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)

Injury of the normal central nervous system is a major concern in the radiotherapy of brain tumors, but the pathogenesis of injury remains poorly understood. Modulation of the production of growth factors is associated with ischemia and traumatic injury in the central nervous system. Ionizing radiation has been shown to induce basic fibroblast growth factor in endothelial cells and in cells of a human breast carcinoma cell line. The inducibility of basic fibroblast growth factor after irradiation and its potential role in the recovery response of the central nervous system led us to investigate the effects of radiation on the expression of this growth factor in primary cultures of normal rat type 1 astrocytes. Astrocyte monolayers were exposed to ionizing radiation (1 to 10 Gy). Northern blot analysis revealed that doses of 2 to 10 Gy markedly reduced the expression of basic fibroblast growth factor as early as 1 h after irradiation, and that it remained below levels in unirradiated cells for at least 24 h. The effect was not associated with astrocyte cytotoxicity, and it appears to have some specificity for basic fibroblast growth factor since the levels of mRNA coding for ciliary neurotrophic factor and glial fibrillary acidic protein were not affected.
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PMID:X-ray-mediated reduction in basic fibroblast growth factor expression in primary rat astrocyte cultures. 909 29

Long-term survival of carcinomas in the body and tail of the pancreas after surgery is still rare. One of the major reasons for unresectability is cancerous invasion to major vessels, such as the common hepatic and splenic arteries. Resection of the involved arteries can increase resectability and thus might increase post-operative survival. The aim of this study was to clarify the importance of the Appleby operation for carcinoma of the body and tail of the pancreas. A Case Report was carried out with a 54 year-old man, had suffered back pain and loss of body weight for six months. Imaging procedures such as US, CT or angiography showed a carcinoma in the body of the pancreas, about 3 cm in size, and both the common hepatic and splenic arteries were invaded by the tumor. The Appleby operation was used for this patient, since firstly there was no invasion to the head of the pancreas, secondly neither the proper hepatic artery nor the SMA was involved, thirdly the root of the CA was free of carcinoma, and finally because clear pulsation of the proper hepatic artery could be felt one or two minutes after occlusion of the CHA, which indicated that resection of the CHA would not lead to hepatic ischemia. The postoperative course was uneventful. His appetite recovered well and his body weight increased to the level before the disease. The patient was relieved from back pain and has returned to work 18 months after the operation, although he had a local recurrence eight months after the operation. In addition, eleven cases with carcinoma of the body and tail of the pancreas were used for a literature review. The average survival time after the Appleby operation is 6.6 months, and four patients are still alive. One patient has survived 13 years after the operation. It was concluded that although the prognosis after Appleby procedure is still not satisfactory that this operation can at least offer patients a better quality of life.
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PMID:Appleby operation for carcinoma of the body and tail of the pancreas. 916 7

The following article contains a short review on gastrointestinal problems of the elderly. The diseases of the esophagus occurring in the elderly are not much different from those in younger patients. Clinically relevant in the stomach are above all bleeding ulcerations and the gastric carcinoma occurring more frequently in advanced age. The pyogenic liver abscess is diagnosed primarily in the elderly and is at a rule the consequence of an infection of the gall bladder and other abdominal sites. The hepatocellular carcinoma does not grow rapidly in the elderly, but its accompanying unfavourable survival rate at five years is also approximately 5 per cent. In the case of symptomatic cholelithiasis, older high risk patients do especially profit from minimally invasive laparoscopic surgical procedures. Today, bile duct calculi are preferably treated by endoscopic papillotomy and following extraction of the calculi. The pancreas is subjected to atrophy, lipomatosis and fibrosis at the advanced age. However, these changes are rarely of clinical relevance. A frequent problem in clinical practice is that of constipation, from which 35% of patients suffer above the age of 65 years. Another typical symptom of the elderly is the incontinence, the different causes are being discussed. In advanced age, gastrointestinal hemorrhages are mostly occurring above the Treitz's ligament. Hemorrhages of the lower gastrointestinal tract occur mostly in the form of diverticle bleedings and those of angiodysplasias in the elderly. The diverticulosis is also a disease observed in over 50 per cent of patients above 70 years, but it is symptomatic in only part of the patients. When suspecting an inflammatory bowel disease in the elderly, the possibility of a mesenterial ischemia must always be considered as differential diagnosis. The classical chronic inflammatory bowel diseases can, however, also occur at advanced age. The colon carcinoma is one of the most frequent lethal causes in the Western countries 90 per cent of the cases of colon carcinoma are found in patients older than 50 years of age. Intensive attention is therefore required in this age group.
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PMID:[Gastrointestinal problems in elderly patients]. 933 52

