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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Between April 1978 and April 1981, 70 patients with hypertension and renal artery stenosis were treated by percutaneous transluminal arterial dilatation. Selection of the patients was based solely on arteriographic criteria. Arteriography after dilatation showed considerable widening of the stenosed area in all patients. In 65 patients the effect of treatment on the blood pressure was assessed during follow up periods of one to four years. In 14 of these patients the hypertension was cured, in 29 it was improved, and in 22 there was no change. Patients with fibromuscular lesions benefited distinctly more than did those with atheromatous stenosis, only one of the 21 patients with fibromuscular lesions showing no change as compared with 21 of the 44 patients with atheromatous lesions. The only serious complication encountered was microcholesterol emboli, which developed in two patients with severe atheromatous lesions of the aorta. In the atheromatous group age and overall renal function had no influence on the blood pressure response. In the subgroup of patients with a unilateral lesion the renal vein renin ratios and asymmetrical curves obtained by renography had only a very limited predictive value. In experienced hands percutaneous transluminal arterial dilatation is relatively safe, and this study suggests that it should be attempted in all patients with renal artery stenosis. Only in patients with severe atheromatosis of the aorta should the risk associated with the catheterisation be weighed against the 50% or so chance of benefit from the procedure.
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PMID:Follow up study of 70 patients with renal artery stenosis treated by percutaneous transluminal dilatation. 622 85

A previously normal 58-year-old woman developed a widespread psoriatic rash and asymmetrical peripheral polyarthritis a week after beginning treatment with oxprenolol for hypertension. Skin and joint disease resolved simultaneously after drug withdrawal and have not recurred.
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PMID:Acute psoriatric arthropathy precipitated by oxprenolol. 623 60

To clarify clinically the pathogenesis of septal hypertrophy in terms of its morphology and wall dynamics, simultaneous biventricular cineangiography (BVG) and endomyocardial biopsy of the left ventricle were performed for patients with left ventricular hypertrophy. The patients were categorized in four groups according to their clinical and BVG findings; 1) 24 normal control subjects (C), 2) 39 patients with hypertension and symmetrical septal hypertrophy (SH-HT), 3) 17 patients with hypertension and asymmetrical septal hypertrophy characterized by the ratio (IVS/PW) greater than or equal to 1.3 by BVG, and 4) 25 patients with hypertrophic cardiomyopathy (HCM). The BVG's configuration of the septum in SH-HT showed a normal form of septal hypertrophy (NH form) essentially similar to that of the control subjects (N form), except for septal thickness increases of more than 10 mm. In HCM, a triangle or shell (TS) form or spindle (S) form of the septum was demonstrated by BVG. The TS form was characterized by straight or convex thickening of the septum from its center to its base toward the left ventricle. The S form was characterized by convex thickening localized to the central part and a relatively thin base. However, the configuration in ASH-HT was either the NH form (7 cases) or the TS or S form (10 cases). The configuration in ASH-HT with the NH form was not distinguishable from that of SH-HT, nor was the configuration in ASH-HT with the TS or S form distinguishable from that of HCM. Systolic thickening (%) of the septum and systolic shortening (%) of the septal length decreased significantly in this order: C, SH-HT, ASH-HT with the NH form, and ASH-HT with the TS or S form. Those of HCM were similar to those of ASH-HT with the TS or S form. In the cases of the N or NH form, there was a negative correlation between systolic thickening (%) and thickness of the septum in diastole. In cases with the TS or S form, systolic thickening (%) was not affected by the thickness of the septum in diastole, and a lower value was observed in all cases. Histological studies of endomyocardial biopsies revealed a positive correlation between the transverse diameters of the myocytes and the total systemic peripheral resistance (TSPR) in 25 patients with SH-HT. In 12 patients with HCM, there was no correlation, and severe hypertrophy of the myocytes was observed despite a lower TSPR.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Evaluation of septal hypertrophy and wall dynamics by biventricular cineangiography and endomyocardial biopsy]. 654 88

