Dysregulated L-selectin expression on lymphocytes in patients with chronic venous insufficiency.

In this study we analysed blood samples taken from the dorsalis pedis vein and a brachial vein of 11 healthy test persons and 8 patients with venous leg ulcer under experimental venous hypertension in order to examine changes in the expression of leukocyte adhesion molecules (LFA-1 (CD11a), Mac-1 (CD11b), p150,95 (CD11c), CD18, VLA-4 (CD49d) and L-selectin (CD62L)) which are involved in the adhesion steps of leukocytes to endothelial cells for transmigration into tissues. Under orthostatic stress, lymphocytes in controls collected at the foot level showed a significant reduction in the expression of L-selectin (p=0.002), compared to those of patients.

Morphoea is neither associated with features of Borrelia burgdorferi infection, nor is this agent detectable in lesional skin by polymerase chain reaction.

Background: The aetiology of morphoea is still unknown. Borrelia burgdorferi as a causative agent of morphoea has been discussed since 1985, but the relationship remains uncertain.

Objectives: We aimed to find evidence for infection with B.

[Questionable effectiveness of autologous platelet growth factors (PDWHF) in treatment of venous ulcers of the leg].

Chronic venous insufficiency (CVI) can cause ulcers of the lower limb having the character of a full thickness wound involving the subcutaneous tissues and fat. Healing requires wound contraction, connective tissue formation and finally reepithelialization. To induce wound healing, on an underlying disturbed environment due to longterm effects of CVI, artificial stimuli may be needed.

Biomechanical stimulation therapy. A novel physiotherapy method for systemic sclerosis.

To improve the mobility of joints, particularly of the finger joints and the mandibular joint, and to reduce the edema of the skin, various physical therapies have to be used in patients with SSc. As the quality of patients' life depends on the use of their fingers and of their mouth, these therapeutics belong to the basic measures in the treatment of SSc. In addition to the manually performed lymph drainage a new method, the biomechanical stimulation therapy, has proven to be efficacious to improve the mobility of the joints and to reduce the edema in SSc-patients.

The effect of compression therapy on venous haemodynamics in pregnant women.

Objective: To study the influence of compression on the haemodynamics of the deep venous system in pregnancy.

Design: A prospective, observational study.

Setting: The phlebological unit of the department of dermatology at a university hospital.

Local cold exposure test with a new arterial photoplethysmographic sensor in healthy controls and patients with secondary Raynaud's phenomenon.

Local cold exposure tests are used to diagnose cold-induced vasospastic disorders and to evaluate therapeutic success. We investigated the pulsatile signal detected with a newly developed arterial photoplethysmography (APPG) method and the signal change induced by local cold exposure using a temperature-controlled finger holder, comparing it with laser Doppler flux (red and green laser, rLDF and gLDF) and red blood cell velocity measured in nailfold capillaries (CBV). Ten healthy volunteers and 10 age- and sex-matched patients suffering from Raynaud's phenomenon due to systemic sclerosis were investigated using a moderate cooling temperature of 16 degrees C for 5 min.

[Quality of life in chronic venous insufficiency (CVI). Results of a study with the newly developed Tübingen Questionnaire for measuring quality of life of patients with chronic venous insufficiency].

Across the boundaries of the medical specialties we have realized how important the concepts of quality of life and disease-related coping behavior are to understand the patients' subjective perception of the medical condition and its treatment. Although standardized instruments are already available for different medical indications and even in the related fields of peripheral vascular and cardiac diseases, phlebology still lacks standardized concepts for evaluating quality of life and/or disease-related coping behavior in patients with chronic venous insufficiency (CVI). We report on a newly developed instrument specifically designed for recording quality of life in patients with CVI.

[Physical therapy of venous diseases].

If physical therapy like compression stockings and supervised outpatient vascular exercise programmes are begun early, subjective complaints can be alleviated and ankle flexibility and venous drainage can be improved. Incapacitating congestive diseases such as dermatolipofasciitis and ulcus cruris can be avoided. Once chronic venous congestion has led to joint capsule atrophy, stiffening of the ankle and muscular atrophy in the lower leg, expensive therapeutic measures involving professional physiotherapeutic care become unavoidable.

Improvement of acral circulation in a patient with systemic sclerosis with stellate blocks.

