Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0022116 (ischemia)
 91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

26 patients with subarachnoid hemorrhage from ruptured cerebral aneurysms have been reviewed. Fibrinolytic activity of the C.S.F. has been evaluated by the dosage of Fibrin/Fibrinogen degradation products (F.D.P.). When patients have developed clinical signs of ischemia, F.D.P. levels were significantly higher than in those without neurological deficit. Even, if the detection of F.D.P. seems directly correlated to the presence of blood in the C.S.F., there is no direct relation between their level and the importance of S.A.H. as shown by C.T. scan. However when F.D.P. levels are greater than 80 mcg/ml, there is a high risk of vasospasm with clinical signs.
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PMID:[Prognostic value of cerebrospinal fluid fibrinolytic activity in meningeal hemorrhages as a result of aneurysm rupture]. 688 30

The aim of the present study was to assess the possible modifications in the parameters of red cell aggregation and blood and plasma viscosity in 92 diabetic patients compared to 82 non diabetic control subjects. Based on the presence of microalbuminuria (> 30 mg/24 h) and/or retinopathy each group of diabetic patients was divided into two subgroups. This study shows increased red cell aggregation and blood viscosity among diabetic patients with microangiopathy. There was a very good correlation between fibrinogen level and the different rheological measurements. The results of this study confirm the importance of the blood rheology abnormalities observable in diabetes. These disorders increase peripheral vascular resistances and ischemia and therefore worsen diabetic nephropathy and retinopathy.
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PMID:[Modification of hemorheological parameters in microvascular complications of diabetes]. 755 10

The authors describe a healthy young male smoker with familial history of recurrent thromboembolism who presented with severe, rapidly progressive lower limb ischemia and abnormal results from liver function tests. An arteriogram of the lower extremities showed bilateral infrainguinal atherosclerotic arterial occlusions. The laboratory findings, in addition to abnormal liver function findings, included moderately elevated antiphospholipid antibodies and hemostatic abnormalities involving elevated fibrinogen, lipoprotein (a) levels, and deficient fibrinolysis. He underwent bilateral femoral thrombectomy, which was followed by a meticulous anticoagulation, and had gradual improvement of ischemic symptoms and liver functions. This is, to their knowledge, the first reported case in the English literature of premature lower extremity atherosclerosis and antiphospholipid syndrome associated with elevated lipoprotein (a) levels and documented complex hemostatic abnormalities contributing to systemic thrombosis.
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PMID:Massive lower extremity arterial thrombosis and acute hepatic insufficiency in a young adult with premature atherosclerosis associated with hyperlipoprotein(a)emia and antiphospholipid syndrome. A case report. 766 91

Twenty-four horses were randomly allocated to 3 groups. All horses underwent a ventral midline celiotomy, and the large colon was exteriorized and instrumented. Group-1 horses served as sham-operated controls, group-2 horses underwent 6 hours of colonic ischemia, and group-3 horses were subjected to 3 hours of ischemia and 3 hours of reperfusion. Baseline blood samples were collected, then low-flow colonic ischemia was induced in horses of groups 2 and 3 by reducing colonic arterial blood flow to 20% of baseline. All horses were monitored for 6 hours. Citrated systemic venous (SV) blood samples were collected from the main pulmonary artery, and colonic venous (CV) samples were collected from the colonic vein draining the ventral colon. Samples were collected at 0, and 2, 3, 3.25, 4, and 6 hours for determination of one-stage prothrombin time, activated partial thromboplastin time, antithrombin III activity, and fibrinogen concentration. Data were analyzed statistically, using two-way ANOVA for repeated measures, and post-hoc comparisons were made by use of Student Newman Keul's test. Statistical significance was set at P < 0.05. There were significant decreases in all hemostatic variables by 2 hours in SV and CV samples from horses of all 3 groups, but there were no differences among the 3 groups for any of these variables. These hemostatic alterations could have been secondary to a hypercoagulable state or to fluid therapy-induced hemodilution. Colonic ischemia-reperfusion was not the cause of these alterations because these alterations also were observed in the sham-operated control horses. Significant temporal alterations existed even after accounting for the hemodilution.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Systemic and colonic venous hemostatic alterations in horses during low-flow ischemia and reperfusion of the large colon. 766 64

