis and chronic venous insufficiency. Author(s): Gerkin TM, Beebe HG, Williams DM, Bloom JR, Wakefield TW. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 1993 November; 18(5): 760-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8230561

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PPG, APG, duplex: which noninvasive tests are most appropriate for the management of patients with chronic venous insufficiency? Author(s): Marston WA. Source: Semin Vasc Surg. 2002 March; 15(1): 13-20. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11840421

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Pre-operative evaluation and treatment of patients with chronic venous insufficiency. Author(s): Rulli F, Del Rio P, Sianesi M. Source: Acta Biomed Ateneo Parmense. 1999; 70(5-6): 101-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11402815

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Prevalence and distribution of incompetent perforating veins in chronic venous insufficiency. Author(s): Delis KT, Ibegbuna V, Nicolaides AN, Lauro A, Hafez H. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 1998 November; 28(5): 815-25. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9808848

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Prevalence and risk factors of chronic venous insufficiency. Author(s): Fowkes FG, Evans CJ, Lee AJ. Source: Angiology. 2001 August; 52 Suppl 1: S5-15. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11510598

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Prevalence of varicose veins and chronic venous insufficiency in men and women in the general population: Edinburgh Vein Study. Author(s): Evans CJ, Fowkes FG, Ruckley CV, Lee AJ. Source: Journal of Epidemiology and Community Health. 1999 March; 53(3): 149-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10396491

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Prevention of venous thrombo-embolism. National Working Party on the Prevention and Management of Venous Thrombo-embolism and Chronic Venous Insufficiency. Author(s): Fletcher JP, McLellan D, Cade J, Fisher C, Gibbs H, Stacey M, Vedig A. Source: The Australian and New Zealand Journal of Surgery. 1999 January; 69(1): 4-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9932911

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Progress in the investigation of chronic venous insufficiency. Author(s): Nicolaides A, Christopoulos D, Vasdekis S. Source: Annals of Vascular Surgery. 1989 July; 3(3): 278-92. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2673322

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Prospective evaluation of chronic venous insufficiency based on foot venous pressure measurements and air plethysmography findings. Author(s): Fukuoka M, Sugimoto T, Okita Y. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 2003 October; 38(4): 804-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14560234

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Quality of life (Spain and France): validation of the chronic venous insufficiency questionnaire (CIVIQ). Author(s): Lozano FS, Launois R; Reflux Assessment and Quality of Life Improvement with Micronized Flavonoids (RELIEF) Spanish group. Source: Methods Find Exp Clin Pharmacol. 2002 September; 24(7): 425-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12428431

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Quantification of venous reflux by means of some duplex scanner and light reflection rheography parameters and its correlation with chronic venous insufficiency symptoms. Author(s): Mosti G, Iabichella ML, Picerni P, De Marco G. Source: Minerva Cardioangiol. 2000 November; 48(11): 331-9. English, Italian. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11214424

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Quantitative photoplethysmography in chronic venous insufficiency: a new method of noninvasive estimation of ambulatory venous pressure. Author(s): Norris CS, Beyrau A, Barnes RW. Source: Surgery. 1983 November; 94(5): 758-64. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6635940

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Rationale of the substitute "valve" operation by technique II in the treatment of chronic venous insufficiency. Author(s): Psathakis ND, Psathakis DN. Source: International Angiology : a Journal of the International Union of Angiology. 1985 October-December; 4(4): 397-412. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3914522

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Recompensation of capillary function in chronic venous insufficiency in the supine position. Author(s): Gloor M, Sprenger HJ, Priebe L, Osswald F. Source: Archives of Dermatological Research. 1979 March 31; 264(2): 249-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=464642

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Regarding "chronic venous insufficiency is associated with increased platelet and monocyte activation and aggregation". Author(s): Manfredini R, Zamboni P. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 2000 September; 32(3): 622. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10957675

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Regarding "Healing of venous ulcers in an ambulatory care program: the roles of chronic venous insufficiency and patient compliance". Author(s): Scriven JM, London NJ. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 1996 November; 24(5): 905. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8918344

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Regarding "Optimal therapy for advanced chronic venous insufficiency". Author(s): Escribano JM. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 2003 August; 38(2): 411; Author Reply 411. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12894791

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Reliability study of the Leg-O-Meter, an improved tape measure device, in patients with chronic venous insufficiency of the leg. VEINES Group.(Venous Insufficiency Epidemiologic and Economic Study). Author(s): Berard A, Kurz X, Zuccarelli F, Ducros JJ, Abenhaim L. Source: Angiology. 1998 March; 49(3): 169-73. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9523538

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Restoration of muscle-pump function in chronic venous insufficiency. Author(s): Zelikovski A, Ganz D, Sternberg A, Manoah M, Haddad M, Urca I. Source: Angiology. 1979 February; 30(2): 117-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=434565

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Retinoblastoma protein: a molecular regulator of chronic venous insufficiency. Author(s): Pappas PJ, Gwertzman GA, DeFouw DO, Padberg FT Jr, Silva MB Jr, Duran WN, Hobson RW 2nd. Source: The Journal of Surgical Research. 1998 May; 76(2): 149-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9698515

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Risk factors for chronic venous insufficiency: a dual case-control study. Author(s): Scott TE, LaMorte WW, Gorin DR, Menzoian JO. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 1995 November; 22(5): 622-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7494366

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Role of matrix metalloproteinases 1, 2, and 9 and tissue inhibitor of matrix metalloproteinase-1 in chronic venous insufficiency. Author(s): Saito S, Trovato MJ, You R, Lal BK, Fasehun F, Padberg FT Jr, Hobson RW 2nd, Duran WN, Pappas PJ. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 2001 November; 34(5): 930-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11700497

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Sensory impairment: a feature of chronic venous insufficiency. Author(s): Padberg FT Jr, Maniker AH, Carmel G, Pappas PJ, Silva MB Jr, Hobson RW 2nd. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 1999 November; 30(5): 836-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10550181

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Skin damage in chronic venous insufficiency: does an oxygen diffusion barrier really exist? Author(s): Cheatle TR, McMullin GM, Farrah J, Smith PD, Scurr JH. Source: Journal of the Royal Society of Medicine. 1990 August; 83(8): 493-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2231575

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Skin elasticity in patients with chronic venous insufficiency. Author(s): Jagtman BA, Kuiper JP, Brakkee AJ, Wijn PF. Source: Vasa. Zeitschrift Fur Gefasskrankheiten. Journal for Vascular Diseases. 1985; 14(2): 113-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4013487

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Skin microcirculatory responses in chronic venous insufficiency: the effect of shortterm venous hypertension. Author(s): Cheatle TR, Coleridge Smith PD, Scurr JH. Source: Vasa. Zeitschrift Fur Gefasskrankheiten. Journal for Vascular Diseases. 1991; 20(1): 63-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2031403

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Skin temperature and chronic venous insufficiency. Author(s): Kelechi TJ, Haight BK, Herman J, Michel Y, Brothers T, Edlund B. Source: Journal of Wound, Ostomy, and Continence Nursing : Official Publication of the Wound, Ostomy and Continence Nurses Society / Wocn. 2003 January; 30(1): 17-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12529590

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Socioeconomic impact of chronic venous insufficiency and leg ulcers. Author(s): Ruckley CV. Source: Angiology. 1997 January; 48(1): 67-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8995346

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Socio-economic impact of chronic venous insufficiency. An underestimated public health problem. Author(s): Van den Oever R, Hepp B, Debbaut B, Simon I. Source: International Angiology : a Journal of the International Union of Angiology. 1998 September; 17(3): 161-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9821029

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Squamous cell carcinoma and basal cell carcinoma within the clinical picture of a chronic venous insufficiency in the third stage. Author(s): Blank AA, Schnyder UW. Source: Dermatologica. 1990; 181(3): 248-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2269390

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Structured exercise improves calf muscle pump function in chronic venous insufficiency: a randomized trial. Author(s): Padberg FT Jr, Johnston MV, Sisto SA. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 2004 January; 39(1): 79-87. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14718821

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Subcutaneous calcification of the legs in chronic venous insufficiency. Author(s): Sundquist AB, Kurien A, Duke M. Source: Conn Med. 1966 January; 30(1): 41-2. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5903192

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Surgical management of chronic venous insufficiency. Author(s): Weiss VJ, Surowiec SM, Lumsden AB. Source: Annals of Vascular Surgery. 1998 September; 12(5): 504-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9732432

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Surgical management of chronic venous insufficiency. Author(s): Lofgren KA. Source: Acta Chir Scand Suppl. 1988; 544: 62-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3051827

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Surgical management of varicose veins in advanced chronic venous insufficiency. Author(s): Cassina PC, Brunner U, Kessler W. Source: Current Problems in Dermatology. 1999; 27: 174-81. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10547744

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Target selection for surgical intervention in severe chronic venous insufficiency: comparison of duplex scanning and phlebography. Author(s): Depalma RG, Kowallek DL, Barcia TC, Cafferata HT. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 2000 November; 32(5): 913-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11054223

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Technetium-99m MDP uptake in chronic venous insufficiency. Author(s): Lucas-Fehm LM, Makler PT Jr, Shapiro B. Source: Clinical Nuclear Medicine. 1986 November; 11(11): 803. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3791792

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The 4 rights of compression therapy for patients with chronic venous insufficiency and venous ulceration. Author(s): Bauer NA. Source: Home Healthcare Nurse. 1998 July; 16(7): 443-8; Quiz 448-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9726204

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The clinical impact of iliac venous stents in the management of chronic venous insufficiency. Author(s): Raju S, Owen S Jr, Neglen P. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 2002 January; 35(1): 8-15. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11802127

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The effect of passage number on fibroblast cellular senescence in patients with chronic venous insufficiency with and without ulcer. Author(s): Raffetto JD, Mendez MV, Phillips TJ, Park HY, Menzoian JO. Source: American Journal of Surgery. 1999 August; 178(2): 107-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10487259

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The influence of environmental factors in chronic venous insufficiency. Author(s): Jawien A. Source: Angiology. 2003 July-August; 54 Suppl 1: S19-31. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12934754

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The management of chronic venous insufficiency. Author(s): Gould SA, Kerstein MD. Source: Conn Med. 1979 March; 43(3): 127-30. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=421472

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The mechanical basis of supportive therapy in chronic venous insufficiency. I. The ankle pump. Author(s): Lippmann HI. Source: Zentralbl Phlebol. 1970 May; 9(2): 77-86. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5484286

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The microvascular pathophysiology of chronic venous insufficiency. Author(s): McDonagh PF. Source: Yale J Biol Med. 1993 January-February; 66(1): 27-36. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8256461

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The muscle pump function in chronic venous insufficiency: plethysmographic results. Author(s): Aelvoet G, Geerts R, Dockx P. Source: Acta Dermato-Venereologica. 1984; 64(5): 428-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6208724

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The non-healing leg ulcer: peripheral vascular disease, chronic venous insufficiency, and ischemic vasculitis. Author(s): Kerstein MD. Source: Ostomy Wound Manage. 1996 November-December; 42(10A Suppl): 19S-35S. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9397880

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The peripheral resistance in arteries of legs is inversely proportional to the severity of chronic venous insufficiency. Author(s): Malanin K, Haapanen A, Kolari PJ, Helander I, Havu VK. Source: Acta Dermato-Venereologica. 1997 January; 77(1): 22-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9059671

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The prevalence of hyperhomocysteinemia, methylene tetrahydrofolate reductase C677T mutation, and vitamin B12 and folate deficiency in patients with chronic venous insufficiency. Author(s): Sam RC, Burns PJ, Hobbs SD, Marshall T, Wilmink AB, Silverman SH, Bradbury AW. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 2003 November; 38(5): 904-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14603192

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The role of air plethysmography in the diagnosis of chronic venous insufficiency. Author(s): Criado E, Farber MA, Marston WA, Daniel PF, Burnham CB, Keagy BA. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 1998 April; 27(4): 660-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9576079

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The role of the distribution and anatomic extent of reflux in the development of signs and symptoms in chronic venous insufficiency. Author(s): Labropoulos N, Delis K, Nicolaides AN, Leon M, Ramaswami G. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 1996 March; 23(3): 504-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8601895

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The role of venous reflux and calf muscle pump function in nonthrombotic chronic venous insufficiency. Correlation with severity of signs and symptoms. Author(s): Labropoulos N, Giannoukas AD, Nicolaides AN, Veller M, Leon M, Volteas N. Source: Archives of Surgery (Chicago, Ill. : 1960). 1996 April; 131(4): 403-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8615726

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The utilisation of superficial venous surgery for chronic venous insufficiency by the U.K. Asian population. Author(s): Hobbs SD, Sam R, Rehman A, Marshall T, Wilmink AB, Bradbury AW. Source: European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery. 2003 September; 26(3): 322-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14509898

Studies

43

•

The value of air plethysmography in predicting clinical outcome after surgical treatment of chronic venous insufficiency. Author(s): Owens LV, Farber MA, Young ML, Carlin RE, Criado-Pallares E, Passman MA, Keagy BA, Marston WA. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 2000 November; 32(5): 961-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11054228

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The value of foot-to-throat circulation time in chronic venous insufficiency and lymphedema of the leg. Author(s): VanHaeften FF. Source: Vascular Surgery. 1968 September; 2(3): 174-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5759060

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The veno-arteriolar reflex in chronic venous insufficiency. Author(s): Shami SK, Scurr JH, Smith PD. Source: Vasa. Zeitschrift Fur Gefasskrankheiten. Journal for Vascular Diseases. 1993; 22(3): 227-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8379253

