PURPOSE: The risk factors and clinical characteristics in young patients with deep venous thrombosis (DVT) were analyzed. METHOD: The clinical characteristics of the 118 patients registered at our DVT clinic, from September 2000 to August 2002, were retrospectively reviewed. Information reviewed included sex ratio, site and extent of DVT, frequency of pulmonary embolism (PE), recurrence rate, and thrombophilic states. The patients were dichotomized into two groups according to their age, less than 40 years vs. older than 40 years. Their risk factors were also analyzed according to "Reporting Standards in Venous Disease". RESULT: Among 118 patients, 48 (40.7%) were younger than 40 years. Right leg DVT was more common (37.5% vs. 18.2%) in the younger group although the more common site for DVT was in the left leg. Also, PE (14.6% vs. 10.0%) and mesenteric venous thrombosis (14.6% vs. 4.3%) were more common, with higher recurrence rates (35.4% vs. 21.4%), in the younger group. However, there was no significant difference. Except for age or pregnancy and postpartum state, mean total scores of risk factors were higher in the older group (1.06 vs. 1.77). On the contrary, positive family history of DVT (10.4%) was found only in the younger group. Thrombophilic states, including antithrombin III, protein C, and protein S deficiencies, and Behcet's disease were more prevalent in the younger group whereas activated protein C resistance was found more often in the older group. In patients who had thrombophilic states, recurrence rate of DVT was much higher. CONCLUSION: For proper diagnosis and management of young DVT patients, especially to prevent a disastrous PE and recurrence, we must make efforts to identify risk factors including thrombophilic states.
Activated Protein C Resistance ; Antithrombin III ; Diagnosis ; Humans ; Leg ; Postpartum Period ; Pregnancy ; Protein C ; Protein S Deficiency ; Pulmonary Embolism ; Recurrence ; Retrospective Studies ; Risk Factors ; Sex Ratio ; Thrombophilia ; Venous Thrombosis*

PURPOSE: Although varicose veins are common, the primary cause predisposing to venous reflux of great saphenous vein is controversial. We compared histologic features and expressions of matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinase (TIMPs) in the great saphenous veins (GSVs) of normal and patients with varicose veins. METHOD: Ten normal proximal GSV and each twenty diseased proximal, mid, and distal above-knee GSV vein segments were used for this analysis. We compared venous architecture with histology and expression and localization of MMP and TIMP with immunohistochemistry. RESULT: Compared with normal veins, varicose veins showed thickening and disorganization of intimal and medial connective tissue elements. Elastic fibers of varicose vein were fragmented and degenerated. By the immunohistochemistry, MMP-1 and MMP-2 were more strongly expressed than MMP-9, TIMP-1 and TIMP-2 either normal and varicose veins. MMPs were localized to endothelial cells, medial connective tissues and adventitial microvessels in normal veins. Whereas they were more diffusely localized to subintimal and medial connective tissues in varicose veins. Compared with proximal varicose veins, TIMP-2 was more significantly expressed in distal varicose veins. CONCLUSION: In varicose veins, vein wall architectures are disorganized and MMPs are more prominently expressed in these degenerative subintimal and medial areas.
Connective Tissue ; Elastic Tissue ; Endothelial Cells ; Humans ; Immunohistochemistry ; Matrix Metalloproteinases* ; Microvessels ; Saphenous Vein* ; Tissue Inhibitor of Metalloproteinase-1 ; Tissue Inhibitor of Metalloproteinase-2 ; Varicose Veins* ; Veins