Systematic review of the safety and efficacy of foam sclerotherapy for venous disease of the lower limbs

Background: Foam sclerotherapy is a potential treatment for lower limb venous disease. Methods: A systematic review, with no restriction on study design, to assess the safety and efficacy of foam sclerotherapy. Results: 69 studies were included. For serious adverse events including pulmonary embolism and deep vein thrombosis, the median event rates were less than 1%. Median rate for visual disturbance was 1.4%. Median rates for some other adverse events were more common, including headache (4.2%), thrombophlebitis (4.7%), matting/skin staining/pigmentation (17.8%) and pain at the site of injection (25.6%). Median rate for complete occlusion of treated veins was 87.0% and for recurrence or development of new veins was 8.1%. Evidence from meta-analysis for complete occlusion suggests that foam sclerotherapy is associated with a lower rate compared with surgery (RR 0.86, 95% CI 0.67 to 1.10) and a higher rate compared with liquid sclerotherapy (RR 1.39, 95% CI 0.91 to 2.11). However, there was substantial heterogeneity across the studies in the meta-analysis. Conclusion: Serious adverse events were rare. There is insufficient evidence to reliably compare the effectiveness of foam sclerotherapy with other minimally invasive therapies or surgery. Evidence from high quality randomised controlled trials is required.This manuscript is based on a systematic review commissioned and funded by the National Institute for Health and Clinical Excellence (NICE) through its Interventional Procedures Programme. The Health Services Research Unit is supported by a core grant from the Chief Scientist Office of the Scottish Executive Health Department

Semiclassical theory of transport in a random magnetic field

We study the semiclassical kinetics of 2D fermions in a smoothly varying magnetic field $B({\bf r})$. The nature of the transport depends crucially on both the strength $B_0$ of the random component of $B({\bf r})$ and its mean value $\bar{B}$. For $\bar{B}=0$, the governing parameter is $\alpha=d/R_0$, where $d$ is the correlation length of disorder and $R_0$ is the Larmor radius in the field $B_0$. While for $\alpha\ll 1$ the Drude theory applies, at $\alpha\gg 1$ most particles drift adiabatically along closed contours and are localized in the adiabatic approximation. The conductivity is then determined by a special class of trajectories, the "snake states", which percolate by scattering at the saddle points of $B({\bf r})$ where the adiabaticity of their motion breaks down. The external field also suppresses the diffusion by creating a percolation network of drifting cyclotron orbits. This kind of percolation is due only to a weak violation of the adiabaticity of the cyclotron rotation, yielding an exponential drop of the conductivity at large $\bar{B}$. In the regime $\alpha\gg 1$ the crossover between the snake-state percolation and the percolation of the drift orbits with increasing $\bar{B}$ has the character of a phase transition (localization of snake states) smeared exponentially weakly by non-adiabatic effects. The ac conductivity also reflects the dynamical properties of particles moving on the fractal percolation network. In particular, it has a sharp kink at zero frequency and falls off exponentially at higher frequencies. We also discuss the nature of the quantum magnetooscillations. Detailed numerical studies confirm the analytical findings. The shape of the magnetoresistivity at $\alpha\sim 1$ is in good agreement with experimental data in the FQHE regime near $\nu=1/2$.Comment: 22 pages REVTEX, 14 figure

Variation of elastic scattering across a quantum well

The Drude scattering times of electrons in two subbands of a parabolic quantum well have been studied at constant electron sheet density and different positions of the electron distribution along the growth direction. The scattering times obtained by magnetotransport measurements decrease as the electrons are displaced towards the well edges, although the lowest-subband density increases. By comparing the measurements with calculations of the scattering times of a two-subband system, new information on the location of the relevant scatterers and the anisotropy of intersubband scattering is obtained. It is found that the scattering time of electrons in the lower subband depends sensitively on the position of the scatterers, which also explains the measured dependence of the scattering on the carrier density. The measurements indicate segregation of scatterers from the substrate side towards the quantum well during growth.Comment: 4 pages, 4 figure