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The venous wall and valvular function in chronic venous insufficiency. Author(s): Thulesius O. Source: International Angiology : a Journal of the International Union of Angiology. 1996 June; 15(2): 114-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8803634

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Therapeutic management of chronic venous insufficiency: microcirculation as a target. Author(s): Bergan JJ, Schmid-Schonbein GW. Source: Microcirculation (New York, N.Y. : 1994). 2000; 7(6 Pt 2): S23-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11151967

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Thrombophlebitis and chronic venous insufficiency. Author(s): Young JR. Source: Geriatrics. 1973 September; 28(9): 63-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4125262

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Transcapillary and interstitial diffusion of Na-fluorescein in chronic venous insufficiency with white atrophy. Author(s): Bollinger A, Jager K, Geser A, Sgier F, Seglias J. Source: Int J Microcirc Clin Exp. 1982; 1(1): 5-17. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7188441

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Transcutaneous oxygen tension in chronic venous insufficiency syndrome. Author(s): Neumann HA, van Leeuwen M, van den Broek MJ, Berretty PJ. Source: Vasa. Zeitschrift Fur Gefasskrankheiten. Journal for Vascular Diseases. 1984; 13(3): 213-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6485525

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Transcutaneous oxygen tension in patients with and without pericapillary fibrin cuffs in chronic venous insufficiency, porphyria cutanea tarda and non-venous leg ulcers. Author(s): Neumann HA, van den Broek MJ, Boersma IH, Veraart JC. Source: Vasa. Zeitschrift Fur Gefasskrankheiten. Journal for Vascular Diseases. 1996; 25(2): 127-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8659214

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Update on fundamental causes and management of chronic venous insufficiency. Executive summary. Author(s): Allegra C, Bergan J. Source: Angiology. 2003 July-August; 54 Suppl 1: S1-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12934751

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Value of phlebomanometry in the diagnosis of chronic venous insufficiency. Author(s): Siano Quiros R, Kitainik E. Source: The Journal of Cardiovascular Surgery. 1967 September-October; 8(5): 416-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6060231

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Valvular density alone cannot account for sites of chronic venous insufficiency and ulceration in the lower extremity. Author(s): Aharinejad S, Nedwed S, Michlits W, Dunn R, Abraham D, Vernadakis A, Marks SC Jr. Source: Microcirculation (New York, N.Y. : 1994). 2001 October; 8(5): 347-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11687946

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Valvuloplasty in chronic venous insufficiency: a worthwhile procedure? Author(s): Raju S. Source: Vasa Suppl. 1991; 33: 42-3. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1788759

Studies

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Varicose veins (VV) and chronic venous insufficiency (CVI). Medical and socioeconomic aspects, Basle study. Author(s): Biland L, Widmer LK. Source: Acta Chir Scand Suppl. 1988; 544: 9-11. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3176810

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Varicose veins and chronic venous insufficiency disorder or disease? A critical epidemiological review. Author(s): Madar G, Widmer LK, Zemp E, Maggs M. Source: Vasa. Zeitschrift Fur Gefasskrankheiten. Journal for Vascular Diseases. 1986; 15(2): 126-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3487896

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Varicose veins and chronic venous insufficiency in Brazil: prevalence among 1755 inhabitants of a country town. Author(s): Maffei FH, Magaldi C, Pinho SZ, Lastoria S, Pinho W, Yoshida WB, Rollo HA. Source: International Journal of Epidemiology. 1986 June; 15(2): 210-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3721683

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Varicose veins and chronic venous insufficiency. Author(s): da Silva A, Widmer LK, Martin H, Mall T, Glaus L, Schneider M. Source: Vasa. Zeitschrift Fur Gefasskrankheiten. Journal for Vascular Diseases. 1974; 3(2): 118-25. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4831533

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Varicose veins and chronic venous insufficiency. Author(s): Fegan WG. Source: The Practitioner. 1970 April; 204(222): 555-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5443541

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Vasomotion in the leg skin of patients with chronic venous insufficiency. Author(s): Chittenden SJ, Shami SK, Cheatle TR, Scurr JH, Coleridge Smith PD. Source: Vasa. Zeitschrift Fur Gefasskrankheiten. Journal for Vascular Diseases. 1992; 21(2): 138-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1621430

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Venoarteriolar response to experimental venous hypertension in legs with chronic venous insufficiency and in healthy legs, measured using a double-wavelength laser Doppler technique. Author(s): Malanin K, Vilkko P, Kolari PJ. Source: Angiology. 1998 September; 49(9): 729-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9756424

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Venous morphology predicts class of chronic venous insufficiency. Author(s): Jones GT, Solomon C, Moaveni A, van Rij AM, Thomson IA, Galvin I. Source: European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery. 1999 October; 18(4): 349-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10550272

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Venous plethysmography in the diagnosis of chronic venous insufficiency. Author(s): Bygdeman S, Aschberg S, Hindmarsh T. Source: Acta Chir Scand. 1971; 137(5): 423-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5149367

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Venous ulcers in chronic venous insufficiency: King Khalid University Hospital experience. Author(s): Al-Salman MM. Source: International Angiology : a Journal of the International Union of Angiology. 1998 June; 17(2): 108-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9754899

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Volume tests for chronic venous insufficiency: an appraisal. Author(s): Peirce EC 2nd, Chiang K, Schanzer H. Source: Surgery. 1991 May; 109(5): 567-74. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2020901

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White cell and platelet trapping in patients with chronic venous insufficiency. Author(s): Thomas PR, Dormandy JA. Source: Phlebologie. 1988 November-December; 41(4): 771-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3247394

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CHAPTER

2.

NUTRITION AND INSUFFICIENCY

CHRONIC

VENOUS

Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and chronic venous insufficiency.

Finding Nutrition Studies on Chronic Venous Insufficiency The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail: [email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.7 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “chronic venous insufficiency” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

7

Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.

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The following information is typical of that found when using the “Full IBIDS Database” to search for “chronic venous insufficiency” (or a synonym): •

Drug treatment of chronic venous insufficiency and venous ulceration: a review. Author(s): University College and Middlesex School of Medicine, Middlesex Hospital, London. Source: Cheatle, T R Scurr, J H Smith, P D J-R-Soc-Med. 1991 June; 84(6): 354-8 0141-0768

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Edema in chronic venous insufficiency and the effect of modern pharmacotherapy. Source: Nicolaides, A N Angiology. 2000 January; 51(1): 1-2 0003-3197

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Efficacy of orally administered extract of red vine leaf AS 195 (folia vitis viniferae) in chronic venous insufficiency (stages I-II). A randomized, double-blind, placebocontrolled trial. Author(s): Institut fur Transfusionsmedizin und Immunhaematologie, Universitatsklinikum Charite, Berlin, Germany. Source: Kiesewetter, H Koscielny, J Kalus, U Vix, J M Peil, H Petrini, O van Toor, B S de Mey, C Arzneimittelforschung. 2000 February; 50(2): 109-17 0004-4172

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Flavonoids. A review of the pharmacology and therapeutic efficacy of Daflon 500 mg in patients with chronic venous insufficiency and related disorders. Author(s): Department of Gastroenterological Surgery, Herlev University Hospital, Copenhagen, Denmark. Source: Struckmann, J R Nicolaides, A N Angiology. 1994 June; 45(6): 419-28 0003-3197

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Investigation of the efficacy of oxerutins compared to placebo in patients with chronic venous insufficiency treated with compression stockings. Author(s): Zyma GmbH, Medizin und Entwicklung, Munich, Germany. Source: Unkauf, M Rehn, D Klinger, J de la Motte, S Grossmann, K Arzneimittelforschung. 1996 May; 46(5): 478-82 0004-4172

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Therapeutic approach to chronic venous insufficiency and its complications: place of Daflon 500 mg. Author(s): Department of Surgery, University of California, San Diego, USA. Source: Bergan, J J Schmid Schonbein, G W Takase, S Angiology. 2001 August; 52 Suppl 1: S43-7 0003-3197

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Therapeutic effects of hidrosmin on chronic venous insufficiency of the lower limbs. Author(s): Vascular Surgery Services, University Hospital of the Canary Islands, Tenerife, Spain. Source: Dominguez, C Brautigam, I Gonzalez, E Gonzalez, J A Nazco, J Valiente, R Boada, J Curr-Med-Res-Opin. 1992; 12(10): 623-30 0300-7995

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Total triterpenic fraction of Centella asiatica in chronic venous insufficiency and in high-perfusion microangiopathy. Author(s): Vascular Unit, Ealing Hospital, London, UK. Source: Incandela, L Cesarone, M R Cacchio, M De Sanctis, M T Santavenere, C D'Auro, M G Bucci, M Belcaro, G Angiology. 2001 October; 52 Suppl 2: S9-13 0003-3197

Nutrition

49

Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •

healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0

•

The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov

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The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov

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The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/

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The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/

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Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/

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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/

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Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/

Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats

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Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html

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Google: http://directory.google.com/Top/Health/Nutrition/

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Healthnotes: http://www.healthnotes.com/

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Open Directory Project: http://dmoz.org/Health/Nutrition/

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Yahoo.com: http://dir.yahoo.com/Health/Nutrition/

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WebMDHealth: http://my.webmd.com/nutrition

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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

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Chronic Venous Insufficiency

The following is a specific Web list relating to chronic venous insufficiency; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

Food and Diet Berries Source: Healthnotes, Inc.; www.healthnotes.com Tea Source: Healthnotes, Inc.; www.healthnotes.com

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CHAPTER 3. ALTERNATIVE MEDICINE AND CHRONIC VENOUS INSUFFICIENCY Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to chronic venous insufficiency. At the conclusion of this chapter, we will provide additional sources.

National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to chronic venous insufficiency and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “chronic venous insufficiency” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to chronic venous insufficiency: •

A comparative clinical trial of graduated compression stockings and O-(betahydroxyethyl)-rutosides (HR) in the treatment of patients with chronic venous insufficiency. Author(s): Neumann HA, van den Broek MJ. Source: Z Lymphol. 1995 August; 19(1): 8-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7571793

•

A double-blind trial of O-(beta-hydroxyethyl)-rutoside in patients with chronic venous insufficiency. Author(s): Bergqvist D, Hallbook T, Lindblad B, Lindhagen A. Source: Vasa. Zeitschrift Fur Gefasskrankheiten. Journal for Vascular Diseases. 1981; 10(3): 253-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7025500

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A long term treatment with a venotropic drug. Results on efficacy and safety of Daflon 500 mg in chronic venous insufficiency. Author(s): Guillot B, Guilhou JJ, de Champvallins M, Mallet C, Moccatti D, Pointel JP. Source: International Angiology : a Journal of the International Union of Angiology. 1989 October-December; 8(4 Suppl): 67-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2632651

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A systematic review of pneumatic compression for treatment of chronic venous insufficiency and venous ulcers. Author(s): Berliner E, Ozbilgin B, Zarin DA. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 2003 March; 37(3): 539-44. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12618689

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An original microhaemorheological approach to the pharmacological effects of Daflon 500 mg in severe chronic venous insufficiency. Author(s): Allegra C, Bartolo M Jr, Carioti B, Cassiani D. Source: Int J Microcirc Clin Exp. 1995; 15 Suppl 1: 50-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8748890

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Are the phlebotonic properties shown in clinical pharmacology predictive of a therapeutic benefit in chronic venous insufficiency? Our experience with Daflon 500 mg. Author(s): Tsouderos Y. Source: International Angiology : a Journal of the International Union of Angiology. 1989 October-December; 8(4 Suppl): 53-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2698902

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Characteristics of chronic venous insufficiency in 895 patients followed in general practice. Author(s): Boccalon H, Janbon C, Saumet JL, Tafani A, Roux T, Vilain C. Source: International Angiology : a Journal of the International Union of Angiology. 1997 December; 16(4): 226-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9543218

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Chronic venous insufficiency treated with hydroxyethylrutosides (HR). Author(s): Sorensen AH, Hansen H. Source: Angiologica. 1970; 7(3): 187-92. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4913054

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Chronic venous insufficiency: worldwide results of the RELIEF study. Reflux assEssment and quaLity of lIfe improvEment with micronized Flavonoids. Author(s): Jantet G.

