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Hoffmann, R. A wiki for the life sciences where authorship matters. Nature Genetics (2008)
MeSH Review

Varicose Ulcer

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Disease relevance of Varicose Ulcer

  • The interference of hyperglycemia with hypoxia-dependent stabilization of HIF-1alpha protein levels was confirmed in vivo, where only very low levels of HIF-1alpha protein could be detected in diabetic wounds, as compared with chronic venous ulcers [1].
  • Thus, inhibition of COX-1 by non-steroidal anti-inflammatory drugs (NSAIDs) could increase the local ischaemia and hypoxia associated with chronic venous ulcers [2].
  • Micronised purified flavonoid fraction: a review of its use in chronic venous insufficiency, venous ulcers and haemorrhoids [3].
  • The indications for these studies were leg pain (34%), leg swelling (24%), surveillance for DVT in a patient at high risk (23%), searching for a source of pulmonary embolism (14%), follow-up of previously diagnosed DVT (3%), and other indications (i.e., varicose veins, venous ulcer, 2%) [4].
  • RESULTS: TGF-beta3 expression was increased in the epithelium at the edge of diabetic foot ulcers, being more intense than diabetic and normal skin (P = 0.03, 0.02, respectively), as was its expression in venous ulcers compared with normal skin [5].

Psychiatry related information on Varicose Ulcer

  • No studies evaluating topical phlebotonics, chromocarbe, naftazone or disodium flavodate fulfilled the inclusion criteria.Outcomes included oedema, venous ulcers, trophic disorders, subjective symptoms (pain, cramps, restless legs, itching, heaviness, swelling and paraesthesias), global assessment measures and side effects [6].

High impact information on Varicose Ulcer


Chemical compound and disease context of Varicose Ulcer

  • NO overexpression in chronic venous ulcers may be involved directly or indirectly (through production of peroxynitrite) in the pathogenesis and delayed healing of chronic venous ulcers, through its effects on vasculature, inflammation, and collagen deposition [9].
  • No leakage occurred following gamma sterilization of the dressing and, more importantly, the deferoxamine-coupled cellulose dressing retained its iron complexing properties sufficient to reduce iron levels found in chronic venous ulcers to levels comparable to those found in acute wounds [10].
  • The good long-term results in 78% of the cases indicate that patients with recurrent venous stasis ulcers may receive lasting benefit from modified Linton procedures [11].
  • When tissue samples were subjected to fibronectin zymography, the main protease involved in the breakdown of fibronectin in both venous ulcers and acute wounds of elderly subjects was found to be a serine protease with a molecular weight of approximately 30 kd [12].
  • Topical application of povidone-iodine in the management of decubitus and stasis ulcers [13].

Biological context of Varicose Ulcer


Anatomical context of Varicose Ulcer


Gene context of Varicose Ulcer

  • The levels of soluble p55 and p75 receptors in wound fluid showed a significant linear correlation (p < 0.001), suggesting a partially coordinated or common regulatory mechanism for the cleavage of transmembrane TNF receptors in chronic venous ulcers in vivo [21].
  • CONCLUSION: In nonhealing venous ulcers there is a consistently high level of expression of VEGF, at both the gene transcript and protein level [22].
  • CONCLUSION: Non-healing venous ulcers are associated with greater activity MMP-2 activity [23].
  • A significantly higher ratio of TCC/CD59 was found in the ischaemic compared to venous ulcers (p = 0.018) [24].
  • We conclude that venous ulcer fibroblasts show decreased Type II receptor expression and display abnormalities in the downstream signaling pathway involving MAPK and the early Smad pathway [25].