Fifty-two consecutive patients undergoing major hepatic resection for liver tumor were divided into two groups according to the operative procedure. Group A consisted of 34 patients in whom vascular inflow occlusion was performed "de principle" during parenchymal division and intrahepatic approach of the portal structures; the mean duration of the portal triad clamping was 43 mn (ranged 17 to 70 mn). Group B patients (18 cases) had hilar division of the structures of that portion of the liver due to be removed, prior to parenchymal division was performed without vascular arrest, except in five "de necessitate" cases during 5 to 22 mn. Groups A and B were comparable in terms of patient age or status, of king of liver tumors and extent of resection. Mean operating duration (215 vs 263 mn), volume of intraoperative blood transfusion (557 vs 1019 ml), intensive care (2.5 vs 4.2 days) and total hospital stays (19.6 vs 30.5 days) were significantly reduced in group A. A higher but transient increase of amino-transferase level was the only biochemical consequence of liver ischemia in group A, whereas postoperative disturbance in serum bilirubin, prothrombin time, fibrinogen, and total protein were significantly greater in group B, probably because of the greater volume of blood transfusion in this group. Thus, routine vascular inflow occlusion with transhepatic approach of the portal structures may be an effective and innocuous procedure for major liver resection.
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PMID:[Pedicular clamping in major hepatectomies: clamping "of principle" or "of necessity"? A comparative study]. 775 41

Prolonged intravascular infusion of urokinase has proven beneficial in reestablishing patency of chronically occluded peripheral arteries and saphenous vein grafts. This study was performed to assess the efficacy and safety of prolonged urokinase infusion as a prelude to angioplasty in chronically occluded native coronary arteries, that had failed standard angioplasty techniques. Twenty-five patients with objective evidence for ischemia in the distribution of a chronic coronary occlusion were referred for percutaneous intervention. Patients were assessed for any potential exclusions from lytic therapy. Urokinase infusion through both a SOS wire and a stable guiding catheter was continued at 100,000-240,000 units/hr for 8-25 hr; patients then underwent attempted balloon angioplasty. Mean duration of urokinase infusion was 20.6 +/- 7.7 hr (total dose 163,000 +/- 52,447 units/hr). Fibrinogen levels dropped slightly with this (300 +/- 129 to 203 +/- 81 mg/dl, P = 0.02). Angiography posturokinase showed improvement in 7 (28%) with regard to coronary flow (> or = 1 TIMI-grade). Angioplasty was successful in 13 (52%), with final angiographic result revealing thrombus in 5 (20%), or dissection 8 (32%). The infusions were well-tolerated with a low incidence of chest pain, 2 (8%) or ischemic ECG response, 2 (8%); myocardial infarction, 2 (8%); or significant bleeding 2 (8%). All patients survived the procedure, with a length-of-hospital stay = 5.1 +/- 4 days. Use of prolonged preangioplasty intracoronary urokinase infusion can be done safely with success in roughly one-half of patients with chronic total native coronary occlusions who have failed prior attempts at percutaneous intervention.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Prolonged urokinase infusion for chronic total native coronary occlusions: clinical, angiographic, and treatment observations. 778 87

Although well established myocardial infarcts (MI) are not difficult to identify in routine hematoxylin and eosin stained sections, recent MI may present diagnostic problems. Fibrinogen is a useful marker for detecting early ischemic cell damage. Using immunofluorescence on frozen tissue, albumin, IgG and fibrinogen have been found throughout the sarcoplasm of ischemic fibers in human hearts. In this report, monoclonal antibodies to all three proteins were reacted using the avidin-biotin technique in formalin fixed, paraffin embedded sections from autopsy cases of sudden or intraoperative deaths with either subtle or no definite ischemic changes evident in routine sections. Strong staining of fibrinogen in the fibers associated with coagulative necrosis, contraction bands or wavy fibers, and in the fibers presumably associated with acute ischemia. Albumin and IgG staining was nonspecific. Fibrinogen is a reliable and reproducible marker for recognizing early ischemia. This method can be used to diagnose early sudden ischemic and intraoperative deaths due to coronary artery bypass graft and prosthesis-related complications and may be particularly useful for forensic autopsies.
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PMID:Fibrinogen: a diagnostic marker for early ischemia. 781 21