Alternative Medicine 53

Source: Angiology. 2002 May-June; 53(3): 245-56. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12025911 •

Clinical benefits of Daflon 500 mg in the most severe stages of chronic venous insufficiency. Author(s): Ramelet AA. Source: Angiology. 2001 August; 52 Suppl 1: S49-56. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11510597

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Comparative clinical efficacy and tolerability of oxerutins and horse chestnut extract in patients with chronic venous insufficiency. Author(s): Rehn D, Unkauf M, Klein P, Jost V, Lucker PW. Source: Arzneimittel-Forschung. 1996 May; 46(5): 483-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8737631

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Comparative study of Venostasin and Pycnogenol in chronic venous insufficiency. Author(s): Koch R. Source: Phytotherapy Research : Ptr. 2002 March; 16 Suppl 1: S1-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11933130

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Comparison between the efficacy and tolerability of oxerutins and troxerutin in the treatment of patients with chronic venous insufficiency. Author(s): Rehn D, Golden G, Nocker W, Diebschlag W, Lehmacher W. Source: Arzneimittel-Forschung. 1993 October; 43(10): 1060-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8267669

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Comparison of leg compression stocking and oral horse-chestnut seed extract therapy in patients with chronic venous insufficiency. Author(s): Diehm C, Trampisch HJ, Lange S, Schmidt C. Source: Lancet. 1996 February 3; 347(8997): 292-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8569363

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Controlled studies of Daflon 500 mg in chronic venous insufficiency. Author(s): Geroulakos G, Nicolaides AN. Source: Angiology. 1994 June; 45(6 Pt 2): 549-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8203786

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Diagnosis and treatment in the management of chronic venous insufficiency. Author(s): Yuwono HS. Source: Clinical Hemorheology and Microcirculation. 2000; 23(2-4): 233-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11321445

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Drug treatment of chronic venous insufficiency and venous ulceration: a review. Author(s): Cheatle TR, Scurr JH, Smith PD. Source: Journal of the Royal Society of Medicine. 1991 June; 84(6): 354-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2061904

•

Edema in chronic venous insufficiency and the effect of modern pharmacotherapy. Author(s): Nicolaides AN. Source: Angiology. 2000 January; 51(1): 1-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10667635

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Effect of O-( -hydroxyethyl)-rutosides on oedema in chronic venous insufficiency of the lower limb. A double blind trial. Author(s): Rish L, Rodriguez JC. Source: Angiologica. 1972; 9(1): 62-6. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4657310

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Efficacy and safety of a Butcher's broom preparation (Ruscus aculeatus L. extract) compared to placebo in patients suffering from chronic venous insufficiency. Author(s): Vanscheidt W, Jost V, Wolna P, Lucker PW, Muller A, Theurer C, Patz B, Grutzner KI. Source: Arzneimittel-Forschung. 2002; 52(4): 243-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12040966

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Efficacy of a 6-month treatment with Daflon 500 mg in patients with venous leg ulcers associated with chronic venous insufficiency. Author(s): Roztocil K, Stvrtinova V, Strejcek J. Source: International Angiology : a Journal of the International Union of Angiology. 2003 March; 22(1): 24-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12771852

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Efficacy of orally administered extract of red vine leaf AS 195 (folia vitis viniferae) in chronic venous insufficiency (stages I-II). A randomized, double-blind, placebocontrolled trial. Author(s): Kiesewetter H, Koscielny J, Kalus U, Vix JM, Peil H, Petrini O, van Toor BS, de Mey C. Source: Arzneimittel-Forschung. 2000 February; 50(2): 109-17. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10719612

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Efficacy, routine effectiveness, and safety of horsechestnut seed extract in the treatment of chronic venous insufficiency. A meta-analysis of randomized controlled trials and large observational studies. Author(s): Siebert U, Brach M, Sroczynski G, Berla K.

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Source: International Angiology : a Journal of the International Union of Angiology. 2002 December; 21(4): 305-15. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12518108 •

Evaluation of haemorheological and microcirculatory disturbances in chronic venous insufficiency: activity of Daflon 500 mg. Author(s): Le Devehat C, Khodabandehlou T, Vimeux M, Kempf C. Source: Int J Microcirc Clin Exp. 1997; 17 Suppl 1: 27-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9477042

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Fibrinolysis and hemorheology in chronic venous insufficiency: a double blind study of troxerutin efficiency. Author(s): Boisseau MR, Taccoen A, Garreau C, Vergnes C, Roudaut MF, GarreauGomez B. Source: The Journal of Cardiovascular Surgery. 1995 August; 36(4): 369-74. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7593149

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Flavonoids. A review of the pharmacology and therapeutic efficacy of Daflon 500 mg in patients with chronic venous insufficiency and related disorders. Author(s): Struckmann JR, Nicolaides AN. Source: Angiology. 1994 June; 45(6): 419-28. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8203767

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Horse chestnut seed extract for chronic venous insufficiency. Author(s): Pittler M, Ernst E. Source: Cochrane Database Syst Rev. 2004; 2: Cd003230. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15106197

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Horse chestnut seed extract for chronic venous insufficiency. Author(s): Pittler MH, Ernst E. Source: Cochrane Database Syst Rev. 2002; (1): Cd003230. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11869657

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Horse-chestnut seed extract for chronic venous insufficiency. Author(s): Bielanski TE, Piotrowski ZH. Source: The Journal of Family Practice. 1999 March; 48(3): 171-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10086755

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Horse-chestnut seed extract for chronic venous insufficiency. Author(s): Simini B.

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Source: Lancet. 1996 April 27; 347(9009): 1182-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8609778 •

Horse-chestnut seed extract for chronic venous insufficiency. Author(s): Vayssairat M, Debure C, Maurel A, Gaitz JP. Source: Lancet. 1996 April 27; 347(9009): 1182; Author Reply 1183. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8609777

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Horse-chestnut seed extract for chronic venous insufficiency. A criteria-based systematic review. Author(s): Pittler MH, Ernst E. Source: Archives of Dermatology. 1998 November; 134(11): 1356-60. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9828868

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Hydroxyethylrutosides in elderly patients with chronic venous insufficiency: its efficacy and tolerability. Author(s): MacLennan WJ, Wilson J, Rattenhuber V, Dikland WJ, Vanderdonckt J, Moriau M. Source: Gerontology. 1994; 40(1): 45-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8034203

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Increase in circulating endothelial cells in patients with primary chronic venous insufficiency: protective effect of Ginkor Fort in a randomized double-blind, placebocontrolled clinical trial. Author(s): Janssens D, Michiels C, Guillaume G, Cuisinier B, Louagie Y, Remacle J. Source: Journal of Cardiovascular Pharmacology. 1999 January; 33(1): 7-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9890390

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Inflammation in chronic venous insufficiency. Is the problem insurmountable? Author(s): Takase S, Delano FA, Lerond L, Bergan JJ, Schmid-Schonbein GW. Source: Journal of Vascular Research. 1999; 36 Suppl 1: 3-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10474045

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Intravital capillaroscopy in patients with chronic venous insufficiency and lymphoedema: relevance to Daflon 500 mg. Author(s): Bollinger A, Herrig I, Fischer M, Hoffmann U, Franzeck UK. Source: Int J Microcirc Clin Exp. 1995; 15 Suppl 1: 41-4. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8748888

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Investigation of the efficacy of oxerutins compared to placebo in patients with chronic venous insufficiency treated with compression stockings. Author(s): Unkauf M, Rehn D, Klinger J, de la Motte S, Grossmann K.

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Source: Arzneimittel-Forschung. 1996 May; 46(5): 478-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8737630 •

Laser Doppler and transcutaneous oximetry: modern investigations to assess drug efficacy in chronic venous insufficiency. Author(s): Belcaro G, Cesarone MR, de Sanctis MT, Incandela L, Laurora G, Fevrier B, Wargon C, De Gregoris P. Source: Int J Microcirc Clin Exp. 1995; 15 Suppl 1: 45-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8748889

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Leg oedema protection from a buckwheat herb tea in patients with chronic venous insufficiency: a single-centre, randomised, double-blind, placebo-controlled clinical trial. Author(s): Ihme N, Kiesewetter H, Jung F, Hoffmann KH, Birk A, Muller A, Grutzner KI. Source: European Journal of Clinical Pharmacology. 1996; 50(6): 443-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8858269

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Meta-analysis of clinical trials of Cyclo 3 Fort in the treatment of chronic venous insufficiency. Author(s): Boyle P, Diehm C, Robertson C. Source: International Angiology : a Journal of the International Union of Angiology. 2003 September; 22(3): 250-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14612852

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Meta-analysis of hydroxyethylrutosides in the treatment of chronic venous insufficiency. Author(s): Poynard T, Valterio C. Source: Vasa. Zeitschrift Fur Gefasskrankheiten. Journal for Vascular Diseases. 1994; 23(3): 244-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7975870

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Micronised purified flavonoid fraction: a review of its use in chronic venous insufficiency, venous ulcers and haemorrhoids. Author(s): Lyseng-Williamson KA, Perry CM. Source: Drugs. 2003; 63(1): 71-100. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12487623

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Micronized purified flavonoid fraction and the treatment of chronic venous insufficiency: microcirculatory mechanisms. Author(s): Smith PD.

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Source: Microcirculation (New York, N.Y. : 1994). 2000; 7(6 Pt 2): S35-40. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11151970 •

Oedema protective properties of the red vine leaf extract AS 195 (Folia vitis viniferae) in the treatment of chronic venous insufficiency. A 6-week observational clinical trial. Author(s): Schaefer E, Peil H, Ambrosetti L, Petrini O. Source: Arzneimittel-Forschung. 2003; 53(4): 243-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12785119

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Oxerutins (Venoruton): efficacy in chronic venous insufficiency--a double-blind, randomized, controlled study. Author(s): Petruzzellis V, Troccoli T, Candiani C, Guarisco R, Lospalluti M, Belcaro G, Dugall M. Source: Angiology. 2002 May-June; 53(3): 257-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12025912

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Paroven in the treatment of chronic venous insufficiency. Author(s): Pulvertaft TB. Source: The Practitioner. 1979 December; 223(1338): 838-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=396527

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Pharmacodynamics and pharmacokinetics of Veliten (rutine, alpha-tocopherol and ascorbic acid) in patients with chronic venous insufficiency. Author(s): Auteri A, Pasqui AL, Bruni F, Di Renzo M, Bova G, Chiarion C, Delchambre J. Source: Int J Clin Pharmacol Res. 1994; 14(3): 95-100. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7883390

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Pharmacodynamics of troxerutine in patients with chronic venous insufficiency: correlations with plasma drug levels. Author(s): Auteri A, Blardi P, Frigerio C, de Lillo L, di Perri T. Source: Int J Clin Pharmacol Res. 1990; 10(4): 235-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2079382

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PYCNOGENOL in chronic venous insufficiency. Author(s): Petrassi C, Mastromarino A, Spartera C. Source: Phytomedicine : International Journal of Phytotherapy and Phytopharmacology. 2000 October; 7(5): 383-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11081989

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Pycnogenol in chronic venous insufficiency. Author(s): Arcangeli P.

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Source: Fitoterapia. 2000 June; 71(3): 236-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10844161 •

Rational therapy of chronic venous insufficiency--chances and limits of the therapeutic use of horse-chestnut seeds extract. Author(s): Ottillinger B, Greeske K. Source: Bmc Cardiovascular Disorders [electronic Resource]. 2001; 1(1): 5. Epub 2001 December 07. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11747472

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Regulation of adhesion molecules: a new target for the treatment of chronic venous insufficiency. Author(s): Verbeuren TJ, Bouskela E, Cohen RA, Vanhoutte PM. Source: Microcirculation (New York, N.Y. : 1994). 2000; 7(6 Pt 2): S41-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11151971

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Studies on blood viscosity in chronic venous insufficiency, with regard to treatment with flavonoids. Author(s): Thulesius O, Gjores JE. Source: Angiologica. 1972; 9(3-6): 390-6. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4669475

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The effect of O-( -hydroxyethyl)-rutosides (HR) on the peripheral circulation in patients with chronic venous insufficiency. Author(s): Roztocil K, Fischer A, Novak P, Razgova L. Source: European Journal of Clinical Pharmacology. 1971 September; 3(4): 243-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5151308

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The efficacy and safety of a coumarin-/troxerutin-combination (SB-LOT) in patients with chronic venous insufficiency: a double blind placebo-controlled randomised study. Author(s): Vanscheidt W, Rabe E, Naser-Hijazi B, Ramelet AA, Partsch H, Diehm C, Schultz-Ehrenburg U, Spengel F, Wirsching M, Gotz V, Schnitker J, Henneicke-von Zepelin HH. Source: Vasa. Zeitschrift Fur Gefasskrankheiten. Journal for Vascular Diseases. 2002 August; 31(3): 185-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12236023

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Therapeutic approach to chronic venous insufficiency and its complications: place of Daflon 500 mg. Author(s): Bergan JJ, Schmid-Schonbein GW, Takase S.

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Source: Angiology. 2001 August; 52 Suppl 1: S43-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11510596 •

Therapeutic effects of hidrosmin on chronic venous insufficiency of the lower limbs. Author(s): Dominguez C, Brautigam I, Gonzalez E, Gonzalez JA, Nazco J, Valiente R, Boada J. Source: Current Medical Research and Opinion. 1992; 12(10): 623-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1633720

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Three treatments for chronic venous insufficiency: escin, hydroxyethylrutoside, and Daflon. Author(s): Frick RW. Source: Angiology. 2000 March; 51(3): 197-205. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10744007

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Total triterpenic fraction of Centella asiatica in chronic venous insufficiency and in high-perfusion microangiopathy. Author(s): Incandela L, Cesarone MR, Cacchio M, De Sanctis MT, Santavenere C, D'Auro MG, Bucci M, Belcaro G. Source: Angiology. 2001 October; 52 Suppl 2: S9-13. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11666128

Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •

Alternative Medicine Foundation, Inc.: http://www.herbmed.org/

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AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats

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Chinese Medicine: http://www.newcenturynutrition.com/

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drkoop.com: http://www.drkoop.com/InteractiveMedicine/IndexC.html

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Family Village: http://www.familyvillage.wisc.edu/med_altn.htm

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Google: http://directory.google.com/Top/Health/Alternative/

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Healthnotes: http://www.healthnotes.com/

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MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine

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Open Directory Project: http://dmoz.org/Health/Alternative/

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HealthGate: http://www.tnp.com/

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WebMDHealth: http://my.webmd.com/drugs_and_herbs

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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

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•

Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/

The following is a specific Web list relating to chronic venous insufficiency; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

General Overview Cardiovascular Disease Overview Source: Healthnotes, Inc.; www.healthnotes.com Chronic Venous Insufficiency Source: Healthnotes, Inc.; www.healthnotes.com Edema Source: Healthnotes, Inc.; www.healthnotes.com Hemorrhoids Source: Prima Communications, Inc.www.personalhealthzone.com Peripheral Vascular Disease Source: Healthnotes, Inc.; www.healthnotes.com Restless Legs Syndrome Source: Healthnotes, Inc.; www.healthnotes.com Varicose Veins Source: Prima Communications, Inc.www.personalhealthzone.com

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Herbs and Supplements Aesculus Alternative names: Horse Chestnut; Aesculus hippocastanum L. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Aortic Glycosaminoglycans Source: Prima Communications, Inc.www.personalhealthzone.com Butcher’s Broom Alternative names: Ruscus aculeatus Source: Healthnotes, Inc.; www.healthnotes.com Butcher's Broom Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10010,00.html Gotu Kola Alternative names: Centella asiatica Source: Healthnotes, Inc.; www.healthnotes.com

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Grape Seed Alternative names: Vitis vinifera Source: Integrative Medicine Communications; www.drkoop.com Horse Chestnut Alternative names: Aesculus hippocastanum Source: Healthnotes, Inc.; www.healthnotes.com Horse Chestnut Source: Prima Communications, Inc.www.personalhealthzone.com Horse Chestnut Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10037,00.html OPCS (Oligomeric Proanthocyanidins) Source: Prima Communications, Inc.www.personalhealthzone.com Vitis Vinifera Source: Integrative Medicine Communications; www.drkoop.com

General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.

