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

To investigate the etiology of lower limb edema after arterial reconstruction, 12 patients (16 limbs) who underwent arterial reconstruction due to atherosclerosis obliterans were observed. There was no relationship between the severity of limb edema and serum factors (serum total protein, albumin, BUN and creatinine), ankle/brachial arterial pressure ratio, peripheral venous pressure or RI lymphoscintigraphy in the supine position. The lymphatic flow in RI lymphoscintigraphy at 3-4 weeks after operation increased with statistically significant difference compared to the preoperative flow whether the patient was in the supine or upright position. Though there was no significant relationship between the severity of leg edema and postoperative lymphatic flow in the supine position, postoperative lymphatic flow in the upright position decreased as the severity of leg edema increased. Increased lymphatic flow in the follow-up period was associated with increased severity of leg edema in the upright position. It is concluded that postoperative leg edema is due to the damage to the lymphatic vessels during operation, and then the lymphatic channels cannot adapt to the increased lymphatic flow after the arterial reconstruction.
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PMID:[99mTC-HSA lymphoscintigraphy and leg edema after arterial reconstruction]. 151 14

Magnetic resonance imaging (MRI) was used in the diagnosis of various conditions giving rise to leg oedema, with special attention to the oedema after femoro-distal vascular reconstruction for obliterative atherosclerosis (n = 14). Patients with deep venous thrombosis (n = 6), chronic lymphoedema (n = 6) and closed muscular compartment syndrome (n = 2) were also investigated. Leg volume increase was measured according to the formula of a truncated cone. Interstitial fluid hydrostatic pressure (Pif) was recorded with the wick-in-needle technique. Spin echo series with 10 mm transverse slices were obtained with MRI. Following vascular reconstructions, leg volume increased 26% on the operated side. In the operated leg, no gradient in Pif was found between the posterior muscular compartment and the subcutaneous tissue. However, there was a significantly higher Pif in the subcutaneous tissue compared to the anterior muscular compartment (p less than 0.05). In the operated group, MRI revealed oedema around the entire circumference of the leg, mainly restricted to the subcutaneous tissue. In contrast, oedema of the leg muscles, particularly in the posterior compartments, was typical for patients having deep venous thrombosis. The group with chronic lymphoedema showed circumferential subcutaneous oedema alone or in combination with a fibrotic honeycomb pattern. Oedema of the affected muscular compartment was easily observed in patients who had a closed compartment syndrome. In conclusion, the use of MRI is promising in the investigation of conditions giving rise to leg oedema. It is likely that the formation of post-reconstructive oedema is taking place in the subcutaneous tissue.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The use of MRI in the investigation of leg oedema. 157 51

Intralymphatic end pressure and Starling pressures (interstitial fluid pressure (Pif), plasma and interstitial fluid colloid osmotic pressures (COPpl and COPif)) were measured in leg subcutaneous tissue in 5 patients with local leg edema following femoropopliteal reconstruction for lower limb atherosclerosis. Superficial lymphatics were cannulated proximal to the ankle and the catheter was connected to either syringes for determination of lymph flow and colloid osmotic pressure (COPl), or to a pressure transducer for measurement of intralymphatic end pressure. Samples of interstitial fluid were collected by implantation of nylon wicks and Pif was measured by the "wick-in-needle" technique. In all patients normal end pressure waves with maximum values ranging between 30 and 40 mmHg were recorded, indicating that the ischemia prior to surgery had not significantly affected the intrinsic mechanism for lymph propulsion. COPif of the operated leg averaged 5.7 mmHg +/- 1.0 which was 0.9 mmHg +/- 0.7 higher than the corresponding COPl. This supports the theory of "preferential channels" between the capillaries and the lymphatics. There was a statistically significant correlation between lymph flow and estimated capillary pressure (reabsorption pressure), capillary filtration coefficient, calf blood flow and Pif. According to this study the capillary pressure should at least be 11 mmHg before production of lymph occurs.
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PMID:Lymphatic and transcapillary forces in patients with edema following operation for lower limb atherosclerosis. 689 33