Quantum magneto-oscillations in a two-dimensional Fermi liquid

Quantum magneto-oscillations provide a powerfull tool for quantifying Fermi-liquid parameters of metals. In particular, the quasiparticle effective mass and spin susceptibility are extracted from the experiment using the Lifshitz-Kosevich formula, derived under the assumption that the properties of the system in a non-zero magnetic field are determined uniquely by the zero-field Fermi-liquid state. This assumption is valid in 3D but, generally speaking, erroneous in 2D where the Lifshitz-Kosevich formula may be applied only if the oscillations are strongly damped by thermal smearing and disorder. In this work, the effects of interactions and disorder on the amplitude of magneto-oscillations in 2D are studied. It is found that the effective mass diverges logarithmically with decreasing temperature signaling a deviation from the Fermi-liquid behavior. It is also shown that the quasiparticle lifetime due to inelastic interactions does not enter the oscillation amplitude, although these interactions do renormalize the effective mass. This result provides a generalization of the Fowler-Prange theorem formulated originally for the electron-phonon interaction.Comment: 4 pages, 1 figur

On the Theory of Metal-Insulator Transitions in Gated Semiconductors

It is shown that recent experiments indicating a metal-insulator transition in 2D electron systems can be interpreted in terms of a simple model, in which the resistivity is controlled by scattering at charged hole traps located in the oxide layer. The gate voltage changes the number of charged traps which results in a sharp change in the resistivity. The observed exponential temperature dependence of the resistivity in the metallic phase of the transition follows from the temperature dependence of the trap occupation number. The model naturally describes the experimentally observed scaling properties of the transition and effects of magnetic and electric fields.Comment: 4 two-column pages, 4 figures (included in the text

Effects of posture and venous insufficiency on endothelial-dependent and -independent cutaneous vasodilation in the perimalleolar region

Objectives: To assess the effects of posture, endothelial function and venous insufficiency on cutaneous microvascular vasodilator function in the gaiter area, in particular defining factors which may affect microangiopathy and ulcer formation. Methods: Endothelial-dependent and –independent vasodilator responses to incremental-doses of acetylcholine (Ach) and sodium nitroprusside (SNP) were evaluated in the perimalleolar region in the supine and standing positions in middle-aged patients with isolated superficial venous insufficiency (ISVI) (n=25) and health controls (n=28) using laser Doppler fluximetry (LDF) and iontophoresis of vasodilators. Results: The venoarteriolar reflex (vasoconstriction on standing) was equally present in both groups, and reduced the vasodilator responses to SNP in the upright position (e.g for patients with ISVI, peak SNP response was 82+11 PU [standing] vs 123+15 PU [supine]). The presence of ISVI had no effect on endothelial vasodilator function in the supine position, but on standing cutaneous reactivity to Ach was significantly reduced (e.g peak Ach response 69+8 PU [ISVI] vs 109+11 PU [controls], p<0.003). Conclusions: Upright posture impairs cutaneous endothelial-dependent vasodilation in the gaiter area of patients with ISVI. This may be of clinical and prognostic utility in identifying which patients with uncomplicated ISVI are at highest risk of tissue breakdown and ulcer formation in the gaiter area

Apparent Metallic Behavior at B = 0 of a two-dimensional electron system in AlAs

We report the observation of metallic-like behavior at low temperatures and zero magnetic field in two dimensional (2D) electrons in an AlAs quantum well. At high densities the resistance of the sample decreases with decreasing temperature, but as the density is reduced the behavior changes to insulating, with the resistance increasing as the temperature is decreased. The effect is similar to that observed in 2D electrons in Si-MOSFETs, and in 2D holes in SiGe and GaAs, and points to the generality of this phenomenon

Thermodynamic Signature of a Two-Dimensional Metal-Insulator Transition

We present a study of the compressibility, K, of a two-dimensional hole system which exhibits a metal-insulator phase transition at zero magnetic field. It has been observed that dK/dp changes sign at the critical density for the metal-insulator transition. Measurements also indicate that the insulating phase is incompressible for all values of B. Finally, we show how the phase transition evolves as the magnetic field is varied and construct a phase diagram in the density-magnetic field plane for this system.Comment: 4 pages, 4 figures, submitted to Physical Review Letters; version 1 is identical to version 2 but didn't compile properl