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CHAPTER

4.

PATENTS ON INSUFFICIENCY

CHRONIC

VENOUS

Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.8 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “chronic venous insufficiency” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on chronic venous insufficiency, we have not necessarily excluded non-medical patents in this bibliography.

Patent Applications on Chronic Venous Insufficiency As of December 2000, U.S. patent applications are open to public viewing.9 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to chronic venous insufficiency: 8Adapted

from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm. 9 This has been a common practice outside the United States prior to December 2000.

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Chronic Venous Insufficiency

Composition for treating chronic venous insufficiencies using an extract of red vine leaves Inventor(s): Esperester, Anke; (Mainz, DE), Frey, Hans W.; (Ockenheim, DE), Vix, JeanMichel; (Weisbaden, DE) Correspondence: Boehringer Ingelheim Corporation; 900 Ridgebury Road; P. O. Box 368; Ridgefield; CT; 06877; US Patent Application Number: 20030031739 Date filed: October 2, 2002 Abstract: The invention relates to a dietary supplement consisting of an aqueous extract of red vine leaves and an acceptable carrier which prevents and reduces the discomfort relating to mild-to-moderate chronic venous insufficiency of the legs. Excerpt(s): This application is a divisional of U.S. patent application Ser. No. 09/691,003, filed Oct. 18, 2000, which claims, as does the present application, priority benefit to U.S. Provisional Application serial No. 60/160,518 filed Oct. 20, 1999, the disclosures of all of which are incorporated by reference in their entirety. The present invention relates to a dietary supplement, and more particularly, to a dietary supplement for preventing or alleviating the discomfort associated with mild-to-moderate chronic venous insufficiency of the lower extremities. Presently, there are millions of people around the world who suffer from mild-to-moderate chronic venous insufficiency of the legs. This common condition is characterised by an inadequacy of the venous circulation to return blood from the legs to the heart. The lack of adequate venous return results in venous stasis and an increased pressure within the venous circulation, promoting the development of oedema and tissular water retention. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Compression device for treatment of chronic venous insufficiency Inventor(s): Burek, Paul P.; (Centennial, CO), Jensen, Jeffrey L.; (Evergreen, CO), Macfarlane, Daniel J.; (Littleton, CO) Correspondence: Gibson, Dunn & Crutcher Llp; Suite 4100; 1801 California Street; Denver; CO; 80202; US Patent Application Number: 20040111048 Date filed: December 4, 2002 Abstract: The present invention provides a medical device and treatment method for chronic venous insufficiency and related medical conditions. The device is an inflatable stocking which, when inflated, applies pressure to the foot and lower leg of a patient. The device has several sections that are inflatable to different pressures so that gradient pressure may be applied. The sections are vertically disposed so that greatest pressure is applied to the foot and lower portion of the lower leg, somewhat less pressure is applied to the middle portion of the lower leg, and the least pressure is applied to the upper section of the lower leg. The device surrounds the entire treatment area so that the treated area will not swell. Excerpt(s): The present invention relates to medical devices and treatments for chronic venous insufficiency and related medical conditions, and more particularly to a device and treatment incorporating an inflatable compression device capable of applying gradient compression to the foot and lower leg of a patient. Chronic venous

Patents 65

insufficiency (CVI) is a significant and growing medical problem. The pathophysicologic basis of CVI is venous hypertension in the lower extremities. The calf-muscle pump works by contracting around veins in order to force blood in the veins into motion. Oneway valves within the deep venous systems allow blood to flow only proximally out of the legs. Failure of these valves leads to increased venous hypertension in the superficial system, thereby decreasing calf-muscle pump efficiency. Increasing venous distension can promote increasing valvular incompetence, leading to symptoms such as leg swelling and aching, discoloration of skin, activity intolerance, and finally open ulceration. Increased venous pressure results in extravasation of fluid, serum proteins, and blood cells into the subcutaneous tissue, eventually leading to pigmentation changes and ulceration. The high prevalence and resulting costs of venous pathology, such as health care costs, missed work, and reduced quality of life constitute a heavy burden on society. Approximately 5 million Americans exhibit some evidence of CVI and, depending on estimates, between 500,00 and 600,000 or up to one million of these individuals have or will develop venous leg ulcers, causing recurrent hospitalization, high health care costs, and disability. Fifty percent of venous ulcers may be present for 7-9 months. Between 8 and 34% of the ulcers may be present for more than 5 years, and 67-75% of patients have recurrent problems. An estimated two million workdays are lost each year in the United States. The medical costs of treatment and indirect costs associated with the disease can be significant. According to a study performed at the Cleveland clinic, the medical cost per venous leg ulcer averaged nearly $10,000. While the etiology and pathophysiology of CVI and resulting venous ulcers are well established, there has not been satisfactory progress in the treatment of this problem. It is in response to CVI and resulting venous ulcers that the present invention arises. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Keeping Current In order to stay informed about patents and patent applications dealing with chronic venous insufficiency, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “chronic venous insufficiency” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on chronic venous insufficiency. You can also use this procedure to view pending patent applications concerning chronic venous insufficiency. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

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CHAPTER 5. BOOKS ON CHRONIC VENOUS INSUFFICIENCY Overview This chapter provides bibliographic book references relating to chronic venous insufficiency. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on chronic venous insufficiency include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “chronic venous insufficiency” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “chronic venous insufficiency” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “chronic venous insufficiency” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

Microcirculation in Chronic Venous Insufficiency (Progress in Applied Microcirculation, Vol. 23) by Bodensee Symposium on Microcirculation 1998, K. Messmer; ISBN: 3805568215; http://www.amazon.com/exec/obidos/ASIN/3805568215/icongroupinterna

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APPENDICES

71

APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute10: •

Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm

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National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/

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National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html

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National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25

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National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm

•

National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm

•

National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375

•

National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/

10

These publications are typically written by one or more of the various NIH Institutes.

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•

National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm

•

National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/

•

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm

•

National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm

•

National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/

•

National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/

•

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm

•

National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html

•

National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm

•

National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm

•

National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm

•

National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html

•

National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm

•

Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp

•

National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/

•

National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp

•

Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html

•

Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm

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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.11 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:12 •

Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html

•

HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html

•

NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html

•

Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/

•

Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html

•

Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html

•

Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/

•

Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html

•

Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html

•

Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html

•

MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html

11

Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 12 See http://www.nlm.nih.gov/databases/databases.html.

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•

Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html

•

Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html

The NLM Gateway13 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.14 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “chronic venous insufficiency” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 1874 15 934 1 9 2833

HSTAT15 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.16 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.17 Simply search by “chronic venous insufficiency” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

13

Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.

14

The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 15 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 16 17

The HSTAT URL is http://hstat.nlm.nih.gov/.

Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.

Physician Resources

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Coffee Break: Tutorials for Biologists18 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.19 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.20 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •

CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.

•

Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.

18 Adapted 19

from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 20 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.

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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on chronic venous insufficiency can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to chronic venous insufficiency. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to chronic venous insufficiency. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “chronic venous insufficiency”:

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Circulatory Disorders http://www.nlm.nih.gov/medlineplus/circulatorydisorders.html Congenital Heart Disease http://www.nlm.nih.gov/medlineplus/congenitalheartdisease.html Pulmonary Embolism http://www.nlm.nih.gov/medlineplus/pulmonaryembolism.html Thrombophlebitis http://www.nlm.nih.gov/medlineplus/thrombophlebitis.html Varicose Veins http://www.nlm.nih.gov/medlineplus/varicoseveins.html You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The NIH Search Utility The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to chronic venous insufficiency. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/specific.htm

•

Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/

•

Med Help International: http://www.medhelp.org/HealthTopics/A.html

•

Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/

•

Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/

•

WebMDHealth: http://my.webmd.com/health_topics

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Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to chronic venous insufficiency. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with chronic venous insufficiency. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about chronic venous insufficiency. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “chronic venous insufficiency” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “chronic venous insufficiency”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “chronic venous insufficiency” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months.

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The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “chronic venous insufficiency” (or a synonym) into the search box, and click “Submit Query.”

81

APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.21

Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.

Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of

21

Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.

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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)22: •

Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/

•

Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)

•

Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm

•

California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html

•

California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html

•

California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/

•

California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp

•

California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html

•

California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/

•

California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/

•

California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/

•

California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html

•

California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/

•

Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/

•

Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/

•

Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/

22

Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.

Finding Medical Libraries

83

•

Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml

•

Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm

•

Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html

•

Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm

•

Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp

•

Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/

•

Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm

•

Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html

•

Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/

•

Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm

•

Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/

•

Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/

•

Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/

•

Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm

•

Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html

•

Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm

•

Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/

•

Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/

•

Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10

•

Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/

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•

Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html

•

Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp

•

Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp

•

Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/

•

Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html

•

Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm

•

Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp

•

Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/

•

Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html

•

Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/

•

Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm

•

Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/

•

Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html

•

Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm

•

Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330

•

Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)

•

National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html

•

National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/

•

National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/

Finding Medical Libraries

85

•

Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm

•

New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/

•

New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm

•

New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm

•

New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/

•

New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html

•

New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/

•

New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html

•

New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/

•

Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm

•

Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp

•

Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/

•

Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/

•

Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml

•

Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html

•

Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html

•

Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml

•

Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp

•

Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm

•

Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/

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•

South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp

•

Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/

•

Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/

•

Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72

87

ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •

ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html

•

MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp

•

Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/

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Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html

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On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/

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Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp

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Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm

Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a).

Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •

Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical

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MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html

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Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/

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Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine

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CHRONIC VENOUS INSUFFICIENCY DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Acrylonitrile: A highly poisonous compound used widely in the manufacture of plastics, adhesives and synthetic rubber. [NIH] Actin: Essential component of the cell skeleton. [NIH] Adenine: A purine base and a fundamental unit of adenine nucleotides. [NIH] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alkaline: Having the reactions of an alkali. [EU] Allergen: An antigenic substance capable of producing immediate-type hypersensitivity (allergy). [EU] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Ambulatory Care: Health care services provided to patients on an ambulatory basis, rather than by admission to a hospital or other health care facility. The services may be a part of a hospital, augmenting its inpatient services, or may be provided at a free-standing facility. [NIH]

Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amplification: The production of additional copies of a chromosomal DNA sequence, found as either intrachromosomal or extrachromosomal DNA. [NIH] Ampulla: A sac-like enlargement of a canal or duct. [NIH] Amyloid: A general term for a variety of different proteins that accumulate as extracellular fibrils of 7-10 nm and have common structural features, including a beta-pleated sheet conformation and the ability to bind such dyes as Congo red and thioflavine (Kandel, Schwartz, and Jessel, Principles of Neural Science, 3rd ed). [NIH] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH]

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Analogous: Resembling or similar in some respects, as in function or appearance, but not in origin or development;. [EU] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Ankle: That part of the lower limb directly above the foot. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticoagulant: A drug that helps prevent blood clots from forming. Also called a blood thinner. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Aqueous: Having to do with water. [NIH] Arachidonic Acid: An unsaturated, essential fatty acid. It is found in animal and human fat as well as in the liver, brain, and glandular organs, and is a constituent of animal phosphatides. It is formed by the synthesis from dietary linoleic acid and is a precursor in the biosynthesis of prostaglandins, thromboxanes, and leukotrienes. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arteriolar: Pertaining to or resembling arterioles. [EU] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Arteriovenous: Both arterial and venous; pertaining to or affecting an artery and a vein. [EU] Arteriovenous Fistula: An abnormal communication between an artery and a vein. [NIH] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Arthroplasty: Surgical reconstruction of a joint to relieve pain or restore motion. [NIH] Ascites: Accumulation or retention of free fluid within the peritoneal cavity. [NIH] Ascorbic Acid: A six carbon compound related to glucose. It is found naturally in citrus fruits and many vegetables. Ascorbic acid is an essential nutrient in human diets, and necessary to maintain connective tissue and bone. Its biologically active form, vitamin C, functions as a reducing agent and coenzyme in several metabolic pathways. Vitamin C is considered an antioxidant. [NIH] Astringents: Agents, usually topical, that cause the contraction of tissues for the control of

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bleeding or secretions. [NIH] Atmospheric Pressure: The pressure at any point in an atmosphere due solely to the weight of the atmospheric gases above the point concerned. [NIH] Atrial: Pertaining to an atrium. [EU] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Autologous: Taken from an individual's own tissues, cells, or DNA. [NIH] Basal cell carcinoma: A type of skin cancer that arises from the basal cells, small round cells found in the lower part (or base) of the epidermis, the outer layer of the skin. [NIH] Basal cells: Small, round cells found in the lower part (or base) of the epidermis, the outer layer of the skin. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological therapy: Treatment to stimulate or restore the ability of the immune system to fight infection and disease. Also used to lessen side effects that may be caused by some cancer treatments. Also known as immunotherapy, biotherapy, or biological response modifier (BRM) therapy. [NIH] Biological Transport: The movement of materials (including biochemical substances and drugs) across cell membranes and epithelial layers, usually by passive diffusion. [NIH] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Biotransformation: The chemical alteration of an exogenous substance by or in a biological system. The alteration may inactivate the compound or it may result in the production of an active metabolite of an inactive parent compound. The alteration may be either nonsynthetic (oxidation-reduction, hydrolysis) or synthetic (glucuronide formation, sulfate conjugation, acetylation, methylation). This also includes metabolic detoxication and clearance. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber.

