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)

Various blood flow disturbances in intraabdominal digestive organs were studied clinically and experimentally from a viewpoint of vascular surgery. Acute gastric mucosal lesion may occur due to ischemia and reperfusion injury of the gastric mucosa. Bleeding from stomach ulcer may be rarely caused by consumption coagulopathy along with aortic aneurysm. Heparin therapy was successful to interrupt it. Gastrectomy is not indicated for such condition but aneurysm should be repaired. Portal vein reconstruction for the radical resection of hepatic, biliary and pancreatic cancers should be carefully made, because early or late stenosis occurs frequently, and they may connect to early or late morbidities or mortalities. On the other hand, resection and replacement of the suprarenal vena cava invaded by the retroperitoneal malignant tumor may be safely carried out. For the acute mesenteric arterial occlusion, early diagnosis and arterial reconstruction are essential to save catastrophe. Positive Doppler sound on the vasa recta seems to be the most reliable parameter for assessing bowel viability. Approach from the proximal large arteries is recommended for uncontrollable intraperitoneal bleeding.
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PMID:[Blood flow disturbance in digestive organs--a viewpoint of vascular surgery]. 258 8

The National Cancer Institute (NCI) Extramural IL2/LAK Working Group treated 93 patients with 114 cycles of high-dose intravenous (IV) interleukin-2 (IL-2) and lymphokine-activated killer (LAK) cells in three phase II trials. Thirty-six patients had metastatic melanoma, 35 had metastatic renal cell cancer, and 22 had colorectal cancer. All patients had a Karnofsky performance status greater than or equal to 80% and normal laboratory tests and organ function, and had received no more than one prior form of immunotherapy or chemotherapy. Objective responders were eligible to receive up to two additional courses of therapy at 12-week intervals. The most frequent toxicities were a capillary leak syndrome resulting in marked extravascular fluid shifts, and hypotension requiring treatment with large volumes of IV fluids and vasopressor agents. Laboratory and clinical evidence of hepatic and renal dysfunction were virtually universal. Intensive care-level support was routinely provided and the toxicity observations confirmed the need for this level of care. The life-threatening toxicities were cardiac and pulmonary. Five of the 27 patients who experienced significant respiratory compromise required intubation and mechanical ventilatory support. Twenty patients developed cardiac arrhythmias, the majority of which were supraventricular. There was a single episode of ventricular tachycardia requiring cardioversion. Four patients had transient cardiac ischemia, and an additional four had myocardial infarctions, one of which was fatal. With these exceptions, all toxicities were rapidly reversible. The occurrence of only a single therapy-related death and a very low incidence of other irreversible or life-threatening events is comparable to the level of toxicities often observed in other phase II trials. Although the intensity of this regimen limits this approach to a subset of cancer patients with excellent performance status and adequate organ function, because of the frequency and apparent durability of complete responses, this treatment warrants further investigation.
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PMID:Interleukin-2 and lymphokine-activated killer cell therapy of solid tumors: analysis of toxicity and management guidelines. 264 14

To investigate the effects of recombinant human tumor necrosis factor alpha (rHuTNF-alpha) on high-energy phosphate metabolism of cancer cells, 31P nuclear magnetic resonance (NMR) studies were performed on a murine methylcholanthrene-induced sarcoma. Injection of 15 micrograms of rHuTNF-alpha caused progressive depletion of ATP and phosphocreatine within 90 min, together with an increase in inorganic phosphate. Metabolic changes were correlated with the early histological appearance of thrombosis and hemorrhage. A spatially localized NMR technique demonstrated that these changes were specific for the tumor. Acute ischemia of the tumor produced similar metabolic changes; thus the metabolic effects of rHuTNF-alpha could be due to either a primary action on tumor biochemistry or a secondary action produced by ischemia. These findings indicate that rHuTNF-alpha has a very rapid onset of action, which can be detected by 31P NMR. Furthermore, the results suggest that 31P NMR spectroscopy will be extremely useful for detecting early biochemical changes produced by rHuTNF-alpha or other treatments in animal and human cancers.
Cancer Res 1989 Apr 15
PMID:Early metabolic response to tumor necrosis factor in mouse sarcoma: a phosphorus-31 nuclear magnetic resonance study. 270 53

