© 2008 Royal Society of Medicine Press
Mechanisms of varicose vein formation: valve dysfunction and wall dilation
J D Raffetto* and R A Khalil
Varicose veins are a common venous disease of the lower extremity. Although the mechanisms and determinants ... are not clearly defined, recent clinical studies and basic science research have cast some light on possible mechanisms ... reflux and incompetent valves as well as vein wall dilation. Primary structural changes in the valves may make them ‘leaky’, with progressive reflux causing secondary changes in the vein wall. Alternatively, or concurrently, the valves may become incompetent secondary to structural abnormalities and focal dilation in vein wall segments near the valve junctions, and the reflux ensues as an epiphenomenon. The increase in venous pressure causes structural and functional changes in the vein wall that leads to further venous dilation. Increase in vein wall tension augments the expression/activity of matrix metalloproteinases (MMPs), which induces degradation of the extracellular matrix proteins and affect the structural integrity of the vein wall. ... effect of MMPs on the endothelium and smooth muscle components of the vein wall and thereby causing changes in the venous constriction/relaxation properties. Endothelial cell injury also triggers leukocyte infiltration, activation and inflammation, which lead to further vein wall damage. ...vein wall dilation appears to precede valve dysfunction, and the MMP activation and superimposed inflammation and fibrosis would then lead to chronic and progressive venous insufficiency and varicose vein formation.
...Venous ulcers manifest as a breakdown of the collagenous stromal tissue and are highly associated to chronic venous insufficiency.
http://www.ecureme.com/emyhealth/data/C ... ciency.asp
* Chronic venous insufficiency means that blood and fluid in the veins of the legs [JL: or brain?] do not drain out properly. Because of the buildup of fluid, the legs become swollen...
* Usually the first sign is swelling of the leg -- most often around the ankle. [JL: MaggieMae? you on this?]...
* Some patients complain of aching or discomfort in the leg after standing for long periods...
[JL: sounds familiar don't it]
if you didn't catch the post from last may on zinc in ms, this 1992 study found men averaging 13 (range 11-15) and women averaging even lower at 12 (10-14)
- Code: Select all
MS Ctrls MS MS Ctrls
Zn(µmol/l) 13.0±1.9 14.8±1.6 8.6 12.1±2.1 13.2±1.6
Cu(µmol/l) 14.7±3.7 15.3±1.6 15.7±3.3 16.8±2.1
Albumin(g/l) 42 ±3 43 ±4 41 ±4 41 ±3
adapted from: Palm and Hallmans. (1992). Zinc and copper in multiple sclerosis. Journal of Neurology, Neurosurgery, and Psychiatry45:691-698
an interesting update... my lab says normal for zinc is 11-18. this 2006 study of 1113 thai healthy controls finds an AVERAGE zinc level of 18 µmol/l.
The average serum zinc level of the population (n = 1113) was 18.20 μmol/l (95% CI = 18.05–18.36). There was no significant difference in the zinc levels between males and females, i.e. 18.20 μmol/l (95% CI = 17.90–18.36) vs. 18.36 μmol/l (95% CI = 18.05–18.66). The zinc level tended to decrease significantly as age increased, particularly in the male population (p < 0.05).
test yer zinc ppl, fix up those veins.