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Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Blood Viscosity: The internal resistance of the blood to shear forces. The in vitro measure of whole blood viscosity is of limited clinical utility because it bears little relationship to the actual viscosity within the circulation, but an increase in the viscosity of circulating blood can contribute to morbidity in patients suffering from disorders such as sickle cell anemia and polycythemia. [NIH] Blood Volume: Volume of circulating blood. It is the sum of the plasma volume and erythrocyte volume. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Calcification: Deposits of calcium in the tissues of the breast. Calcification in the breast can be seen on a mammogram, but cannot be detected by touch. There are two types of breast calcification, macrocalcification and microcalcification. Macrocalcifications are large deposits and are usually not related to cancer. Microcalcifications are specks of calcium that may be found in an area of rapidly dividing cells. Many microcalcifications clustered together may be a sign of cancer. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Calcium Dobesilate: A drug used to reduce hemorrhage in diabetic retinopathy. [NIH] Capillary: Any one of the minute vessels that connect the arterioles and venules, forming a network in nearly all parts of the body. Their walls act as semipermeable membranes for the interchange of various substances, including fluids, between the blood and tissue fluid; called also vas capillare. [EU] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]

Cardiac: Having to do with the heart. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH]

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Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Division: The fission of a cell. [NIH] Cell Size: The physical dimensions of a cell. It refers mainly to changes in dimensions correlated with physiological or pathological changes in cells. [NIH] Cell Survival: The span of viability of a cell characterized by the capacity to perform certain functions such as metabolism, growth, reproduction, some form of responsiveness, and adaptability. [NIH] Chondrocytes: Polymorphic cells that form cartilage. [NIH] Chromatin: The material of chromosomes. It is a complex of DNA, histones, and nonhistone proteins (chromosomal proteins, non-histone) found within the nucleus of a cell. [NIH] Chromosomal: Pertaining to chromosomes. [EU] Clear cell carcinoma: A rare type of tumor of the female genital tract in which the inside of the cells looks clear when viewed under a microscope. [NIH] Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Coenzyme: An organic nonprotein molecule, frequently a phosphorylated derivative of a water-soluble vitamin, that binds with the protein molecule (apoenzyme) to form the active enzyme (holoenzyme). [EU] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a

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bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Compression bandage: A bandage designed to provide pressure to a particular area. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Computed tomography: CT scan. A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized tomography and computerized axial tomography (CAT) scan. [NIH] Computerized axial tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called CAT scan, computed tomography (CT scan), or computerized tomography. [NIH] Computerized tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized axial tomography (CAT) scan and computed tomography (CT scan). [NIH] Congestive heart failure: Weakness of the heart muscle that leads to a buildup of fluid in body tissues. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Contrast medium: A substance that is introduced into or around a structure and, because of the difference in absorption of x-rays by the contrast medium and the surrounding tissues,

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allows radiographic visualization of the structure. [EU] Controlled clinical trial: A clinical study that includes a comparison (control) group. The comparison group receives a placebo, another treatment, or no treatment at all. [NIH] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]

Corneum: The superficial layer of the epidermis containing keratinized cells. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coumarin: A fluorescent dye. [NIH] Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cystathionine beta-Synthase: A multifunctional pyridoxal phosphate enzyme. In the second stage of cysteine biosynthesis it catalyzes the reaction of homocysteine with serine to form cystathionine with the elimination of water. Deficiency of this enzyme leads to hyperhomocysteinemia and homocystinuria. EC 4.2.1.22. [NIH] Cytokine: Small but highly potent protein that modulates the activity of many cell types, including T and B cells. [NIH] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Delivery of Health Care: The concept concerned with all aspects of providing and distributing health services to a patient population. [NIH] DES: Diethylstilbestrol. A synthetic hormone that was prescribed from the early 1940s until 1971 to help women with complications of pregnancy. DES has been linked to an increased risk of clear cell carcinoma of the vagina in daughters of women who used DES. DES may also increase the risk of breast cancer in women who used DES. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diabetic Retinopathy: Retinopathy associated with diabetes mellitus, which may be of the background type, progressively characterized by microaneurysms, interretinal punctuate macular edema, or of the proliferative type, characterized by neovascularization of the retina and optic disk, which may project into the vitreous, proliferation of fibrous tissue, vitreous hemorrhage, and retinal detachment. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Diffusion: The tendency of a gas or solute to pass from a point of higher pressure or concentration to a point of lower pressure or concentration and to distribute itself throughout the available space; a major mechanism of biological transport. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Dihydrotestosterone: Anabolic agent. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Dissection: Cutting up of an organism for study. [NIH]

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Double-blind: Pertaining to a clinical trial or other experiment in which neither the subject nor the person administering treatment knows which treatment any particular subject is receiving. [EU] Duodenum: The first part of the small intestine. [NIH] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Elastic: Susceptible of resisting and recovering from stretching, compression or distortion applied by a force. [EU] Elasticity: Resistance and recovery from distortion of shape. [NIH] Elastin: The protein that gives flexibility to tissues. [NIH] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Embolectomy: Surgical removal of an obstructing clot or foreign material which has been transported from a distant vessel by the bloodstream. Removal of a clot at its original site is called thrombectomy. [NIH] Embolism: Blocking of a blood vessel by a blood clot or foreign matter that has been transported from a distant site by the blood stream. [NIH] Endoscope: A thin, lighted tube used to look at tissues inside the body. [NIH] Endoscopic: A technique where a lateral-view endoscope is passed orally to the duodenum for visualization of the ampulla of Vater. [NIH] Endothelial cell: The main type of cell found in the inside lining of blood vessels, lymph vessels, and the heart. [NIH] Endotoxin: Toxin from cell walls of bacteria. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzymes: Biological molecules that possess catalytic activity. They may occur naturally or be synthetically created. Enzymes are usually proteins, however catalytic RNA and catalytic DNA molecules have also been identified. [NIH] Epidemiological: Relating to, or involving epidemiology. [EU] Epidermal: Pertaining to or resembling epidermis. Called also epidermic or epidermoid. [EU] Epidermal Growth Factor: A 6 kD polypeptide growth factor initially discovered in mouse submaxillary glands. Human epidermal growth factor was originally isolated from urine based on its ability to inhibit gastric secretion and called urogastrone. epidermal growth factor exerts a wide variety of biological effects including the promotion of proliferation and differentiation of mesenchymal and epithelial cells. [NIH] Epidermal growth factor receptor: EGFR. The protein found on the surface of some cells and to which epidermal growth factor binds, causing the cells to divide. It is found at

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abnormally high levels on the surface of many types of cancer cells, so these cells may divide excessively in the presence of epidermal growth factor. Also known as ErbB1 or HER1. [NIH] Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelial Cells: Cells that line the inner and outer surfaces of the body. [NIH] Epoprostenol: A prostaglandin that is biosynthesized enzymatically from prostaglandin endoperoxides in human vascular tissue. It is a potent inhibitor of platelet aggregation. The sodium salt has been also used to treat primary pulmonary hypertension. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Escin: Saponin occurring in the seed of the horse chestnut tree. Inhibits edema formation and decreases vascular fragility. [NIH] Esophageal: Having to do with the esophagus, the muscular tube through which food passes from the throat to the stomach. [NIH] Esophageal Varices: Stretched veins in the esophagus that occur when the liver is not working properly. If the veins burst, the bleeding can cause death. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Excitation: An act of irritation or stimulation or of responding to a stimulus; the addition of energy, as the excitation of a molecule by absorption of photons. [EU] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extracellular Matrix Proteins: Macromolecular organic compounds that contain carbon, hydrogen, oxygen, nitrogen, and usually, sulfur. These macromolecules (proteins) form an intricate meshwork in which cells are embedded to construct tissues. Variations in the relative types of macromolecules and their organization determine the type of extracellular matrix, each adapted to the functional requirements of the tissue. The two main classes of macromolecules that form the extracellular matrix are: glycosaminoglycans, usually linked to proteins (proteoglycans), and fibrous proteins (e.g., collagen, elastin, fibronectins and laminin). [NIH] Extravasation: A discharge or escape, as of blood, from a vessel into the tissues. [EU] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]

Fibrin: A protein derived from fibrinogen in the presence of thrombin, which forms part of

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the blood clot. [NIH] Fibrinogen: Plasma glycoprotein clotted by thrombin, composed of a dimer of three nonidentical pairs of polypeptide chains (alpha, beta, gamma) held together by disulfide bonds. Fibrinogen clotting is a sol-gel change involving complex molecular arrangements: whereas fibrinogen is cleaved by thrombin to form polypeptides A and B, the proteolytic action of other enzymes yields different fibrinogen degradation products. [NIH] Fibrinolysis: The natural enzymatic dissolution of fibrin. [NIH] Fibrinolytic: Pertaining to, characterized by, or causing the dissolution of fibrin by enzymatic action [EU] Fibroblast Growth Factor: Peptide isolated from the pituitary gland and from the brain. It is a potent mitogen which stimulates growth of a variety of mesodermal cells including chondrocytes, granulosa, and endothelial cells. The peptide may be active in wound healing and animal limb regeneration. [NIH] Fibroblasts: Connective tissue cells which secrete an extracellular matrix rich in collagen and other macromolecules. [NIH] Fibronectin: An adhesive glycoprotein. One form circulates in plasma, acting as an opsonin; another is a cell-surface protein which mediates cellular adhesive interactions. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Filtration: The passage of a liquid through a filter, accomplished by gravity, pressure, or vacuum (suction). [EU] Fixation: 1. The act or operation of holding, suturing, or fastening in a fixed position. 2. The condition of being held in a fixed position. 3. In psychiatry, a term with two related but distinct meanings : (1) arrest of development at a particular stage, which like regression (return to an earlier stage), if temporary is a normal reaction to setbacks and difficulties but if protracted or frequent is a cause of developmental failures and emotional problems, and (2) a close and suffocating attachment to another person, especially a childhood figure, such as one's mother or father. Both meanings are derived from psychoanalytic theory and refer to 'fixation' of libidinal energy either in a specific erogenous zone, hence fixation at the oral, anal, or phallic stage, or in a specific object, hence mother or father fixation. 4. The use of a fixative (q.v.) to preserve histological or cytological specimens. 5. In chemistry, the process whereby a substance is removed from the gaseous or solution phase and localized, as in carbon dioxide fixation or nitrogen fixation. 6. In ophthalmology, direction of the gaze so that the visual image of the object falls on the fovea centralis. 7. In film processing, the chemical removal of all undeveloped salts of the film emulsion, leaving only the developed silver to form a permanent image. [EU] Flow Cytometry: Technique using an instrument system for making, processing, and displaying one or more measurements on individual cells obtained from a cell suspension. Cells are usually stained with one or more fluorescent dyes specific to cell components of interest, e.g., DNA, and fluorescence of each cell is measured as it rapidly transverses the excitation beam (laser or mercury arc lamp). Fluorescence provides a quantitative measure of various biochemical and biophysical properties of the cell, as well as a basis for cell sorting. Other measurable optical parameters include light absorption and light scattering, the latter being applicable to the measurement of cell size, shape, density, granularity, and stain uptake. [NIH] Fluorescence: The property of emitting radiation while being irradiated. The radiation emitted is usually of longer wavelength than that incident or absorbed, e.g., a substance can be irradiated with invisible radiation and emit visible light. X-ray fluorescence is used in

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diagnosis. [NIH] Fluorescent Dyes: Dyes that emit light when exposed to light. The wave length of the emitted light is usually longer than that of the incident light. Fluorochromes are substances that cause fluorescence in other substances, i.e., dyes used to mark or label other compounds with fluorescent tags. They are used as markers in biochemistry and immunology. [NIH] Folate: A B-complex vitamin that is being studied as a cancer prevention agent. Also called folic acid. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Folic Acid: N-(4-(((2-Amino-1,4-dihydro-4-oxo-6-pteridinyl)methyl)amino)benzoyl)-Lglutamic acid. A member of the vitamin B family that stimulates the hematopoietic system. It is present in the liver and kidney and is found in mushrooms, spinach, yeast, green leaves, and grasses. Folic acid is used in the treatment and prevention of folate deficiencies and megaloblastic anemia. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastric: Having to do with the stomach. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucuronic Acid: Derivatives of uronic acid found throughout the plant and animal kingdoms. They detoxify drugs and toxins by conjugating with them to form glucuronides in the liver which are more water-soluble metabolites that can be easily eliminated from the body. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Granulocytes: Leukocytes with abundant granules in the cytoplasm. They are divided into three groups: neutrophils, eosinophils, and basophils. [NIH] Growth factors: Substances made by the body that function to regulate cell division and cell survival. Some growth factors are also produced in the laboratory and used in biological therapy. [NIH] Half-Life: The time it takes for a substance (drug, radioactive nuclide, or other) to lose half of its pharmacologic, physiologic, or radiologic activity. [NIH] Health Care Costs: The actual costs of providing services related to the delivery of health care, including the costs of procedures, therapies, and medications. It is differentiated from health expenditures, which refers to the amount of money paid for the services, and from fees, which refers to the amount charged, regardless of cost. [NIH] Health Expenditures: The amounts spent by individuals, groups, nations, or private or public organizations for total health care and/or its various components. These amounts may or may not be equivalent to the actual costs (health care costs) and may or may not be shared among the patient, insurers, and/or employers. [NIH]

