Properties of the venous vascular system in the lower extremities of individuals with paraplegia

Hopman, Maria T. E.; Nommensen, E; Asten, W.N.J.C. van; Oeseburg, B.; Binkhorst, R. A.

doi:10.1038/sc.1994.128

Cited by 67 publications

(74 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Phenotyping of osteoclasts in HO revealed their derivation from mature local macrophages and expression intensities of the proliferation markers PCNA and MIB1 suggested a proliferation behavior in peripheral areas of osteogenesis similar to that found in autonomous osseous neoplasias and underlined the reactive-proliferative character of HO. 12 Prostaglandins and other eicosanoids have been shown to have a role in bone metabolism and to induce HO in experimental animals. Furthermore, elevation of urinary prostaglandin E2 has been demonstrated to herald the formation of HO.…”

Section: Discussionmentioning

confidence: 99%

Microvascular changes in the lower extremities of paraplegics with heterotopic ossification

Lotta¹,

Scelsi

2001

Spinal Cord

View full text Add to dashboard Cite

Objectives: To investigate the morphological aspects of blood microvasculature of the skin and subcutaneous tissues in subjects with paraplegia with heterotopic ossi®cation (HO). Methods: In two patients with traumatic spinal cord injury and HO, punch biopsies of skin and hypodermic soft tissue in the region of HO near the hip were studied with histological and ultrastructural methods. Results: Alterations of endothelial cell and basement membrane of capillaries and small vessels were observed. Hyperactive endothelium, thickening and reduplication of the basement membrane, changes of the perivascular connective tissues and microcalci®cations in the subcutaneous fat tissue were also seen.Conclusions: This present study indicates microvascular changes in the skin and subcutaneous tissue in the region of HO near the hip of two subjects with paraplegia. In our opinion the described vascular changes may induce hypoxiemic alterations of the soft para-articular tissues leading metabolic changes which may contribute to the development of HO. Therefore, it cannot be concluded whether these changes are directly responsible for HO induction. Spinal Cord (2001) 39, 595 ± 598

show abstract

Section: Discussionmentioning

confidence: 99%

Microvascular changes in the lower extremities of paraplegics with heterotopic ossification

Lotta¹,

Scelsi

2001

Spinal Cord

View full text Add to dashboard Cite

show abstract

“…Interestingly, in our study we observed the highest muscle T 2 values in wheelchair users (S5, S6, S7 and S8). As persons with motor incomplete SCI have vascular disturbances including venous vascular dysfunction, 18 a continuous dependent position of their lower extremities (in the seated position) most likely leads to accumulation of myocellular water in the postural leg muscles.…”

Section: Incomplete Sci (Ambulatory)mentioning

confidence: 99%

Non-invasive assessment of lower extremity muscle composition after incomplete spinal cord injury

et al. 2008

View full text Add to dashboard Cite

Study Design: Cross-sectional study. Objective: (1) To quantify intramyocellular lipid (IMCL) content of the soleus muscle. (2) To assess the T 2 relaxation rates in the lower extremity skeletal muscles in persons with incomplete spinal cord injury (SCI). Setting: Academic Institution, Florida. Methods: Eight subjects (42 ± 10 years old; 70 ± 12 kg; 176 ± 10 cm) with chronic (17 ± 9 months post injury) motor SCI (C4-T12; ASIA C or D) and eight matched healthy controls were tested. Localized unsuppressed proton spectroscopy (H-MRS) was performed to estimate total lipid content and individual lipid components; IMCL and extramyocellular lipid (EMCL) from the soleus muscle. T 2 -weighted imaging of lower extremity muscles yielded muscle T 2 rates. Results: The IMCL content of the soleus muscle was 3.3 times higher in the patient group as compared to controls (P ¼ 0.002; 0.0401 (0.0234-0.0849) versus 0.0123 (0.0090-0.0175)). Similarly, EMCL measures were 4.5 times higher as compared to the controls (P ¼ 0.002). Significant differences were observed in the T 2 relaxation times of the soleus and gastrocnemius muscles (Po0.05). Conclusion:The increased levels of IMCL might interfere with the glucose uptake in skeletal muscle; potentially predisposing persons with incomplete SCI to the development of peripheral insulin resistance. Marked elevations in the T 2 relaxation times of the locomotor muscles are reflective of an altered muscle composition.

