Changes in blood flow and permeability of vessels to protein preceding the development of cutaneous ulcers in the hind limb of the rabbit

Koźniewska, Ewa; Jung, Leszek; Skolasińska, K; Baraniewski, H; Borkowski, M; Wasiutyński, Aleksander; Kwiatkowski, Jacek

doi:10.1016/0026-2862(80)90039-4

Cited by 5 publications

(3 citation statements)

References 5 publications

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“…36,37 Abnormalities in sympathetic vasoconstriction were detectable in the majority of diabetic patients with early-phase autonomic neuropathy. 38 …”

Section: Discussionmentioning

confidence: 97%

Cardiovascular Autonomic Dysfunction Predicts Diabetic Foot Ulcers in Patients With Type 2 Diabetes Without Diabetic Polyneuropathy

et al. 2016

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We investigated the factors that might influence the development of diabetic foot ulcers (DFUs) in type 2 diabetes patients without diabetic polyneuropathy (DPN).From January 2000 to December 2005, a total of 595 patients who had type 2 diabetes without DPN between the ages of 25 and 75 years, and had no prior history of DFUs were consecutively enrolled in the study. A cardiovascular autonomic function test was performed to diagnose cardiovascular autonomic neuropathy (CAN) using heart rate variability parameters.The median follow-up time was 13.3 years. Among the 449 (75.4%) patients who completed the follow-up evaluation, 22 (4.9%) patients developed new ulcers, and 6 (1.3%) patients underwent the procedure for lower extremity amputations. The patients in the DFUs group had a longer duration of diabetes, higher baseline HbA1c levels, higher rates of nephropathy, and CAN. A Cox hazard regression analysis results revealed that the development of DFUs was significantly associated with the presence of CAN (normal vs definite CAN; HR, 4.45; 95% confidence interval, 1.29–15.33) after adjusting for possible confounding factors.The development of DFUs was independently associated with CAN in patients with type 2 diabetes without DPN. We suggested the importance of CAN as a predictor of DFUs even in the patients without DPN, and the need to pay attention to patients with definite CAN and type 2 diabetes.

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“…36,37 Abnormalities in sympathetic vasoconstriction were detectable in the majority of diabetic patients with early-phase autonomic neuropathy. 38 …”

Section: Discussionmentioning

confidence: 97%

Cardiovascular Autonomic Dysfunction Predicts Diabetic Foot Ulcers in Patients With Type 2 Diabetes Without Diabetic Polyneuropathy

et al. 2016

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“…Nine patients suffered from diabetes mellitus, 1 patient from peripheral arterial occlusive disease, and 5 patients were on regular hemodialysis. Treatments were scheduled on Days 1,2,4,6,8,10,13,16,19,22,25,and 28. One hundred forty-four treatments with fibrinogen adsorption were performed.…”

mentioning

confidence: 99%

“…For impaired microcirculation, arteriovenous shunts (13), an increased permeability of the vessel wall (14), and an increase of precapillary resistance (15) are of pathophysiological importance.…”

mentioning

confidence: 99%

Fibrinogen Adsorption in the Diabetic Foot Syndrome and Peripheral Arterial Occlusive Disease: First Clinical Experience

Richter¹,

Jahn²,

Jung

et al. 2001

Therapeutic Apheresis

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The elimination of fibrinogen from plasma improves plasma viscosity and whole‐blood viscosity. For extracorporeal adsorption of fibrinogen, the pentapeptide gly‐pro‐arg‐pro‐lys was coupled to sepharose CL‐4B. Adsorbers containing 135 ml of coupled sepharose CL‐4B were used to eliminate fibrinogen from the plasma of 7 men and 3 women (48–75 years old). Nine patients suffered from diabetes mellitus, 1 patient from peripheral arterial occlusive disease, and 5 patients were on regular hemodialysis. Treatments were scheduled on Days 1, 2, 4, 6, 8, 10, 13, 16, 19, 22, 25, and 28. One hundred forty‐four treatments with fibrinogen adsorption were performed. No clinical side effects due to the fibrinogen adsorption procedure were observed. In these 10 patients, fibrinogen concentration before the first treatment was 473.7 ± 183.7 mg/dl. In the first treatment session, fibrinogen concentration was lowered to 241.4 ± 125.8 mg/dl by treating 4,270 ± 1,180 ml of plasma. In the following 134 treatments, the pretreatment concentration of fibrinogen was 262.6 ± 83.4 mg/dl, and the posttreatment concentration was 120.6 ± 37.2 mg/dl. The mean amount of plasma treated was 3,737 ± 1,643 ml, and the mean duration of a treatment session (except first treatment) was 143.7 ± 63.1 min. In 7 patients, a mean posttreatment fibrinogen concentration of ≤123 mg/dl was obtained; in the other patients, concentrations of 133, 177, and 184 mg/dl were obtained. Yet, the decrease of fibrinogen concentration was also pronounced in these 3 patients: −82%, −67%, and −73%, respectively. During the treatment period of 28 days, wound healing was observed in 9 of the 10 patients. In conclusion, affinity chromatography using the pentapeptide gly‐pro‐arg‐pro‐lys is an effective, selective, and safe procedure to lower fibrinogen concentration in plasma. It could be a therapeutic option in severe blood vessel disease in which drug therapy is not sufficient and invasive procedures such as bypass or angioplasty cannot be applied. Yet, more information is needed, for example, about the fibrinogen concentration that has to be reached to get the maximal improvement of micro‐ and/or macrocirculation.

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The diabetic foot: Pathophysiology and treatment

Edmonds¹

1986

Clinics in Endocrinology and Metabolism

119

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Changes in blood flow and permeability of vessels to protein preceding the development of cutaneous ulcers in the hind limb of the rabbit

Cited by 5 publications

References 5 publications

Cardiovascular Autonomic Dysfunction Predicts Diabetic Foot Ulcers in Patients With Type 2 Diabetes Without Diabetic Polyneuropathy

Cardiovascular Autonomic Dysfunction Predicts Diabetic Foot Ulcers in Patients With Type 2 Diabetes Without Diabetic Polyneuropathy

Fibrinogen Adsorption in the Diabetic Foot Syndrome and Peripheral Arterial Occlusive Disease: First Clinical Experience

The diabetic foot: Pathophysiology and treatment

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