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Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Hemodynamics: The movements of the blood and the forces involved in systemic or regional blood circulation. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemorheology: The study of the flow of blood in relation to the pressures, flow, volumes, and resistances in blood vessels in macroscopic, microscopic, and submicroscopic dimensions. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemorrhoids: Varicosities of the hemorrhoidal venous plexuses. [NIH] Heparin: Heparinic acid. A highly acidic mucopolysaccharide formed of equal parts of sulfated D-glucosamine and D-glucuronic acid with sulfaminic bridges. The molecular weight ranges from six to twenty thousand. Heparin occurs in and is obtained from liver, lung, mast cells, etc., of vertebrates. Its function is unknown, but it is used to prevent blood clotting in vivo and vitro, in the form of many different salts. [NIH] Hepatic: Refers to the liver. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Horny layer: The superficial layer of the epidermis containing keratinized cells. [NIH] Humoral: Of, relating to, proceeding from, or involving a bodily humour - now often used of endocrine factors as opposed to neural or somatic. [EU] Humour: 1. A normal functioning fluid or semifluid of the body (as the blood, lymph or bile) especially of vertebrates. 2. A secretion that is itself an excitant of activity (as certain hormones). [EU] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydroxyethylrutoside: Monohydroxyethyl derivative of rutin. Peripheral circulation stimulant used in treatment of venous disorders. [NIH] Hydroxylysine: A hydroxylated derivative of the amino acid lysine that is present in certain

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collagens. [NIH] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] Hyperhomocysteinemia: An inborn error of methionone metabolism which produces an excess of homocysteine in the blood. It is often caused by a deficiency of cystathionine betasynthase and is a risk factor for coronary vascular disease. [NIH] Hyperplasia: An increase in the number of cells in a tissue or organ, not due to tumor formation. It differs from hypertrophy, which is an increase in bulk without an increase in the number of cells. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Hypoxia: Reduction of oxygen supply to tissue below physiological levels despite adequate perfusion of the tissue by blood. [EU] Iloprost: An eicosanoid, derived from the cyclooxygenase pathway of arachidonic acid metabolism. It is a stable and synthetic analog of epoprostenol, but with a longer half-life than the parent compound. Its actions are similar to prostacyclin. Iloprost produces vasodilation and inhibits platelet aggregation. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Incompetence: Physical or mental inadequacy or insufficiency. [EU] Incubator: Consists of a transparent plastic cubicle, electrical heating equipment, safety and warning devices, and oxygen and air filtering and regulating apparatus; an enclosed transparent boxlike apparatus for housing prematurely born babies under optimum conditions. [NIH] Indolent: A type of cancer that grows slowly. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local

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infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Interleukin-1: A soluble factor produced by monocytes, macrophages, and other cells which activates T-lymphocytes and potentiates their response to mitogens or antigens. IL-1 consists of two distinct forms, IL-1 alpha and IL-1 beta which perform the same functions but are distinct proteins. The biological effects of IL-1 include the ability to replace macrophage requirements for T-cell activation. The factor is distinct from interleukin-2. [NIH] Interleukin-10: Factor that is a coregulator of mast cell growth. It is produced by T-cells and B-cells and shows extensive homology with the Epstein-Barr virus BCRFI gene. [NIH] Interleukin-2: Chemical mediator produced by activated T lymphocytes and which regulates the proliferation of T cells, as well as playing a role in the regulation of NK cell activity. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Involuntary: Reaction occurring without intention or volition. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Kinetic: Pertaining to or producing motion. [EU] Leg Ulcer: Ulceration of the skin and underlying structures of the lower extremity. About 90% of the cases are due to venous insufficiency (varicose ulcer), 5% to arterial disease, and the remaining 5% to other causes. [NIH] Lesion: An area of abnormal tissue change. [NIH] Leucocyte: All the white cells of the blood and their precursors (myeloid cell series, lymphoid cell series) but commonly used to indicate granulocytes exclusive of lymphocytes. [NIH]

Ligation: Application of a ligature to tie a vessel or strangulate a part. [NIH] Linkages: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH]

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Localized: Cancer which has not metastasized yet. [NIH] Loop: A wire usually of platinum bent at one end into a small loop (usually 4 mm inside diameter) and used in transferring microorganisms. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphedema: Edema due to obstruction of lymph vessels or disorders of the lymph nodes. [NIH]

Lymphocytes: White blood cells formed in the body's lymphoid tissue. The nucleus is round or ovoid with coarse, irregularly clumped chromatin while the cytoplasm is typically pale blue with azurophilic (if any) granules. Most lymphocytes can be classified as either T or B (with subpopulations of each); those with characteristics of neither major class are called null cells. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Macrophage: A type of white blood cell that surrounds and kills microorganisms, removes dead cells, and stimulates the action of other immune system cells. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Mammogram: An x-ray of the breast. [NIH] Matrix metalloproteinase: A member of a group of enzymes that can break down proteins, such as collagen, that are normally found in the spaces between cells in tissues (i.e., extracellular matrix proteins). Because these enzymes need zinc or calcium atoms to work properly, they are called metalloproteinases. Matrix metalloproteinases are involved in wound healing, angiogenesis, and tumor cell metastasis. [NIH] Medial: Lying near the midsaggital plane of the body; opposed to lateral. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Health: The state wherein the person is well adjusted. [NIH] Mercury: A silver metallic element that exists as a liquid at room temperature. It has the atomic symbol Hg (from hydrargyrum, liquid silver), atomic number 80, and atomic weight 200.59. Mercury is used in many industrial applications and its salts have been employed therapeutically as purgatives, antisyphilitics, disinfectants, and astringents. It can be absorbed through the skin and mucous membranes which leads to mercury poisoning. Because of its toxicity, the clinical use of mercury and mercurials is diminishing. [NIH] Mesenchymal: Refers to cells that develop into connective tissue, blood vessels, and lymphatic tissue. [NIH] Mesentery: A layer of the peritoneum which attaches the abdominal viscera to the abdominal wall and conveys their blood vessels and nerves. [NIH]

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Meta-Analysis: A quantitative method of combining the results of independent studies (usually drawn from the published literature) and synthesizing summaries and conclusions which may be used to evaluate therapeutic effectiveness, plan new studies, etc., with application chiefly in the areas of research and medicine. [NIH] Metastasis: The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called "secondary tumors" and contain cells that are like those in the original (primary) tumor. The plural is metastases. [NIH] Microcalcifications: Tiny deposits of calcium in the breast that cannot be felt but can be detected on a mammogram. A cluster of these very small specks of calcium may indicate that cancer is present. [NIH] Microcirculation: The vascular network lying between the arterioles and venules; includes capillaries, metarterioles and arteriovenous anastomoses. Also, the flow of blood through this network. [NIH] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Mitosis: A method of indirect cell division by means of which the two daughter nuclei normally receive identical complements of the number of chromosomes of the somatic cells of the species. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monocyte: A type of white blood cell. [NIH] Mononuclear: A cell with one nucleus. [NIH] Monophosphate: So called second messenger for neurotransmitters and hormones. [NIH] Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [NIH] Motility: The ability to move spontaneously. [EU] Mucins: A secretion containing mucopolysaccharides and protein that is the chief constituent of mucus. [NIH] Neonatal: Pertaining to the first four weeks after birth. [EU] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] Neurotransmitter: Any of a group of substances that are released on excitation from the axon terminal of a presynaptic neuron of the central or peripheral nervous system and travel across the synaptic cleft to either excite or inhibit the target cell. Among the many substances that have the properties of a neurotransmitter are acetylcholine, norepinephrine, epinephrine, dopamine, glycine, y-aminobutyrate, glutamic acid, substance P, enkephalins, endorphins, and serotonin. [EU]

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Neutralization: An act or process of neutralizing. [EU] Neutrophil: A type of white blood cell. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Oedema: The presence of abnormally large amounts of fluid in the intercellular tissue spaces of the body; usually applied to demonstrable accumulation of excessive fluid in the subcutaneous tissues. Edema may be localized, due to venous or lymphatic obstruction or to increased vascular permeability, or it may be systemic due to heart failure or renal disease. Collections of edema fluid are designated according to the site, e.g. ascites (peritoneal cavity), hydrothorax (pleural cavity), and hydropericardium (pericardial sac). Massive generalized edema is called anasarca. [EU] Onychomycosis: Mycosis of the nails, possibly due to some extent to humidity. [NIH] Osmosis: Tendency of fluids (e.g., water) to move from the less concentrated to the more concentrated side of a semipermeable membrane. [NIH] Osmotic: Pertaining to or of the nature of osmosis (= the passage of pure solvent from a solution of lesser to one of greater solute concentration when the two solutions are separated by a membrane which selectively prevents the passage of solute molecules, but is permeable to the solvent). [EU] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Oximetry: The determination of oxygen-hemoglobin saturation of blood either by withdrawing a sample and passing it through a classical photoelectric oximeter or by electrodes attached to some translucent part of the body like finger, earlobe, or skin fold. It includes non-invasive oxygen monitoring by pulse oximetry. [NIH] Oxygenation: The process of supplying, treating, or mixing with oxygen. No:1245 oxygenation the process of supplying, treating, or mixing with oxygen. [EU] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Patient Compliance: Voluntary cooperation of the patient in following a prescribed regimen. [NIH] Pentoxifylline: A methylxanthine derivative that inhibits phosphodiesterase and affects blood rheology. It improves blood flow by increasing erythrocyte and leukocyte flexibility. It also inhibits platelet aggregation. Pentoxifylline modulates immunologic activity by stimulating cytokine production. [NIH] Peptic: Pertaining to pepsin or to digestion; related to the action of gastric juices. [EU] Peptic Ulcer: An ulceration of the mucous membrane of the esophagus, stomach or duodenum, caused by the action of the acid gastric juice. [NIH] Peptic Ulcer Hemorrhage: Bleeding from a peptic ulcer. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Perfusion: Bathing an organ or tissue with a fluid. In regional perfusion, a specific area of the body (usually an arm or a leg) receives high doses of anticancer drugs through a blood vessel. Such a procedure is performed to treat cancer that has not spread. [NIH] Pericytes: Smooth muscle cell that wraps around normal blood vessels. [NIH]

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Peripheral Vascular Disease: Disease in the large blood vessels of the arms, legs, and feet. People who have had diabetes for a long time may get this because major blood vessels in their arms, legs, and feet are blocked and these limbs do not receive enough blood. The signs of PVD are aching pains in the arms, legs, and feet (especially when walking) and foot sores that heal slowly. Although people with diabetes cannot always avoid PVD, doctors say they have a better chance of avoiding it if they take good care of their feet, do not smoke, and keep both their blood pressure and diabetes under good control. [NIH] Peritoneal: Having to do with the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Peritoneal Cavity: The space enclosed by the peritoneum. It is divided into two portions, the greater sac and the lesser sac or omental bursa, which lies behind the stomach. The two sacs are connected by the foramen of Winslow, or epiploic foramen. [NIH] Peritoneum: Endothelial lining of the abdominal cavity, the parietal peritoneum covering the inside of the abdominal wall and the visceral peritoneum covering the bowel, the mesentery, and certain of the organs. The portion that covers the bowel becomes the serosal layer of the bowel wall. [NIH] Pharmacokinetic: The mathematical analysis of the time courses of absorption, distribution, and elimination of drugs. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharmacotherapy: A regimen of using appetite suppressant medications to manage obesity by decreasing appetite or increasing the feeling of satiety. These medications decrease appetite by increasing serotonin or catecholamine—two brain chemicals that affect mood and appetite. [NIH] Phlebography: Radiographic visualization or recording of a vein after the injection of contrast medium. [NIH] Phosphodiesterase: Effector enzyme that regulates the levels of a second messenger, the cyclic GMP. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Photoplethysmography: Plethysmographic determination in which the intensity of light reflected from the skin surface and the red cells below is measured to determine the blood volume of the respective area. There are two types, transmission and reflectance. [NIH] Photosensitivity: An abnormal cutaneous response involving the interaction between photosensitizing substances and sunlight or filtered or artificial light at wavelengths of 280400 mm. There are two main types : photoallergy and photoxicity. [EU] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pigment: A substance that gives color to tissue. Pigments are responsible for the color of skin, eyes, and hair. [NIH] Pigmentation: Coloration or discoloration of a part by a pigment. [NIH] Pituitary Gland: A small, unpaired gland situated in the sella turcica tissue. It is connected to the hypothalamus by a short stalk. [NIH]