We report on a 77-year-old male patient with systemic sclerosis. He suffered from secondary Raynaud's phenomenon on the basis of systemic sclerosis. Medical treatment in the past, including the administration of calcium-channel blockers, pentoxifylline and intravenous prostaglandin therapy, was unsuccessful and the clinical situation became worse.

[The effect of compression therapy on the microcirculation of the skin in patients with chronic venous insufficiency (CVI)].

Compression therapy was employed for 4 weeks 20 patients with chronic venous insufficiency stage CVI I and CVI II according to Widmer's classification. Compression bandaging for 2 weeks was followed by compression stockings for 2 more weeks. The cutaneous microcirculation was evaluated before therapy, after 2 weeks and after finishing compression therapy after 4 weeks.

[The technical construction of a computer-supported measuring unit for in-vivo capillary pressure measurement in human nail fold capillaries].

Capillary pressure (CP) is an important determinant of microvascular function. According to Frank Starling, it governs not only the viscosity of the blood and the permeability of the capillary membrane, but also filtration and reabsorption in the microvascular bed. Despite its great significance, the technique of CP measurement is employed in only a few laboratories throughout the world owing to the technical difficulties involved in carrying out such measurements.

[Treatment of venous ulcers with low frequency pulsed current (Dermapulse): effects on cutaneous microcirculation].

Chronic venous insufficiency (CVI) is characterised by stage-dependent microangiopathy. With increasing severity there is a decrease in the number of skin capillaries and the oxygen partial pressure. The cutaneous vascular reserve, which is measured by laser-doppler fluxmetry, is reduced.

[Development of a computer-assisted thermoelectric Peltier cold test procedure with integrated photoplethysmography unit for noninvasive evaluation of acral skin circulation].

Local cold provocation tests are an important, non-invasive diagnostic tool for collecting information about skin perfusion during exposure to cold. In patients suffering from vasospastic circulatory disorders such as Raynaud's phenomenon, it is of particular importance to be able to collect data about acral circulation during the cooling test in the asymptomatic intervals between naturally occurring attacks. By carrying out a series of cold provocation tests, for example, patient response to a newly initiated therapy can be assessed.

Cutaneous inflammation limited to the region of the ulcer in chronic venous insufficiency.

Background: The role of inflammatory reactions in the pathogenesis of chronic venous insufficiency and the persistence of venous ulcerations is still not totally clear and remains a hotly debated topic. An investigation of the intensity and distribution of ICAM-1 expression and different inflammatory cells should help clarify whether inflammatory processes are limited locally to the area of the ulcer or if an upregulation can also be observed in clinically unaffected skin of CVI-III patients, as a sign of a primary inflammatory process.

Patients And Methods: We examined two skin areas in 10 patients with venous ulcerations.

[Dynamic in vivo skin pressure measurement in quality control of compression stockings].

The well-documented positive effect of compression stocking therapy on the venous macro- and microhemodynamics of the legs can only be attained if the stockings fit well. In order to determine the effective pressure exerted by compression stockings, we usually deleted in US journals. One can get this out of journal and author's address have developed a new measuring method based on piezoresistant microprobes and a microprocessor unit.

[Vascular sports in ambulatory therapy of venous circulatory disorders of the legs. Diagnostic, therapeutic and prognostic aspects].

In 33 patients with chronic venous incompetence (CVI) caused by primary varicoses or postthrombotic syndrome stage I-III (according to Widmer) the therapeutic benefit of 6 months of medically supervised physical exercise training was documented. During the training penud there was an improvement in subjective complains such as pain and tendency for edema in the legs. Mobility in the upper ankle joint was improved asuss as venous drainage function.

[Cap image--a new kind of computer-assisted video image analysis system for dynamic capillary microscopy].

We describe a newly developed multi-function video image analysis system for the computer-aided evaluation of capillaroscopic findings in microcirculation research. The Cap image analysis system comprises an IBM-compatible PC with a Matrox image processing card and real-time video tape digitalization. The video recorder is driven by a personal computer to which it is connected via an RS-232 interface.

[Biomechanical stimulation therapy as physical treatment of arthrogenic venous insufficiency].

We report about a new type of physical therapy which can be used in patients with joint immobility secondary to by chronic venous insufficiency. Biomechanical stimulation therapy (BMS) uses mechanical vibration of standardised frequencies from 18-35 Hz spectrum to expose the feet and legs to longitudinal mechanical stimuli. Therapeutic benefit and clinical improvement can be achieved after a short period of treatment.