In western countries, acute myocardial infarction is the commonest cause of morbidity and mortality [19]. An occlusive coronary thrombus on an ulcerated atherosclerotic plaque in the coronary arteries is the etiological event in more than 90% of patients with Q-wave myocardial infarction [38]. The underlying abnormality in non-Q-wave myocardial infarction is often a ruptured atherosclerotic plaque, which acts as a nidus for the deposition and activation of platelets. In this case, thrombosis occurs, but may not be totally occlusive, or an early spontaneous recanalization may occur. On the other hand, some clinical trials showed that a prolonged treatment with antiplatelet drugs significantly reduces the recurrence of coronary ischemia. Thus, atherosclerosis is a necessary condition for myocardial infarction, but it is not sufficient in that it usually needs the occurrence of thrombosis. However, only 25-30% of these thrombotic events are prevented by the administration of antiplatelets drugs. In recent years, epidemiological studies identified some hemostatic parameters whose abnormalities may help predict the risk of ischemic events: fibrinogen [14], plasminogen activator inhibitor-1 (PAI-1) [3], lipoprotein(a) [46], anticardiolipin antibodies (ACA) and lupus anticoagulant (LA) [10], leukocyte count [34], blood viscosity [34]. Some of these, such as fibronogen and PAI-1 are acute-phase proteins.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Plasma predictors of ischemic complications of atherosclerosis: open issues. 806 Dec 44

From July 1990 to July 1993, we performed 41 percutaneous intra-arterial thrombolysis procedures for the treatment of obstructed infra-inguinal bypass grafts in 32 patients. There were 27 men and five women with a mean age of 63 +/- 17 years (range 21 to 83 years). The symptoms of occlusion were intermittent claudication in three cases, rest pain in 12 cases, severe ischemia without sensitive-motor loss in 26 cases. Bypasses were achieved using a prosthesis in 18 cases (43.9%), a saphenous vein in 10 cases (24.4%), an arterial allograft in nine cases (21.9%), and a composite prosthesis-vein graft in four cases (9.8%) (table I). The distal anastomosis of the bypass graft was located on the popliteal artery in 26 cases (63.4%) and a crural artery in 15 cases (36.6%). The mean duration of the occlusion was 4.9 +/- 3.4 days (range 1 to 15 days). The percutaneous approach was through the contralateral common femoral artery in 26 cases (63.4%), through the ipsilateral common femoral artery in seven cases (17.1%), through the left humeral artery in eight cases (19.5%). In all cases the thrombolytic agent was the recombinant tissue-type plasminogen activator (rt-PA). Each procedure began with the injection of a five milligram bolus of rt-PA into or onto the thrombus followed by infusion of rt-PA into the thrombus at a dose of 0.05 mg/kg/h. Intravenous heparin was simultaneously administered. Serum fibrinogen, prothrombin time, and partial thromboplastin time (PTT) were measured every three hours.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Intra-arterial thrombolysis using rt-PA for the treatment of occluded infra-inguinal bypasses]. 807 60

The impact of various general risk factors on long-term results of percutaneous transluminal angioplasty (PTA) in chronic critical lower limb ischemia is poorly known. In a prospective trial 209 PTAs were performed in 103 consecutive patients with 117 limbs with chronic critical ischemia. The general risk factors that might affect the long-term results of PTA in this patient population were reviewed. Among the factors that showed no statistical significance were all associated diseases, smoking history, and medication used. Of the various clinical chemical parameters, only serum high density lipoprotein (S-HDL) cholesterol and plasma fibrinogen had a statistically significant influence on limb salvage rate in Kaplan-Meier analysis. These parameters proved to be significant determinants also in Cox multiple regression analysis when PTA target-vessel-related parameters (peripheral runoff and number of diseased vessels) were also included in the model. Cox model predicts up to 86% one-year limb salvage for the "good" group (one to five diseased lower limb vessels/limb, S-HDL cholesterol > 0.78 mmol/L, plasma fibrinogen < 4.9 g/L).
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PMID:Impact of risk factors on limb salvage after angioplasty in chronic critical lower limb ischemia. A prospective trial. 809 45


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