The authors report their experience of 20 cases of renal artery stenosis in children, seen over the last ten years. The stenosis was latent in 8 of the 20 cases and was usually discovered during investigation for headaches or a complication of hypertension. The search for a renal cause involved the use of urography (which shows the classical signs of asymmetrical kidney size, delayed excretion, very sharp image, asymmetry on the fluid load test) (19 of the 20 cases) and arteriography which, in 5 cases, showed a bilateral lesion. Almost all of the anatomical lesions were situated in the arterial trunk (20 out of 25), 4 lesions were at the bifurcation of the trunk and only one lesion involved a branch. The most common lesions were dysplasia and hyperplasia of the arterial wall. These lesions were treated by aorto-renal by-pass grafting (without any synthetic prosthesis) in 8 cases, by direct re-implantation into the aorta in 5 cases, by spleno-renal anastomosis in 5 cases, by resection and anastomosis in 4 cases, by enlargement venous angioplasty in 1 case and by auto-transplantation in 1 case. The following results were obtained: 9 cures (45%), 3 moderate results (15%) and 8 failures (40%), including 7 cases of early thrombosis and 1 delayed stenosis. The cases treated by direct aorto-renal re-implantation or by resection and end-to-end anastomosis were always successful. The failures occurred in children operated by one of the other techniques of arterial repair. Surgery provided these authors with excellent or satisfactory results in 60% of cases.
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PMID:[Results of reconstructive surgery of renal artery stenosis in children]. 667 80

The age specific incidence of the palmomental reflex (PMR) has been investigated in persons without any former or present evidence of a neurological or mental involvement. Also excluded were persons with hypertension, diabetes mellitus, thyroid dysfunction, alcohol abuse and other diseases as these could effect the central or peripheral nervous system. From the newborn period up to the age of 20 years the incidence of the PMR was between 3,3% and 20%, the differences being statistically insignificant. After the age of 20 years the incidence of the PMR rises with increasing age, the rise being approximately 10% per decade. There was no asymmetry of the PMR in persons without affection of the nervous system and who met the above mentioned criteria. Since a symmetrical PMR can be found in a considerable percentage of persons with no indication of a neurological or mental involvement, it should not be considered as a pathological sign. An asymmetrical PMR was found in 20 persons who did not meet the above mentioned criteria. In 5 out of these 20 persons additional neurological signs could be detected. 9 patients had histories of brain trauma, meningitis, cerebrovascular disease and polyneuropathy. 9 others were suffering from severe cardiovascular disease, carcinoma and alcohol abuse. In only one patient, although presenting with some neurological signs, no relevant history could be detected. An asymmetrical PMR, therefore, must be considered as a discrete indication of an involvement, either of the central or the peripheral nervous system. The PMR has no certain localizing significance.
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PMID:The clinical value of the palmomental reflex. 726 87

A comparison of the major cerebral arteries between humans and rats shows many similarities, including anomalies in their general organization, the structure of these vessels at the light and electron microscope levels and their morphological changes associated with cerebral vascular diseases. The general organization of the major cerebral arteries shows the following main differences between humans and rats. In rats, the internal carotid arteries have become an integral part of the circle of Willis. In the anterior cerebral arteries, a common variation in humans is the underdevelopment of one of the two arteries, whereas in rats, buttonhole-like structures are common in one or both arteries. The anterior communicating artery present in humans is absent in rats. The olfactory artery is prominent in rats, but absent in humans. The posterior communicating artery in humans is the most variable component of the circle of Willis, being asymmetric in its origin, diameters and branches. Similarly, the posterior cerebral arteries in rats often exhibit asymmetrical origin from the basilar artery. There was some confusion in the literature regarding the name of the posterior cerebral arteries in rats, but this was caused mainly by misquotations and incorrect interpretations of the papers. In humans, most aneurysms occur in the anterior half of the circle of Willis, and the incidence is higher in females than males; the middle cerebral artery is most often the one to become occluded, and the vertebral arteries are common sites for thrombosis. The various channels that constitute collateral circulation in humans provide a margin of safety, so that in case of cerebral occlusion due to thrombosis, atherosclerosis, or vasospasm related to hemorrhage, blood supply to the affected area can be maintained through these collaterals. Collateral circulation is also present in rats. However, in rats, information on the presence of various types of aneurysms, their location and frequency in normal and experimental models of hypertension and stroke is still lacking. Cerebral arteries from humans and rats are characterized by the absence of external elastic lamina, as compared with systemic arteries. A type of multipolar cell resembling the interstitial cell of Cajal is present in the cerebral arteries of humans. Its function is unknown. Earlier reports of cerebral valves have been shown to represent intimal cushions near the branching points of the cerebral arteries. Intravascular bridges present in human cerebral arteries, have not been reported in rats. Finally, the presence of vascular remodeling, as found in the cerebral arterioles of hypertensive rats, remains to be established in the cerebral arterioles of human hypertensives.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Morphology of cerebral arteries. 763 Sep 27