Analytical, diagnostic and therapeutic context of Varicose Ulcer


  1. Hyperglycemia regulates hypoxia-inducible factor-1alpha protein stability and function. Catrina, S.B., Okamoto, K., Pereira, T., Brismar, K., Poellinger, L. Diabetes (2004) [Pubmed]
  2. Expression of cyclooxygenase isoforms in normal human skin and chronic venous ulcers. Abd-El-Aleem, S.A., Ferguson, M.W., Appleton, I., Bhowmick, A., McCollum, C.N., Ireland, G.W. J. Pathol. (2001) [Pubmed]
  3. Micronised purified flavonoid fraction: a review of its use in chronic venous insufficiency, venous ulcers and haemorrhoids. Lyseng-Williamson, K.A., Perry, C.M. Drugs (2003) [Pubmed]
  4. Inappropriate use of venous duplex scans: an analysis of indications and results. Fowl, R.J., Strothman, G.B., Blebea, J., Rosenthal, G.J., Kempczinski, R.F. J. Vasc. Surg. (1996) [Pubmed]
  5. Transforming growth factor-beta 1, 2, 3 and receptor type I and II in diabetic foot ulcers. Jude, E.B., Blakytny, R., Bulmer, J., Boulton, A.J., Ferguson, M.W. Diabet. Med. (2002) [Pubmed]
  6. Phlebotonics for venous insufficiency. Martinez, M.J., Bonfill, X., Moreno, R.M., Vargas, E., Capellà, D. Cochrane database of systematic reviews (Online) (2005) [Pubmed]
  7. Sucralfate and chronic venous stasis ulcers. Tsakayannis, D., Li, W.W., Razvi, S., Spirito, N. Lancet (1994) [Pubmed]
  8. Sequential changes in histologic pattern and extracellular matrix deposition during the healing of chronic venous ulcers. Herrick, S.E., Sloan, P., McGurk, M., Freak, L., McCollum, C.N., Ferguson, M.W. Am. J. Pathol. (1992) [Pubmed]
  9. Expression of nitric oxide synthase isoforms and arginase in normal human skin and chronic venous leg ulcers. Abd-El-Aleem, S.A., Ferguson, M.W., Appleton, I., Kairsingh, S., Jude, E.B., Jones, K., McCollum, C.N., Ireland, G.W. J. Pathol. (2000) [Pubmed]
  10. Selective pick-up of increased iron by deferoxamine-coupled cellulose abrogates the iron-driven induction of matrix-degrading metalloproteinase 1 and lipid peroxidation in human dermal fibroblasts in vitro: a new dressing concept. Wenk, J., Foitzik, A., Achterberg, V., Sabiwalsky, A., Dissemond, J., Meewes, C., Reitz, A., Brenneisen, P., Wlaschek, M., Meyer-Ingold, W., Scharffetter-Kochanek, K. J. Invest. Dermatol. (2001) [Pubmed]
  11. Surgical management of refractory venous stasis ulceration. Cikrit, D.F., Nichols, W.K., Silver, D. J. Vasc. Surg. (1988) [Pubmed]
  12. Up-regulation of elastase in acute wounds of healthy aged humans and chronic venous leg ulcers are associated with matrix degradation. Herrick, S., Ashcroft, G., Ireland, G., Horan, M., McCollum, C., Ferguson, M. Lab. Invest. (1997) [Pubmed]
  13. Topical application of povidone-iodine in the management of decubitus and stasis ulcers. Lee, B.Y., Trainor, F.S., Thoden, W.R. Journal of the American Geriatrics Society. (1979) [Pubmed]
  14. Differences in cellular infiltrate and extracellular matrix of chronic diabetic and venous ulcers versus acute wounds. Loots, M.A., Lamme, E.N., Zeegelaar, J., Mekkes, J.R., Bos, J.D., Middelkoop, E. J. Invest. Dermatol. (1998) [Pubmed]
  15. The effect of passage number on fibroblast cellular senescence in patients with chronic venous insufficiency with and without ulcer. Raffetto, J.D., Mendez, M.V., Phillips, T.J., Park, H.Y., Menzoian, J.O. Am. J. Surg. (1999) [Pubmed]