The wick technique and the blister suction technique are the most common methods for sampling of subcutaneous interstitial tissue fluid in man. The blister suction technique has the advantage of being less invasive than the wick technique, but the reliability of this method is still controversial. The aim of this study was to evaluate whether the simpler blister suction technique using large (8 mm) blisters could replace the wick technique in the investigation of patients with postreconstructive leg edema. Fifteen patients with ipsilateral leg edema following infrainguinal bypass surgery for lower limb atherosclerosis were investigated. The two different fluid sampling techniques were applied simultaneously on both legs. The concentration of total protein and albumin as well as colloid osmotic pressure of the subcutaneous interstitial tissue fluid in the leg were measured in all fluid samples. Agreement analysis was applied to compare the two methods, while the correspondence between the methods was estimated with linear regression analysis. The agreement index was found to be positive for all variables from the operated as well as from the contralateral control limb. Furthermore, all values were within the agreement limit. The best agreement between the two methods was found for colloid osmotic pressure on the operated side. According to the equation of linear regression, there was a slight overestimation of the wick values compared to the observed blister values. In conclusion, there was a good methodological agreement between the blister suction technique and the wick technique. The less invasive blister suction technique should be regarded as the method of choice for the investigation of subcutaneous interstitial tissue fluid in patients with postreconstructive leg edema.
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PMID:Protein concentration of subcutaneous interstitial fluid in the human leg. A comparison between the wick technique and the blister suction technique. 885 83

In 1989, we encountered a 68-year-old male patient with marked hyperlipoprotein(a)emia (hyperLp(a)emia), who was being treated for hypertension and arteriosclerotic obliterans (ASO) at an outpatient clinic of our hospital. He began to develop leg edema in 2002 and was referred to the Department of Internal Medicine. It was determined that he had severe hyperlipidemia (total cholesterol, 362 mg/dl), proteinuria, and hypoalbuminemia, suggesting the presence of nephrotic syndrome. On lipoprotein analysis, he was found to have very high levels of Lp(a) in the plasma (329 mg/dl). Severe atherosclerosis was also found: that is, abdominal aortic aneurysm (AAA) and coronary artery disease (CAD) were detected, in addition to ASO. After remission of the nephrotic syndrome, the plasma Lp(a) level decreased to 204 mg/dl and the total cholesterol concentration decreased to 179 mg/dl, while very high levels of Lp(a) persisted. We estimate that the markedly elevated Lp(a) plasma levels in this patient may have played some role in the progression of atherosclerosis.
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PMID:A case of marked hyperlipoprotein(a)emia associated with nephrotic syndrome and advanced atherosclerosis. 1614 4

A 58-year-old woman with a past medical history significant for tobacco use presented with shortness of breath. Physical examination revealed a 30 mm Hg difference in upper-extremity blood pressures (right arm greater than left), elevated jugular venous pressure, and leg edema. A two-dimensional echocardiogram revealed an ejection fraction of 20%. During angiography a heavily calcified lesion was noted in the aortic arch, across which a significant gradient was measured. Computed tomographic scanning identified a focal calcified area in the aortic arch and diffuse atherosclerosis elsewhere. Acquired thromboatheromatous coarctation of the aorta is an uncommon entity found in patients who smoke and are hypertensive. It is almost always seen in conjunction with severe peripheral vascular disease, which this patient had. She was started on heart failure therapy and referred for surgical repair.
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PMID:Acquired atheromatous coarctation of the aortic arch. 2130 71

A 78-year-old man with hypertension, nephrosclerosis, and angina pectoris visited his family doctor with a history of fatigue and leg edema. He had a history of percutaneous coronary intervention 5 years prior, and was taking low-dose aspirin. Blood tests revealed hypoalbuminemia, gastrointestinal 99mTc-HSA scintigraphy was positive, and alpha-1 antitrypsin clearance was high;therefore, the hypoalbuminemia was thought to be secondary to a protein-losing enteropathy. A small bowel series revealed multiple, ring-shaped, longitudinal ulcers in the ileum. Balloon-assisted enteroscopy from the anus showed severe stenosis with an ileal ulcer. Since we were not able to diagnose the ulcers, mesalazine and supplemental nutritional care were provided. Four years after the hypoalbuminemia had been diagnosed, the patient died because of pulmonary congestion secondary to renal failure. An autopsy revealed severe atherosclerosis in his aorta and multiple cholesterol embolisms in his small intestine, kidney, stomach, colon, liver, and spleen. The multiple ulcers in the small intestine were thought to be caused by cholesterol crystal embolism, which should be considered in the differential diagnosis of small intestinal ulcers in elderly men or patients after cardiovascular intervention.
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PMID:Multiple small intestinal ulcers associated with protein-losing enteropathy secondary to cholesterol crystal embolism:a case report. 2878 54