Quigley's hypothesis indicates that the dense connective tissue is the least and the pores of the lamina cribrosa are the largest at the superior and inferior poles of the lamina cribrosa, therefore they are the most vulnerable locations to be involved by the characteristic glaucomatous optic nerve damage. To get clinical evidences of the hypothesis, the reversal or contraction of glaucomatous optic cup after reduction of intraocular pressure (IOP) was examined (The change is primarily caused by intraocular hypertension--induced distortion and posterior ectasia of the lamina cribrosa which moves forward reversely, leading to dilated optic cup contraction.). The method of examination was a stereoscopic flicker comparison with a computerized image system, alternatively displaying superposed 2 serial stereo pairs rapidly and the changing part presenting jumping appearance. Under stereoscopic observations, the changes of 3-dimension optic cup end be seen and the false positive phenomena caused by photographic angle variation, vascular pulsation, etc. can be differentiated from the characteristic changes of the cup. Stereo fundus photographs were taken from 31 eyes with high intraocular pressures before and after treatment for reduction of IOPs which was either diamox administration or trabeculectomy. The results show that the reversal of optic cups after reduction of IOPs are mostly asymmetrical, especially at the superior and/or inferior poles. By multiple stepwise regression, it is known that the amount of the change is only correlated with the initial IOP.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Characteristics of reversed optic cupping in glaucoma after reduction of intraocular pressure]. 784 9

The clinical course, transcranial Doppler ultrasound (TCD) findings, and angiographic outcome are reported for a patient with a traumatic carotid artery dissection. Transient asymmetrical decreased middle cerebral artery blood flow velocities led to the suspicion of an internal carotid artery (ICA) stenosis. Duplex scanning and angiography subsequently demonstrated an extracranial traumatic ICA dissection in combination with a traumatic saccular aneurysm. These data imply that TCD monitoring has a potential to diagnose not only well established complications of neurotrauma, such as vasospasm and intracranial hypertension, but may also suggest the presence of traumatic extracranial carotid obstructions.
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PMID:Diagnosis of traumatic carotid artery dissection by transcranial Doppler ultrasound: case report and review of the literature. 794 Jan 12

To determine whether asymmetrical septal hypertrophy (ASH) in patients with essential hypertension (HT) is a type of hypertensive left ventricular (LV) hypertrophy or hypertrophic cardiomyopathy (HCM) combined with HT, we investigated a group of 7 hypertensive patients with ASH compared with 12 HCM patients and 10 healthy controls using radionuclide angiography and right ventricular endomyocardial biopsy. The LV time-volume curve and its first and second derivative curves were constructed from cardiac output and time-activity curves constructed by combined forward and reverse-gating from the R wave. The LV wall thickness and ejection fraction were significantly greater in both the HT and HCM groups than in the control group, whereas there were no differences in these indices between the HT and HCM groups. Rapid filling volume index and rapid filling fraction showed significantly lower values in the HCM group than in the control group (p < 0.005). In contrast to the HCM group, these indices in the HT group did not differ from those in the control group. The time to peak filling rate was prolonged in the control, hypertension, and HCM groups in increasing order. Histopathological study revealed a higher incidence of myocardial cell disarray in the HCM than in the HT group. The above results suggest that ASH in hypertensive patients is a type of hypertensive LV hypertrophy.
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PMID:Asymmetrical septal hypertrophy in patients with hypertension: a type of hypertensive left ventricular hypertrophy or hypertrophic cardiomyopathy combined with hypertension? 841 59

Study of group of 61 patients, nephrectomized as a result of various diseases and who before and three months after surgery underwent blood pressure, effective renal plasma flow (EPFF) and unilateral renal function determinations in order to verify the compensating ability of the remaining kidney. Effective renal plasma flow was determined by a single injection and removal of six serial blood samples with 125-I-Hippuran. Unilateral renal function was determined from the relative uptake of 99mTc-DMSA 24 hours after injection. The patients were divided into four groups according to their overall and unilateral renal function as well as the presence or absence of hypertension. Patients with normal EPFF and symmetrical renal function showed a significantly increase in the function of the remaining kidney after surgery (p < 0.001). Patients with normal or slightly reduced EPFF (< 10%) and highly asymmetrical unilateral function as well as those with decreased EPFF (> 10%) and symmetrical or asymmetrical unilateral renal function did not increased the function of the remaining kidney after nephrectomy, and hypertensive patients whose blood pressure returned to normal values after nephrectomy had a decreased function of the remaining kidney after surgery (< 0.001). It is concluded that it is possible to predict the functional behaviour of the remaining kidney after nephrectomy, and that the compensating ability will basically depend on the previously existing (overall and unilateral) renal function as well as the presence or absence of hypertension.
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PMID:[Renal hypertrophy studied by techniques of nuclear medicine in post-nephrectomy patients]. 845 85


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