5-fluorouracil (FUra) is one of the most frequently used drugs in cancer treatment, particularly in combination with other agents. Its activity when administered as an infusion rather than a bolus has led to a renewed and increased use. A cardiotoxicity that mimics ischemia has been associated with the administration of FUra in cancer patients. This cardiotoxicity may manifest itself as: (a) dysrythmias with and without cardiorespiratory symptoms (b) ECG changes with and without cardiorespiratory symptoms (c) cardiorespiratory symptoms with and without ECG changes (d) acute myocardial infarct; symptoms and ECG changes (e) ventricular dysfunction (f) cardiogenic shock and (g) sudden death. Several case studies which illustrate the cardiotoxic sequelae that may be associated with the use of this drug are discussed. The incidence, contributing factors, risk factors and mechanisms underlying this phenomenon are undetermined. No appropriate recommendations for monitoring patients or for predicting those patients that will develop such toxicity while receiving FUra can be made at present. Prospective studies to determine the true incidence, spectrum and mechanisms causing this syndrome are ongoing and required for its understanding and prevention.
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PMID:The clinical syndrome of 5-fluorouracil cardiotoxicity. 273 45

When mammalian phagocytes encounter appropriate stimuli, highly reactive oxygen derived free radicals (superoxide and hydroxyl) and related species (hydrogen peroxide and hypochlorous acid) may be produced as a normal mechanism in the defence of the host against invading microorganisms. These radicals are destructive to most biological molecules and are responsible for much of the damage inflicted by phagocytes on both microorganisms and surrounding tissues at sites of infection or inflammation. Increasing evidence suggests that the generation of oxygen metabolites plays an important role not only for perpetuation of chronic inflammation, but also for the etiology of other health problems i.e. ageing, cancer, ischemia, and radiationinduced injuries. The extent of tissue damage in inflammation may partly be the result of the balance between free radicals generated and the antioxidant/radical scavenger protective defence systems. The implication of oxygen free radicals in inflammation and future directions are briefly discussed in the present overview.
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PMID:[Inflammation and free oxygen radicals]. 275 92

When mammalian phagocytes encounter appropriate stimuli, highly reactive oxygen derived free radicals (superoxide and hydroxyl) and related species (hydrogen peroxide and hypochlorous acid) may be produced as a normal mechanism in the defence of the host against invading microorganisms. The radicals are destructive to most biological molecules and are responsible for much of the damage inflicted by phagocytes on both microorganisms and surrounding tissues at sites of infection or inflammation. Increasing evidence suggests that the generation of oxygen metabolites plays an important role not only for perpetuation of chronic inflammation, but also for the etiology of other health problems i.e. ageing, cancer, ischemia, and radiationinduced injuries. The extent of tissue damage in inflammation may partly be the result of the balance between free radicals generated and the antioxidant/radical scavenger protective defence systems. The implication of oxygen free radicals in inflammation and future directions are briefly discussed in the present overview.
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PMID:[Inflammation and free oxygen radicals]. 278 Feb 75

Transcatheter arterial chemoinfusion and/or chemoembolization of the internal iliac artery have been used for the treatment of pelvic malignancies. Intraarterial chemoinfusion is expected to deliver a higher concentration of chemotherapeutic agents directly to the neoplasm, reducing the problems of systemic side effects. In 35 cases of pelvic malignancies, 61 procedures of intraarterial chemoinfusion and/or chemoembolization of cisplatin (CDDP) and/or adriamycin (ADR) were performed in combination with or without occlusion of the superior and/or inferior gluteal arteries by the use of steel coils. For chemoinfusion and chemoembolization, the anterior division of the internal iliac artery was selected. In 19 procedures of 14 cases, pain of the lower extremities and the hips developed soon after chemoinfusion and chemoembolization, and gradually followed by paresthesia. Each patient was complicated with numbness, dysesthesia and/or weariness of the lower extremities, thighs and the plantar and dorsal of the foot. These symptoms continued long without recovery. Additionally, the most severe complication such as paralysis and muscular atrophy of the unilateral lower limb occurred in one patient, and at the 14 months follow-up the patient was still suffering from paralysis and gait disturbance. A neurologic examination revealed damage of the sciatic nerve at the level of L5, S1 and S2. It was suggested that the cause of the neurologic complications was attributed to ischemia and/or to deliver a higher concentration of chemotherapeutic agents of the sciatic nerves, and that any previous surgery, radiotherapy or intraarterial chemoinfusion combined with embolization was not related to the symptoms under discussion.
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PMID:[Neurologic complications following intraarterial chemoinfusion and/or chemoembolization of pelvic malignancies]. 279 64