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Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Platelet Activation: A series of progressive, overlapping events triggered by exposure of the platelets to subendothelial tissue. These events include shape change, adhesiveness, aggregation, and release reactions. When carried through to completion, these events lead to the formation of a stable hemostatic plug. [NIH] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH] Platelet-Derived Growth Factor: Mitogenic peptide growth hormone carried in the alphagranules of platelets. It is released when platelets adhere to traumatized tissues. Connective tissue cells near the traumatized region respond by initiating the process of replication. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Plethysmography: Recording of change in the size of a part as modified by the circulation in it. [NIH] Pleural: A circumscribed area of hyaline whorled fibrous tissue which appears on the surface of the parietal pleura, on the fibrous part of the diaphragm or on the pleura in the interlobar fissures. [NIH] Pleural cavity: A space enclosed by the pleura (thin tissue covering the lungs and lining the interior wall of the chest cavity). It is bound by thin membranes. [NIH] Pneumonia: Inflammation of the lungs. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Porphyria: A group of disorders characterized by the excessive production of porphyrins or their precursors that arises from abnormalities in the regulation of the porphyrin-heme pathway. The porphyrias are usually divided into three broad groups, erythropoietic, hepatic, and erythrohepatic, according to the major sites of abnormal porphyrin synthesis. [NIH]

Porphyria Cutanea Tarda: A form of hepatic porphyria (porphyria, hepatic) characterized by photosensitivity resulting in bullae that rupture easily to form shallow ulcers. This condition occurs in two forms: a sporadic, nonfamilial form that begins in middle age and has normal amounts of uroporphyrinogen decarboxylase with diminished activity in the liver; and a familial form in which there is an autosomal dominant inherited deficiency of uroporphyrinogen decarboxylase in the liver and red blood cells. [NIH] Porphyria, Hepatic: Porphyria in which the liver is the site where excess formation of porphyrin or its precursors is found. Acute intermittent porphyria and porphyria cutanea tarda are types of hepatic porphyria. [NIH] Potentiates: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [NIH]

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Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Proline: A non-essential amino acid that is synthesized from glutamic acid. It is an essential component of collagen and is important for proper functioning of joints and tendons. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]

Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]

Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Randomized Controlled Trials: Clinical trials that involve at least one test treatment and one control treatment, concurrent enrollment and follow-up of the test- and control-treated groups, and in which the treatments to be administered are selected by a random process, such as the use of a random-numbers table. Treatment allocations using coin flips, odd-even numbers, patient social security numbers, days of the week, medical record numbers, or other such pseudo- or quasi-random processes, are not truly randomized and trials employing any of these techniques for patient assignment are designated simply controlled clinical trials. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH]

Dictionary 109

Recur: To occur again. Recurrence is the return of cancer, at the same site as the original (primary) tumor or in another location, after the tumor had disappeared. [NIH] Red blood cells: RBCs. Cells that carry oxygen to all parts of the body. Also called erythrocytes. [NIH] Reductase: Enzyme converting testosterone to dihydrotestosterone. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflex: An involuntary movement or exercise of function in a part, excited in response to a stimulus applied to the periphery and transmitted to the brain or spinal cord. [NIH] Reflux: The term used when liquid backs up into the esophagus from the stomach. [NIH] Regeneration: The natural renewal of a structure, as of a lost tissue or part. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Regurgitation: A backward flowing, as the casting up of undigested food, or the backward flowing of blood into the heart, or between the chambers of the heart when a valve is incompetent. [EU] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Rheology: The study of the deformation and flow of matter, usually liquids or fluids, and of the plastic flow of solids. The concept covers consistency, dilatancy, liquefaction, resistance to flow, shearing, thixotrophy, and viscosity. [NIH] Ribose: A pentose active in biological systems usually in its D-form. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Rubber: A high-molecular-weight polymeric elastomer derived from the milk juice (latex) of Hevea brasiliensis and other trees. It is a substance that can be stretched at room temperature to atleast twice its original length and after releasing the stress, retractrapidly, and recover its original dimensions fully. Synthetic rubber is made from many different chemicals, including styrene, acrylonitrile, ethylene, propylene, and isoprene. [NIH] Rutin: 3-((6-O-(6-Deoxy-alpha-L-mannopyranosyl)-beta-D-glucopyranosyl)oxy)-2-(3,4dihydroxyphenyl)-5,7-dihydroxy-4H-1-benzopyran-4-one. Found in many plants, including buckwheat, tobacco, forsythia, hydrangea, pansies, etc. It has been used therapeutically to decrease capillary fragility. [NIH] Saphenous: Applied to certain structures in the leg, e. g. nerve vein. [NIH] Saphenous Vein: The vein which drains the foot and leg. [NIH] Sclerotherapy: Treatment of varicose veins, hemorrhoids, gastric and esophageal varices, and peptic ulcer hemorrhage by injection or infusion of chemical agents which cause localized thrombosis and eventual fibrosis and obliteration of the vessels. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Senescence: The bodily and mental state associated with advancing age. [NIH]

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Sensitization: 1. Administration of antigen to induce a primary immune response; priming; immunization. 2. Exposure to allergen that results in the development of hypersensitivity. 3. The coating of erythrocytes with antibody so that they are subject to lysis by complement in the presence of homologous antigen, the first stage of a complement fixation test. [EU] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Skin graft: Skin that is moved from one part of the body to another. [NIH] Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Social Security: Government sponsored social insurance programs. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Somatic cells: All the body cells except the reproductive (germ) cells. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spinous: Like a spine or thorn in shape; having spines. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [EU] Stasis: A word termination indicating the maintenance of (or maintaining) a constant level; preventing increase or multiplication. [EU] Stents: Devices that provide support for tubular structures that are being anastomosed or for body cavities during skin grafting. [NIH] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation.

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[EU]

Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Styrene: A colorless, toxic liquid with a strong aromatic odor. It is used to make rubbers, polymers and copolymers, and polystyrene plastics. [NIH] Subcutaneous: Beneath the skin. [NIH] Submaxillary: Four to six lymph glands, located between the lower jaw and the submandibular salivary gland. [NIH] Suction: The removal of secretions, gas or fluid from hollow or tubular organs or cavities by means of a tube and a device that acts on negative pressure. [NIH] Supine: Having the front portion of the body upwards. [NIH] Supine Position: The posture of an individual lying face up. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Symptomatic treatment: Therapy that eases symptoms without addressing the cause of disease. [NIH] Systemic: Affecting the entire body. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Testosterone: A hormone that promotes the development and maintenance of male sex characteristics. [NIH] Thigh: A leg; in anatomy, any elongated process or part of a structure more or less comparable to a leg. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombectomy: Surgical removal of an obstructing clot or foreign material from a blood vessel at the point of its formation. Removal of a clot arising from a distant site is called embolectomy. [NIH] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thromboembolism: Obstruction of a vessel by a blood clot that has been transported from a distant site by the blood stream. [NIH] Thrombophlebitis: Inflammation of a vein associated with thrombus formation. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thymus: An organ that is part of the lymphatic system, in which T lymphocytes grow and multiply. The thymus is in the chest behind the breastbone. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tomography: Imaging methods that result in sharp images of objects located on a chosen plane and blurred images located above or below the plane. [NIH]

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Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicokinetics: Study of the absorption, distribution, metabolism, and excretion of test substances. [NIH] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Transcutaneous: Transdermal. [EU] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Trees: Woody, usually tall, perennial higher plants (Angiosperms, Gymnosperms, and some Pterophyta) having usually a main stem and numerous branches. [NIH] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tumor Necrosis Factor: Serum glycoprotein produced by activated macrophages and other mammalian mononuclear leukocytes which has necrotizing activity against tumor cell lines and increases ability to reject tumor transplants. It mimics the action of endotoxin but differs from it. It has a molecular weight of less than 70,000 kDa. [NIH] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ulceration: 1. The formation or development of an ulcer. 2. An ulcer. [EU] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Urokinase: A drug that dissolves blood clots or prevents them from forming. [NIH] Uroporphyrinogen Decarboxylase: One of the enzymes active in heme biosynthesis. It catalyzes the decarboxylation of uroporphyrinogen III to coproporphyrinogen III by the conversion of four acetic acid groups to four methyl groups. EC 4.1.1.37. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Valves: Flap-like structures that control the direction of blood flow through the heart. [NIH] Varicose: The common ulcer in the lower third of the leg or near the ankle. [NIH] Varicose Ulcer: Ulcer due to varicose veins. Chronic venous insufficiency in the deep veins of the legs leads to shunting the venous return into the superficial veins, in which pressure and flow rate, as well as oxygen content, are increased. [NIH] Varicose vein: An abnormal swelling and tortuosity especially of the superficial veins of the legs. [EU] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vascular endothelial growth factor: VEGF. A substance made by cells that stimulates new blood vessel formation. [NIH]

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Vasculitis: Inflammation of a blood vessel. [NIH] Vasodilation: Physiological dilation of the blood vessels without anatomic change. For dilation with anatomic change, dilatation, pathologic or aneurysm (or specific aneurysm) is used. [NIH] VE: The total volume of gas either inspired or expired in one minute. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venous Pressure: The blood pressure in a vein. It is usually measured to assess the filling pressure to the ventricle. [NIH] Venous Thrombosis: The formation or presence of a thrombus within a vein. [NIH] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Viscera: Any of the large interior organs in any one of the three great cavities of the body, especially in the abdomen. [NIH] Viscosity: A physical property of fluids that determines the internal resistance to shear forces. [EU] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]

Wound Healing: Restoration of integrity to traumatized tissue. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH]

115

INDEX A Abdominal, 89, 103, 106 Acrylonitrile, 89, 109 Actin, 11, 89 Adenine, 89 Adenosine, 6, 89, 106 Algorithms, 89, 91 Alkaline, 89, 92 Allergen, 89, 110 Alternative medicine, 89 Ambulatory Care, 25, 37, 89 Amino Acids, 89, 105, 107, 108 Amplification, 4, 89 Ampulla, 89, 96 Amyloid, 89 Analog, 89, 101 Analogous, 90, 112 Anatomical, 90, 91, 101 Anemia, 90, 92, 99 Ankle, 41, 90, 112 Antibody, 90, 93, 100, 101, 110 Anticoagulant, 29, 90 Antigen, 90, 94, 100, 101, 110 Anti-inflammatory, 4, 90 Antioxidant, 90 Aqueous, 64, 90, 91, 95 Arachidonic Acid, 90, 101 Arterial, 10, 26, 90, 101, 102, 108, 111 Arteries, 42, 90, 92, 95 Arteriolar, 43, 90 Arterioles, 90, 92, 104 Arteriovenous, 10, 18, 90, 104 Arteriovenous Fistula, 18, 90 Artery, 90, 92, 108, 113 Arthroplasty, 21, 90 Ascites, 90, 105 Ascorbic Acid, 58, 90, 101 Astringents, 90, 103 Atmospheric Pressure, 4, 91 Atrial, 34, 91 Atrium, 91, 113 Atrophy, 44, 91 Autologous, 17, 91 B Basal cell carcinoma, 39, 91 Basal cells, 91 Base, 7, 10, 89, 91, 102 Bile, 91, 100, 102

Biochemical, 91, 98, 110 Biological therapy, 91, 99 Biological Transport, 91, 95 Biotechnology, 8, 73, 91 Biotransformation, 91 Blood Coagulation, 24, 28, 91, 92 Blood Glucose, 91, 100 Blood pressure, 91, 101, 106, 113 Blood vessel, 91, 92, 96, 100, 102, 103, 105, 106, 111, 112, 113 Blood Viscosity, 59, 92 Blood Volume, 92, 106 Bone Marrow, 92, 101, 103 C Calcification, 39, 92 Calcium, 9, 11, 16, 28, 92, 93, 103, 104 Calcium Dobesilate, 9, 16, 92 Capillary, 6, 11, 17, 29, 37, 92, 109, 113 Carbohydrate, 92 Carbon Dioxide, 7, 92, 98, 109 Carcinoma, 39, 92 Cardiac, 34, 92 Case report, 14, 92, 93 Catecholamine, 93, 106 Cell Division, 93, 99, 104, 107 Cell Size, 93, 98 Cell Survival, 93, 99 Chondrocytes, 93, 98 Chromatin, 93, 103 Chromosomal, 89, 93 Clear cell carcinoma, 93, 95 Clinical study, 93, 95 Clinical trial, 3, 51, 57, 58, 73, 93, 95, 96, 108 Cloning, 91, 93 Coenzyme, 90, 93 Collagen, 15, 26, 93, 97, 98, 103, 107, 108 Complement, 93, 94, 110 Complementary and alternative medicine, 51, 62, 94 Complementary medicine, 51, 94 Compression bandage, 7, 9, 94 Computational Biology, 73, 94 Computed tomography, 29, 94 Computerized axial tomography, 94 Computerized tomography, 94 Congestive heart failure, 6, 18, 94 Connective Tissue, 90, 92, 93, 94, 98, 103