show abstract

“…Using venous occlusion plethysmography, and in contrast to the comparable LF SBP ®ndings, investigators have reported signi®cantly reduced venous vascular function below the level of injury in subjects with tetraplegia or paraplegia relative to able-bodied controls (0.34+ 0.11 or 0.51+0.21% vs 0.255+0.92% respectively; P50.05). 186,191 Venous compliance, a measure of the responsiveness of the vascular system, was approximately ®vefold lower in the SCI groups than controls, indicating that the combination of autonomic disruption, immobility and inactivity caused considerable reduction in vessel compliance and responsiveness. The clinical implications of these ®ndings suggest that orthostatic intervention and/or regular physical activity may improve vascular integrity and, potentially, peripheral and central venous pressure in individuals with SCI.…”

Section: Peripheral Vascular Functionmentioning

confidence: 99%

Risk factors for atherogenesis and cardiovascular autonomic function in persons with spinal cord injury

et al. 1999

View full text Add to dashboard Cite

Persons with spinal cord injury (SCI) have been recognized to have several metabolic changes that adversely impact their risk for cardiovascular disease. An increased prevalence of disorders of carbohydrate metabolism and dyslipidemia may be related predominantly to paralysis with immobilization and associated loss of lean body tissue and gain in relative adiposity. Studies have reported an increased risk of vascular disease in those with SCI. As such, an understanding of the constellation of carbohydrate and lipid changes that occur after SCI is relevant to the clinical practice of medicine in this population. Oral glucose tolerance testing and associated studiesImpaired glucose tolerance and diabetes mellitus are more prevalent in individuals with SCI than in those who are able-bodied. 1 ± 4 In most of the individuals with SCI and abnormal carbohydrate tolerance, resistance to insulin mediation of glucose uptake by peripheral tissues may be demonstrable. In the presence of insulin resistance, the normal homeostatic response to glucose challenge is increased pancreatic b-cell secretion of insulin. If the compensatory response of the pancreas is insu cient to control the serum glucose concentration, worsening of carbohydrate tolerance will ensue.Bauman et al 3 performed a 75 g oral glucose tolerance test in 100 male veterans with SCI and in 50 able-bodied veteran controls. According to criteria established by the World Health Organization, 5 22% of those with SCI were diabetic whereas only 6% of the control group were diabetic. Eighty-two per cent of the controls had normal oral glucose tolerance, compared with 38% of those with quadriplegia and 50% of those with paraplegia. Subjects with SCI had signi®cantly higher mean plasma glucose and insulin values at several points during the oral glucose tolerance test when compared with controls ( Figure 1). In subgroups, determinants of insulin sensitivity were measured: per cent lean body mass, per cent fat mass, and cardiopulmonary ®tness. Values for insulin sensitivity were linearly related with those of ®tness (VO 2 max) determined from a progressive incremental upper-body exercise stress test. Insulin sensitivity was suggestively correlated with lean body mass, and negatively correlated with body fat. Thus, in a relatively small subgroup of untrained subjects with paraplegia, the strongest determinant of insulin sensitivity was cardiopulmonary ®tness.In 201 non-veteran subjects with SCI, Bauman et al 2 studied the relationship of oral carbohydrate tolerance after a 75 g glucose load to several variables, including level and completeness of lesion, gender, ethnicity, age, duration of injury, and anthropometric measures. Of the total group, 27 (13%) had diabetes mellitus and 56 (29%) had impaired glucose tolerance. 2,6 The subjects with complete tetraplegia had sign®cantly worse carbohydrate tolerance (Figure 2) and were more frequently classi®ed with a disorder of carbohydrate tolerance than the other neurological de®cit subgroups. 2 There were no signi®cant gend...

show abstract

Properties of the venous vascular system in the lower extremities of individuals with paraplegia

Cited by 67 publications

References 18 publications

Microvascular changes in the lower extremities of paraplegics with heterotopic ossification

Microvascular changes in the lower extremities of paraplegics with heterotopic ossification

Non-invasive assessment of lower extremity muscle composition after incomplete spinal cord injury

Risk factors for atherogenesis and cardiovascular autonomic function in persons with spinal cord injury

Contact Info

Product

Resources

About