  16. Mitogen-activated protein kinase pathway regulates cell proliferation in venous ulcer fibroblasts. Raffetto, J.D., Vasquez, R., Goodwin, D.G., Menzoian, J.O. Vascular and endovascular surgery. (2006) [Pubmed]
  17. Venous ulcer fibroblasts compared with normal fibroblasts show differences in collagen but not fibronectin production under both normal and hypoxic conditions. Herrick, S.E., Ireland, G.W., Simon, D., McCollum, C.N., Ferguson, M.W. J. Invest. Dermatol. (1996) [Pubmed]
  18. Effect of venous ulcer exudates on angiogenesis in vitro. Drinkwater, S.L., Smith, A., Sawyer, B.M., Burnand, K.G. The British journal of surgery. (2002) [Pubmed]
  19. Clinical benchmark for healing of chronic venous ulcers. Venous Ulcer Study Collaborators. Lyon, R.T., Veith, F.J., Bolton, L., Machado, F. Am. J. Surg. (1998) [Pubmed]
  20. The history of vascular surgery in Canada. McPhail, N.V. Canadian journal of surgery. Journal canadien de chirurgie. (1995) [Pubmed]
  21. Levels of tumor necrosis factor-alpha (TNF-alpha) and soluble TNF receptors in chronic venous leg ulcers--correlations to healing status. Wallace, H.J., Stacey, M.C. J. Invest. Dermatol. (1998) [Pubmed]
  22. Increased but ineffectual angiogenic drive in nonhealing venous leg ulcers. Drinkwater, S.L., Burnand, K.G., Ding, R., Smith, A. J. Vasc. Surg. (2003) [Pubmed]
  23. The impact of differential expression of extracellular matrix metalloproteinase inducer, matrix metalloproteinase-2, tissue inhibitor of matrix metalloproteinase-2 and PDGF-AA on the chronicity of venous leg ulcers. Mwaura, B., Mahendran, B., Hynes, N., Defreitas, D., Avalos, G., Adegbola, T., Adham, M., Connolly, C.E., Sultan, S. European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery. (2006) [Pubmed]
  24. The terminal complement complex is generated in chronic leg ulcers in the absence of protectin (CD59). Balslev, E., Thomsen, H.K., Danielsen, L., Sheller, J., Garred, P. APMIS (1999) [Pubmed]
  25. Fibroblasts from chronic wounds show altered TGF-beta-signaling and decreased TGF-beta Type II receptor expression. Kim, B.C., Kim, H.T., Park, S.H., Cha, J.S., Yufit, T., Kim, S.J., Falanga, V. J. Cell. Physiol. (2003) [Pubmed]
  26. Patterns of matrix metalloproteinase and TIMP-1 expression in chronic and normally healing human cutaneous wounds. Vaalamo, M., Weckroth, M., Puolakkainen, P., Kere, J., Saarinen, P., Lauharanta, J., Saarialho-Kere, U.K. Br. J. Dermatol. (1996) [Pubmed]
  27. A reduction in serum cytokine levels parallels healing of venous ulcers in patients undergoing compression therapy. Murphy, M.A., Joyce, W.P., Condron, C., Bouchier-Hayes, D. European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery. (2002) [Pubmed]
  28. Prevalence, incidence, management, and predictors of venous ulcers in the long-term-care population using the MDS. Wipke-Tevis, D.D., Rantz, M.J., Mehr, D.R., Popejoy, L., Petroski, G., Madsen, R., Conn, V.S., Grando, V.T., Porter, R., Maas, M. Advances in skin & wound care. (2000) [Pubmed]
  29. Sclerotherapy for varicose veins. Treatment prevents stasis ulcers and other complications. Fitzgerald, A., Turner-Brown, A.D., Roddel, J., Sheilds, T. Advance for nurse practitioners. (2004) [Pubmed]
  30. Subfascial endoscopic ligation of perforator veins (SEPS) in the treatment of venous ulcers. Olivencia, J.A. International surgery. (2000) [Pubmed]
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