Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0004153 (atherosclerosis)
 77,401 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A family with multiple spinal xanthomas and sitosterolemia is described. A 48-year-old woman presented with paraplegia due to multiple intradural extramedullary tumors. The patient also showed marked tendon xanthomas and analysis of sterol composition in both plasma and the xanthoma established the diagnosis of the rare inherited metabolic disease, sitosterolemia and xanthomatosis. Two other siblings in the family presented with marked tendon xanthomas and coronary atherosclerosis, but did not show any neurological signs or symptoms. Magnetic resonance imaging (MRI) study revealed multiple intradural extramedullary tumors in spinal canals of the proband and her sister, but not in the other affected sibling (brother). This is the first report of familial occurrence of multiple extramedullary spinal tumors due to the inherited metabolic abnormality.
 ...
PMID:Familial spinal xanthomatosis with sitosterolemia. 147 63

Between May 1966 and June 1991, 129 patients underwent surgical repair of thoracoabdominal aneurysms, with an overall 30-day mortality rate of 35%. In 75 operations (58%) performed electively, 11 deaths (15%) occurred, and in 54 cases (42%) of either symptomatic or ruptured aneurysms 34 deaths (63%; p less than 0.001) occurred. No one survived among six patients with preoperative hypotension (less than 90 mm Hg) or cardiac arrest. In 16 patients (12%) the etiology of aneurysms was a result of chronic aortic dissection, and the mortality rate in this subgroup was 44%. In the remaining 113 patients (88%) where the etiology was atherosclerosis, 38 deaths occurred (34%; p = 0.433). Spinal cord ischemia occurred in 25 cases (21%) among 116 patients who survived operation. Partial ischemia occurred in six cases (25%), and complete paraplegia occurred in the remainder. Complete and partial paraplegia occurred in 16 of 42 cases (38%) when all of the thoracic aorta was replaced (Crawford groups I, II) and in 9 of 74 cases (12%) when only the abdominal or lower thoracic aorta was replaced (Crawford groups III, IV; p = 0.016). Other complications included myocardial infarction (14 cases, 11%), respiratory failure (46 cases, 36%), and renal failure (33 cases, 27%). The major prospect for improved early survival of patients with thoracoabdominal aneurysms seems to be early detection and elective repair before the occurrence of symptoms.
 ...
PMID:Thoracoabdominal aneurysm repair: a representative experience. 157 33

Between 1975 and 1986, 100 consecutive patients with aneurysms of the descending thoracic (84 cases) or the thoracoabdominal aorta (16 cases) underwent surgical repair. Intraluminal graft inclusion procedure was employed in principle under routine circulatory support with partial cardiopulmonary bypass. In this study, overall surgical results were reviewed, and multiple factors discriminately contributing to early results were assessed using multivariate analysis (quantification theory type II) to determine if this therapeutic modality is pertinent. Fifty-five patients had non-dissecting, 42 had dissecting aneurysms and 3 had pseudoaneurysms. Seventeen patients were treated in the emergency setting. Perioperative or early deaths occurred in 14 patients. Mortality increased with advanced age (greater than 70 years) and with atherosclerotic aneurysms, especially when they involved the entire thoracic or thoracoabdominal aorta. Operative mortality during the last 5 years of the study was 9.3%: significantly lower than the figure in the first 5 years of 28% (p = 0.0198). The incidence of renal dysfunction (7.4%) or paraplegia (2.1%) was not related to aortic cross-clamp time, and both were markedly decreased to 3.8% and 0.0%, respectively, when the cases of thoracoabdominal aneurysms were excluded. There were 8 cases of exploration for postoperative hemorrhage and 6 cases of pulmonary insufficiency requiring more than 3 days of mechanical ventilation. Prolonged bypass time was a discriminative risk factor for these two complications. Cerebral vascular accidents developed in 5 patients, three of them terminated in death. In spite of partial bypass, the factors of advanced age, atherosclerosis, and cross-clamp on the aortic arch were defined responsible for brain stroke.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Surgical repair of descending aortic aneurysms--experience in 100 patients under partial cardiopulmonary bypass]. 189 63

The technique of heterotopically transplanting a rabbit heart into the abdominal position of a recipient rabbit is discussed. Myocardial preservation, vascular anatomy of the recipient, and general anesthetic considerations are described, as are techniques to avoid anesthetic death, hemorrhage, and paraplegia. Application of these techniques to experimental models of accelerated coronary atherosclerosis and reperfusion injury are suggested.
 ...
PMID:Revised technique of heterotopic heart transplantation in rabbits. 191 3

We retrospectively evaluated the surgical results in 95 patients with aneurysm of the thoracic aorta who were surgically treated using partial cardiopulmonary bypass (CPB) as an adjunctive method during the past 10 years. The cause of the aneurysm was atherosclerosis in 52% and dissection in 41%. Fifty-eight percent of the patients had an aneurysm of the entire descending thoracic aorta and 14 of these patients had a thoracoabdominal aneurysm. Emergency operation was performed in 16 patients (17%). There were 14 early deaths (14.7%) within one month after operation. Postoperative complications included renal dysfunction, partial paraplegia, and hemorrhage. Renal dysfunction occurred in 7 (7.8%) of the operative survivors; 2 of the 7 required hemodialysis. Partial paraplegia was observed in 2 patients undergoing total replacement of the thoracoabdominal aorta. Neither renal dysfunction nor paraplegia was related to the duration of aortic cross-clamping. Postoperative hemorrhage necessitating reopening of the chest occurred in 8 (8.9%) of the operative survivors. Partial CPB is useful in reducing the incidence of postoperative complications among patients undergoing aortic cross-clamping for a long period.
 ...
PMID:Surgical treatment of aneurysms of the thoracic aorta with the aid of partial cardiopulmonary bypass: an analysis of 95 patients. 359 32