Ventricular arrhythmias during transient myocardial ischemia were studied in 60 patients with spontaneous angina and greater than or equal to 1 ischemic attack with ST-segment depression during 24-hour ambulatory electrocardiography. The patients were divided into 2 groups: group 1, 10 patients (17%) who developed ventricular arrhythmias during 26 of 92 (28%) ischemic attacks; and group 2, 50 patients who did not show this phenomenon. Daily ischemic attacks, total ischemic time and the proportion of symptomatic ischemic attacks were significantly greater (p less than 0.01) in group 1 versus group 2. In group 1 patients, ischemic attacks were found to have twice the duration in the presence of arrhythmias than in their absence (20.4 +/- 11.9 vs 9.1 +/- 8.4 minutes, p less than 0.01); arrhythmias were more common during symptomatic than during silent ischemic attacks (39 vs 13%, p less than 0.02). Arrhythmias occurred at the onset or peak of ST-segment depression (ischemia phase) in 6 cases (60%), during the resolution of ST-segment depression (recovery phase) in 2 cases (20%) and during both phases of ischemic attacks in the remaining 2 (20%). When compared to recovery phase arrhythmias, ischemia phase arrhythmias were characterized by a later onset time (173 +/- 144 vs 58 +/- 54 seconds, p less than 0.01) and a longer duration (105 +/- 107 vs 41 +/- 22 seconds, p less than 0.01). During the ischemia phase, 16 of 353 ventricular premature complexes initiated ventricular tachycardia, while during the recovery phase only 1 of 161 ventricular premature complexes resulted in ventricular tachycardia (4.5 vs 0.6%, p less than 0.02). Thus, ventricular arrhythmias may accompany spontaneous ischemic ST-segment depression, when the latter is recurrent, prolonged and symptomatic; arrhythmias are characterized by a greater frequency, duration and malignancy during the ischemia phase than during the recovery phase of ischemic attacks.
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PMID:Prevalence, time course and malignancy of ventricular arrhythmia during spontaneous ischemic ST-segment depression. 280 59

Febrile illnesses commonly arise in hospitalized patients after admission, but most previous studies have been of specific subsets of febrile illnesses. To provide practical information about the problem as a whole, we studied febrile illnesses arising after admission (nosocomial febrile illnesses [NFls]) in 123 inpatients of an internal medicine service who had been afebrile for the preceding week. We compared them with 123 randomly selected patients without NFl. Causes of NFl included infections in 83 cases; noninfectious, inflammatory states in 15; malignancy in 12; ischemia in eight; and procedures in three. Evidence for the cause of the NFl was present at onset in at least 110 of the 123 patients. Despite this, antimicrobial agents were administered to 23 (58%) of 40 patients without infections. Thirty-four patients with NFl died; the NFl contributed to death in 26. In contrast, only eight comparison patients died. "Do not resuscitate" status was present in 32 patients with NFl compared with only 12 comparison patients, and 19 (59%) of the former died. The data from this study provide a comprehensive description of NFl arising in hospitalized internal medicine patients, indicate that the occurrence of a new febrile illness signifies a poor prognosis, and provide a rational basis for management.
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PMID:Nosocomial febrile illnesses in patients on an internal medicine service. 231 Feb 89

Dietary fish oils rich in eicosapentaenoic acid (EPA) possess immunostimulant, anti-inflammatory, cancer-retardant, antithrombotic and ischemia-protective properties that are remarkably parallel to the effects of high-dose nutritional antioxidants. EPA and nutritional antioxidants may show complementary activities in a wide range of preventive and therapeutic applications.
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PMID:Homologous physiological effects of nutritional antioxidants and eicosapentaenoic acid. 303 36


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