Biomedical subjects

Y K Vandongen

Publications and source records attributed to Y K Vandongen.

6 recordsLinked to original sources

PubMed1999

Changes in calf muscle function in chronic venous disease.

The aim of this study was to assess calf muscle function in patients with chronic venous disease and recently healed venous ulcers. Forty-nine consecutive patients with recently healed proven venous leg ulcers and 20 age- and sex-matched control subjects were entered into this study. Both patients and control subjects underwent duplex scan evaluation of their leg veins and isokinetic measurement for calf muscle strength and endurance. Calf muscle function was significantly impaired in patients with chronic venous disease compared with control subjects. Both peak torque/body weight (strength), P = 0.049 (CI 0.3-18.4%) and total work (endurance), P = 0.05 (Cl 6.01-97.6 Nm) were reduced. This study has shown that patients with chronic venous disease have a significant impairment of calf muscle function compared with healthy control subjects. This study suggests that there is a need to evaluate whether a programme to improve muscle strength may be of benefit in both healing and preventing the recurrence of chronic venous ulcers.

Adult↗

PubMed1999

Effect of exercise on calf muscle pump function in patients with chronic venous disease.

BACKGROUND: Musculoskeletal dysfunction may be associated with poor calf muscle pump function in patients with chronic venous ulceration. The aim of this study was to evaluate the effects of physical exercise on calf muscle pump function. METHODS: Twenty patients were recruited into a 6-week intensive exercise programme. Calf muscle function and calf muscle pump function were assessed using an isokinetic device and air plethysmography respectively, before and after the exercise programme. RESULTS: There was significant improvement in calf muscle pump function, measured as increased ejection fraction and decreased residual fraction (P < 0.05); however, venous reflux was not altered (P > 0.05). Calf muscle strength and endurance parameters all increased, but not significantly (P > 0.05). CONCLUSION: Poor calf muscle pump function in patients with chronic venous ulceration can be improved by physical exercise.

Adult↗

PubMed1997

Variability and reliability of air plethysmographic measurements for the evaluation of chronic venous disease.

PURPOSE: Air plethysmography (APG) has the potential to help evaluate different treatments for the prevention of recurrence of venous ulcers; however, there are little reported data on the variation and reliability of the different parameters. This study aimed to assess the variation in different APG parameters in patients with chronic venous disease and to evaluate the reliability of APG in test-retest situations. METHOD: Seventeen patients (18 limbs) with chronic venous disease were recruited into this study. Subjects were asked to undergo tests on two occasions, 1 to 6 weeks apart. Three tests were performed at each visit, and three patients had 10 tests performed at one visit. The coefficients of variation were calculated for repeated measurements and test-retest reliability, and the differences between the means of three tests and the 10 tests were also analyzed. RESULTS: The coefficients of variation for the repeated measurements ranged from 7.5% to 27% for the majority of parameters of APG. The differences between the means of three tests and the means of 10 tests were less than 10% in this study. The coefficients of variation of method error were approximately 10% in test-retest measures. CONCLUSIONS: This study has shown that evaluations of calf pump function and venous reflux using APG display variations in repeated measurements and in the test-retest measures. The variations found within patients and on retesting patients on different days suggest that APG is very unlikely to be able to detect small changes in the parameters of venous reflux and calf pump function. It is essential to understand the inherent variation of APG measurements when they are used to assess treatments that are designed to improve venous function.

Aged↗

PubMed1996

Malignancy in chronic leg ulcers.

OBJECTIVE: To evaluate the frequency of malignant ulcers in patients presenting with leg ulcers. DESIGN: A descriptive study from data collected between July 1988 and June 1995 from 981 patients (2448 ulcers) attending a leg ulcer clinic. SETTING: A specialised leg ulcer clinic at a tertiary teaching hospital. SUBJECTS: 43 patients with 55 malignant skin lesions. OUTCOME MEASURES: Tissue biopsies in ulcerated lesions that suggested malignancy or were not responding to appropriate treatment. RESULTS: Forty-three patients were found to have malignant lesions on the legs, giving a frequency of malignant ulcers of 4.4 per 100 leg ulcer patients, or 2.2 per 100 leg ulcers. Seventy-five per cent of the malignant ulcers were basal cell carcinoma and 25% were squamous cell carcinoma. CONCLUSIONS: Malignant skin changes are common in chronic leg ulcers. A biopsy should be taken from all suspicious ulcers or ulcers that do not respond to appropriate treatment.

Aged↗

PubMed1993

Acetylation phenotype and cytochrome P450IA2 phenotype are unlikely to be associated with peripheral arterial disease.

The hypothesis that cytochrome P450IA2 (CYPIA2) and/or N-acetyltransferase 2 (NAT2) may be involved in the pathogenesis of peripheral arterial disease was investigated in 90 Australian patients with significant disease and 81 matched control subjects. CYPIA2 and NAT2 phenotypes were determined from urinary metabolite patterns after an oral dose of caffeine. NAT2 phenotype was similar (chi 2 = 0.01; p = 0.98) in both atherosclerotic patients (43.3% rapid) and control subjects (42.0% rapid). CYPIA2 metabolism as measured by the median ratio of (1,7-dimethylxanthine + 1,7-dimethyluric acid)/caffeine was significantly induced by smoking in both patients with atherosclerosis (ratio of 6.5 in nonsmokers and 12.4 in smokers; p < 0.05) and control subjects (ratio of 8.2 in nonsmokers and 14.8 in smokers; p < 0.05), but values in atherosclerotic and control nonsmokers and smokers were similar. Probit transformation of the data revealed a trimodal distribution of ratios in control subjects who were nonsmokers, with 5% classified as poor metabolizers (homozygous rapid) and 95% as extensive metabolizers. The distribution of ratios in control subjects who were smokers was unimodal, whereas among the patients with arterial disease, both smokers and nonsmokers exhibited a bimodal pattern with 8.2% to 16% poor metabolizer and 84% to 91.8% extensive metabolizer phenotypes. When data from both nonsmokers and smokers were combined, the overall proportion of subjects who were poor metabolizers was not significantly different (chi 2 = 1.82; p = 0.18) between control subjects (3.8%) and patients with atherosclerosis (10.6%). Thus biotransformation of environmental or dietary aromatic or heterocyclic amines by NAT2 or CYPIA2 is unlikely to have a significant role in the cause or pathogenesis of peripheral arterial disease.

Acetylation↗

PubMed1984

Assessment of the impact of coronary artery surgery on mortality after recovery from myocardial infarction.

Death rates over a nine year period were studied in 1,232 survivors of myocardial infarction. From 1973 to 1981, the 29 to 365 day case fatality rate in 28 day survivors dropped from 13.3% to 3.2%. This down-trend in case fatality was highly significant, averaging 14.3% in each year. After adjustment for changes in age and severity of infarction, using a prognostic score derived from the Perth Coronary Register (the PCR score), the estimated decline was still 12.2% in each year. During the nine years, the rate of coronary surgery in the post-infarction year rose from 1.5% to 12.0%. Overall, the surgically treated cases had a lower case fatality rate (1.6%) than the medically treated cases (7.7%). However, the surgical cases had a better prognosis at the time of infarction than the medical cases. When the severity of infarction (PCR score) and year of admission were considered, coronary surgery in the post-infarction year had no independent effect on outcome.

Australia↗