We experienced 4 cases of thoracoabdominal and suprarenal abdominal aortic aneurysm in the last 6 months. There were 3 males and 1 female ranging in age from 43 to 66 years, 2 with an etiology of aortitis syndrome, 1 with non-specific inflammation and 1 with atherosclerosis. In all cases the modified Hardy procedure was employed. A 18 to 22mm X 9 to 11mm bifurcation, double velour woven dacron graft was sutured from the side of the lower descending thoracic aorta to the side of both common iliac arteries. Grafts of the same kind as above 6 to 7mm in size were attached from the main graft to major visceral arteries by end-to-end or end-to-side anastomosis. A permanent aortic-excluding clamp was attached to the normal aorta just proximal to the aneurysm. Another clamp, or double ligature with silk, was placed on the lower abdominal aorta or both common iliac arteries distal to the aneurysm. No renal and spinal preservation of any kind was employed, but renal failure and paraplegia were not recognized in any of the cases. One patient died 2 days and another 21 days after the operation due to uncontrollable bleeding and multiple organ failure. The other two are doing well.
 ...
PMID:[Surgical treatment for thoracoabdominal and suprarenal abdominal aortic aneurysm]. 398 85

In the 1940s major amputation in paraplegic and tetraplegic patients was performed mainly for the complications of pressure sores. With the increased understanding of paraplegia, life expectancy has greatly improved, with the consequence that the chief indication for amputation is now gangrene due to atherosclerosis. The special problems of the spinal-cord-paralysed amputee are reviewed.
 ...
PMID:Major amputation in paraplegic and tetraplegic patients. 652 77

The occurrence of lower limb gangrene due to atherosclerosis is reported in 14 spinal cord paralysed patients. A further three patients became paraplegic and developed lower limb gangrene following aortic surgery for atherosclerotic complications. The clinical features are described and the difficulty in diagnosing ischaemia in the paralysed limb is emphasised. The incidence and prognosis following amputation are similar to those in the general population and there is no evidence from this series that paraplegia and tetraplegia predispose to atherosclerosis.
Paraplegia 1983 Oct
PMID:Amputation for peripheral vascular disease in the paraplegic and tetraplegic. 664 3

Between 1953 and 1993, 659 patients underwent descending thoracic aneurysm resection. The most common etiology was atherosclerosis. Pain was the main presenting symptom. Perioperative mortality fell from 24.2% between 1953 and 1964 to 14.3% between 1970 and 1993. Paraplegia occurred in 4.1% (27/659) patients overall and was little affected by time of operation or use of atriofemoral bypass. Paraparesis occurred in 5.9% (39/659) patients and was reduced by use of atriofemoral bypass. The low rate of paraparesis in the earlier experience was offset by the higher perioperative mortality from hemorrhage, attributable to the use of systemic heparin. The use of heparin-free circuits with centrifugal pumps should be considered in patients likely to have a clamp time greater than 30 minutes. The major source of perioperative morbidity and mortality was cardiac causes (48%) followed by perioperative hemorrhage (14.4%), pulmonary complications (14.4%), and rupture of another aneurysmal segment (12.0%). Late mortality occurred most commonly from cardiac causes (30.6% of deaths) and rupture of another aneurysm (16.3% of deaths). Improvement in results was due to general refinements of management in all areas rather than any single factor. These results indicate that complete preoperative assessment of the patient and the entire aorta is essential and that regular life-long follow-up is critical in order to avoid unnecessary morbidity and mortality from cardiac, cerebrovascular, or subsequent aneurysmal complications.
 ...
PMID:Evolution of surgical techniques for aneurysms of the descending thoracic aorta: twenty-nine years experience with 659 patients. 784 45

Infection is a devastating complication of synthetic aortic graft surgery. Patients with significant occlusive atherosclerosis of the internal iliac arteries undergoing aortic graft removal for graft infection may be at risk of pelvic and midbody necrosis. An unusual and fatal complication of this nature associated with the management of synthetic aortic graft infection has been encountered in two patients treated by extra-anatomic revascularization and staged removal of the infected aortic prosthesis. The hallmark of their presentation was pelvic and midbody necrosis in the presence of excellent distal perfusion with palpable pulses. Marginal pelvic circulation was therefore compromised further by graft removal and absence of retrograde pelvic perfusion. The finding of focal ischemic changes in the pelvic area of a patient with increasing serum creatinine phosphokinase activity, leukocytosis, myoglobinuria and paraplegia following infected aortic graft removal signals a grave and fatal prognosis.
 ...
PMID:Pelvic necrosis: a complication of infected aortic graft excision. 807 36


1 2 3 Next >>