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Contraindications, ii, 94 Contrast medium, 94, 106 Controlled clinical trial, 56, 57, 95, 108 Controlled study, 58, 95 Corneum, 95, 97 Coronary, 95, 101 Coumarin, 59, 95 Cutaneous, 19, 24, 30, 95, 106 Cyclic, 6, 95, 106 Cystathionine beta-Synthase, 95, 101 Cytokine, 4, 95, 105 Cytoplasm, 95, 99, 103 D Delivery of Health Care, 95, 99 DES, 28, 95 Diabetes Mellitus, 95, 100 Diabetic Retinopathy, 92, 95 Diagnostic procedure, 63, 95 Diastolic, 95, 101 Diffusion, 38, 44, 91, 95 Digestion, 6, 91, 95, 102, 105, 111 Dihydrotestosterone, 95, 109 Direct, iii, 4, 95, 109 Dissection, 20, 95 Double-blind, 9, 21, 48, 51, 54, 56, 57, 58, 96 Duodenum, 91, 96, 105, 111 E Edema, 7, 22, 48, 54, 61, 95, 96, 97, 103, 105 Efficacy, 16, 21, 48, 52, 53, 54, 55, 56, 57, 58, 59, 96 Elastic, 7, 27, 32, 96 Elasticity, 38, 96 Elastin, 93, 96, 97 Electrons, 90, 91, 96, 102 Embolectomy, 96, 111 Embolism, 35, 78, 96 Endoscope, 96 Endoscopic, 20, 22, 31, 96 Endothelial cell, 6, 56, 96, 98 Endotoxin, 96, 112 Environmental Health, 72, 74, 96 Enzymatic, 92, 94, 96, 98 Enzymes, 96, 98, 103, 112 Epidemiological, 45, 96 Epidermal, 33, 96 Epidermal Growth Factor, 33, 96 Epidermal growth factor receptor, 33, 96 Epidermis, 12, 91, 95, 96, 97, 100 Epithelial, 91, 96, 97 Epithelial Cells, 96, 97 Epoprostenol, 97, 101

Erythrocytes, 90, 92, 97, 109, 110 Escin, 60, 97 Esophageal, 97, 109 Esophageal Varices, 97, 109 Esophagus, 97, 105, 109, 111 Excitation, 97, 98, 104 Exogenous, 91, 97 Extracellular, 89, 94, 97, 98, 103 Extracellular Matrix, 94, 97, 98, 103 Extracellular Matrix Proteins, 97, 103 Extravasation, 4, 65, 97 Extremity, 13, 44, 97, 102 F Family Planning, 73, 97 Fatigue, 97, 100 Fibrin, 44, 91, 97, 98, 111 Fibrinogen, 97, 98, 111 Fibrinolysis, 17, 24, 28, 55, 98 Fibrinolytic, 28, 98 Fibroblast Growth Factor, 33, 98 Fibroblasts, 4, 11, 98 Fibronectin, 4, 98 Fibrosis, 19, 98, 109 Filtration, 6, 23, 98 Fixation, 98, 110 Flow Cytometry, 4, 98 Fluorescence, 98, 99 Fluorescent Dyes, 98, 99 Folate, 42, 99 Fold, 99, 105 Folic Acid, 99 G Gas, 92, 95, 99, 100, 111, 113 Gastric, 96, 99, 105, 109 Gene, 5, 19, 91, 99, 102 Gene Expression, 19, 99 Glucose, 90, 91, 95, 99, 100 Glucuronic Acid, 99, 100 Glycoprotein, 98, 99, 112 Governing Board, 99, 108 Granulocytes, 99, 102, 113 Growth factors, 4, 99 H Half-Life, 99, 101 Health Care Costs, 65, 99 Health Expenditures, 99 Heart failure, 100, 105 Hemodynamics, 18, 21, 25, 26, 27, 100 Hemoglobin, 9, 90, 97, 100, 105 Hemorheology, 22, 53, 55, 100 Hemorrhage, 92, 95, 100 Hemorrhoids, 61, 100, 109

117

Heparin, 28, 100 Hepatic, 100, 107 Heredity, 99, 100 Homologous, 100, 110 Hormonal, 91, 100 Hormone, 95, 100, 107, 111 Horny layer, 97, 100 Humoral, 6, 100 Humour, 100 Hydrogen, 91, 92, 97, 100, 104 Hydroxyethylrutoside, 60, 100 Hydroxylysine, 93, 100 Hydroxyproline, 93, 101 Hyperhomocysteinemia, 42, 95, 101 Hyperplasia, 5, 101 Hypersensitivity, 89, 101, 110 Hypertension, 4, 39, 45, 65, 97, 101 Hypertrophy, 101 Hypoxia, 7, 101 I Iloprost, 10, 101 Immune response, 90, 101, 110, 113 Immunization, 101, 110 Immunologic, 101, 105 Impairment, 38, 101 In vitro, 5, 92, 101 In vivo, 5, 6, 100, 101 Incision, 101, 102 Incompetence, 65, 101 Incubator, 4, 101 Indolent, 4, 101 Infection, 91, 101, 103, 104, 113 Inflammation, 4, 19, 30, 32, 56, 90, 98, 102, 107, 111, 113 Infusion, 102, 109 Interleukin-1, 4, 102 Interleukin-10, 4, 102 Interleukin-2, 102 Intermittent, 26, 28, 102, 107 Interstitial, 44, 102 Invasive, 32, 102, 105 Involuntary, 102, 109 Ions, 91, 100, 102 Ischemia, 91, 102 K Kb, 72, 102 Kinetic, 102 L Leg Ulcer, 11, 12, 18, 39, 41, 44, 54, 65, 102 Lesion, 102, 112 Leucocyte, 16, 28, 102 Ligation, 22, 102

Linkages, 100, 102 Liver, 18, 89, 90, 91, 97, 99, 100, 102, 107 Localized, 5, 98, 101, 103, 105, 107, 109, 112 Loop, 5, 103 Lymph, 96, 100, 103, 111 Lymph node, 103 Lymphatic, 30, 31, 102, 103, 105, 110, 111 Lymphedema, 6, 43, 103 Lymphocytes, 22, 90, 101, 102, 103, 110, 111, 113 Lymphoid, 102, 103 M Macrophage, 102, 103 Malnutrition, 91, 103 Mammogram, 92, 103, 104 Matrix metalloproteinase, 38, 103 Medial, 6, 7, 103 MEDLINE, 73, 103 Membrane, 17, 26, 94, 97, 103, 105 Mental, iv, 3, 72, 74, 97, 101, 103, 108, 109 Mental Health, iv, 3, 72, 74, 103, 108 Mercury, 32, 98, 103 Mesenchymal, 96, 103 Mesentery, 6, 103, 106 Meta-Analysis, 54, 104 Metastasis, 103, 104 Microcalcifications, 92, 104 Microcirculation, 6, 7, 19, 22, 23, 25, 30, 31, 43, 44, 53, 58, 59, 67, 104 Microscopy, 29, 104 Mitosis, 4, 104 Modification, 104, 108 Molecular, 28, 38, 73, 75, 91, 94, 98, 100, 104, 109, 112 Molecule, 90, 91, 93, 94, 97, 104, 108 Monocyte, 4, 13, 34, 37, 104 Mononuclear, 20, 104, 112 Monophosphate, 6, 104 Morphology, 31, 46, 104 Motility, 11, 104, 110 Mucins, 104 N Neonatal, 4, 11, 104 Nervous System, 104, 110 Neural, 89, 100, 104 Neuropathy, 33, 104 Neurotransmitter, 89, 104 Neutralization, 5, 105 Neutrophil, 4, 32, 105 Nuclei, 96, 104, 105 Nucleus, 93, 95, 103, 104, 105

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O Oedema, 54, 57, 58, 64, 105 Onychomycosis, 24, 105 Osmosis, 105 Osmotic, 6, 105 Outpatient, 4, 7, 105 Oximetry, 7, 57, 105 Oxygenation, 9, 105 P Pathophysiology, 32, 41, 65, 105 Patient Compliance, 25, 37, 105 Pentoxifylline, 33, 105 Peptic, 105, 109 Peptic Ulcer, 105, 109 Peptic Ulcer Hemorrhage, 105, 109 Peptide, 34, 98, 105, 107, 108 Perfusion, 6, 7, 29, 48, 60, 101, 105 Pericytes, 26, 105 Peripheral Vascular Disease, 41, 61, 106 Peritoneal, 90, 105, 106 Peritoneal Cavity, 90, 105, 106 Peritoneum, 103, 106 Pharmacokinetic, 106 Pharmacologic, 99, 106, 112 Pharmacotherapy, 48, 54, 106 Phlebography, 9, 40, 106 Phosphodiesterase, 105, 106 Phosphorus, 92, 106 Photoplethysmography, 12, 36, 106 Photosensitivity, 106, 107 Physiologic, 5, 34, 99, 106, 108 Physiology, 5, 106 Pigment, 106 Pigmentation, 65, 106 Pituitary Gland, 98, 106 Plants, 92, 99, 104, 107, 109, 112 Plasma, 34, 58, 92, 98, 100, 107 Platelet Activation, 28, 107 Platelet Aggregation, 97, 101, 105, 107 Platelet-Derived Growth Factor, 27, 107 Platelets, 107, 110 Plethysmography, 9, 10, 20, 32, 34, 36, 42, 43, 46, 107 Pleural, 105, 107 Pleural cavity, 105, 107 Pneumonia, 94, 107 Poisoning, 103, 107 Polypeptide, 93, 96, 98, 107 Porphyria, 44, 107 Porphyria Cutanea Tarda, 44, 107 Porphyria, Hepatic, 107 Potentiates, 102, 107

Practice Guidelines, 74, 108 Prevalence, 35, 42, 45, 65, 108 Progressive, 27, 107, 108 Proline, 93, 101, 108 Protein S, 91, 108 Proteins, 65, 89, 90, 93, 96, 97, 102, 103, 104, 105, 107, 108, 110 Protocol, 7, 108 Public Health, 39, 74, 108 Public Policy, 73, 108 Publishing, 8, 108 Pulse, 105, 108 Q Quality of Life, 19, 36, 65, 108 R Randomized, 21, 39, 48, 54, 56, 58, 96, 108 Randomized Controlled Trials, 54, 108 Receptor, 5, 27, 90, 108, 110 Recur, 4, 109 Red blood cells, 97, 107, 109 Reductase, 42, 109 Refer, 1, 93, 98, 109 Reflex, 43, 109 Reflux, 9, 21, 33, 34, 36, 42, 52, 109 Regeneration, 98, 109 Regimen, 96, 105, 106, 109 Regurgitation, 5, 109 Respiration, 92, 109 Rheology, 105, 109 Ribose, 89, 109 Risk factor, 35, 38, 101, 109 Rubber, 18, 89, 109 Rutin, 100, 109 S Saphenous, 16, 22, 23, 109 Saphenous Vein, 16, 22, 23, 109 Sclerotherapy, 27, 109 Screening, 93, 109 Secretion, 96, 100, 104, 109 Senescence, 4, 41, 109 Sensitization, 18, 110 Serotonin, 104, 106, 110, 112 Serum, 65, 93, 110, 112 Signs and Symptoms, 42, 110 Skeleton, 89, 110 Skin graft, 110 Social Environment, 108, 110 Social Security, 108, 110 Solvent, 105, 110 Somatic, 100, 104, 110 Somatic cells, 104, 110 Specialist, 79, 110

119

Species, 104, 110, 112 Spinal cord, 104, 109, 110 Spinous, 97, 110 Spleen, 103, 110 Sporadic, 107, 110 Stasis, 4, 64, 110 Stents, 40, 110 Stimulant, 100, 110 Stimulus, 97, 109, 111 Stomach, 89, 97, 99, 100, 105, 106, 109, 110, 111 Stress, 6, 93, 109, 111 Styrene, 109, 111 Subcutaneous, 9, 29, 39, 65, 96, 105, 111 Submaxillary, 96, 111 Suction, 98, 111 Supine, 7, 37, 111 Supine Position, 37, 111 Symptomatic, 28, 111 Symptomatic treatment, 28, 111 Systemic, 5, 92, 100, 102, 105, 111 Systolic, 101, 111 T Testosterone, 109, 111 Thigh, 21, 111 Threshold, 101, 111 Thrombectomy, 23, 96, 111 Thrombin, 97, 98, 107, 111 Thromboembolism, 4, 111 Thrombophlebitis, 43, 78, 111 Thrombosis, 4, 5, 24, 28, 108, 109, 111 Thymus, 101, 103, 111 Tomography, 111 Toxic, iv, 104, 111, 112 Toxicity, 103, 112 Toxicokinetics, 112 Toxicology, 74, 112 Transcutaneous, 7, 20, 44, 57, 112 Transfection, 5, 91, 112 Transplantation, 12, 101, 112 Trees, 109, 112

Tryptophan, 93, 110, 112 Tumor Necrosis Factor, 4, 112 U Ulcer, 7, 10, 14, 19, 41, 65, 105, 112 Ulceration, 4, 7, 12, 14, 15, 40, 44, 48, 54, 65, 102, 105, 112 Urine, 96, 112 Urokinase, 31, 112 Uroporphyrinogen Decarboxylase, 107, 112 V Vaccine, 108, 112 Vagina, 95, 112 Valves, 5, 65, 112 Varicose, 24, 34, 35, 40, 45, 61, 78, 102, 109, 112 Varicose Ulcer, 102, 112 Varicose vein, 24, 34, 35, 40, 45, 109, 112 Vascular endothelial growth factor, 27, 112 Vasculitis, 41, 113 Vasodilation, 101, 113 VE, 15, 52, 113 Vein, 4, 5, 12, 15, 22, 23, 24, 31, 35, 90, 106, 109, 111, 113 Venous Pressure, 10, 11, 36, 65, 113 Venous Thrombosis, 4, 35, 113 Ventricle, 108, 111, 113 Venules, 92, 104, 113 Veterinary Medicine, 73, 113 Virus, 102, 113 Viscera, 103, 110, 113 Viscosity, 92, 109, 113 Vitro, 100, 113 Vivo, 6, 113 W White blood cell, 90, 103, 104, 105, 113 Wound Healing, 98, 103, 113 X X-ray, 94, 98, 103, 113

120

Chronic Venous Insufficiency