Abdominal compartment syndrome develops whenever the mean intraperitoneal pressure rises above the physiological pressure, leading to renal and mesenteric ischemia and respiratory decompensation due to pressure on the diaphragm. Abdominal compartment syndrome may occur after conditions such as peritonitis, intestinal obstruction, laparoscopic procedures, or abdominal tumors. Leakage from the urinary tract may cause accumulation of urine in the peritoneal cavity which commonly manifests as single or multiple urinomas, or urinary ascites. The case of a patient who had delayed identification of a ureteral perforation following the abdomino-perineal resection of a rectal carcinoma is presented. Massive urinary leakage into the peritoneal cavity led to the abdominal compartment syndrome. Peritoneal drainage and ureteral stenting improved her condition. A high index of suspicion is necessary in order to diagnose this rare condition.
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PMID:Abdominal compartment syndrome due to delayed identification of a ureteral perforation following abdomino-perineal resection for rectal carcinoma. 947 95

Prostatic atrophy (PA) is one of the most frequent mimics of prostatic adenocarcinoma. It occurs almost exclusively in the peripheral zone of the gland and gained importance with the increasing use of needle biopsies for the detection of prostatic carcinoma The etiopathogenesis is unknown, and there is controversy related to the potential of PA as a precancerous lesion. The frequency increases with age. Compressions caused by hyperplastic nodules, inflammation, hormones, nutritional deficiency, or systemic or local ischemia, are all possible factors in the pathogenesis of PA. The peripheral zone of the prostate was step-sectioned and totally embedded from the bodies of 100 consecutively autopsied men more than 40 years of age. The fragments were microscopically studied for presence of PA, latent (histologic) carcinoma, high-grade prostatic intraepithelial neoplasia, local arteriosclerosis, and prostatitis. The prostates were macroscopically examined for the presence of nodular prostatic hyperplasia. The autopsy reports provided information concerning the presence of generalized atherosclerosis and benign or malignant nephrosclerosis. PA was seen in 85 of the 100 prostates examined and histologically was subtyped into simple, hyperplastic, and sclerotic atrophy. In 65 (76.47%) of 85 cases, the histologic subtypes were combined. In 33 (50.76%) of these 65 cases, the three subtypes were seen concomitantly, favoring the hypothesis that they represent a morphologic continuum of only one lesion. Fibrosis of the stroma may or may not be present in simple and hyperplastic atrophy. Hyperplastic atrophy associated with fibrosis of the stroma is the histologic subtype that most frequently mimics adenocarcinoma Sclerotic atrophy always presents fibrosis of the stroma. PA increases with age, and, in our study, ischemia caused by local intense arteriosclerosis seems to be a potential factor for its etiopathogenesis. Because there was no relation to latent (histologic) carcinoma or high-grade prostatic intraepithelial neoplasia, PA is probably not a premalignant lesion.
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PMID:Prostatic atrophy: an autopsy study of a histologic mimic of adenocarcinoma. 955 22

Hepatoduodenal ligamentectomy (ligamentectomy) is the ultimate surgery for biliary tract carcinoma involving perioperative difficulties such as total hepatic ischemia during revascularization of the hepatic artery and the portal vein, patency of the reconstructed hepatic artery, and high incidence of related operative mortality. In the present study, modified ligamentectomies with extended right hepatic lobectomy, including resection of the caudate lobe, were performed on three patients with advanced biliary tract carcinoma in whom the left hepatic artery had been replaced and the original artery was preserved. In all patients, postoperative courses were uneventful: success of the resection was confirmed by histological examination. This procedure enabled en bloc resection of hepatoduodenal ligament with positive cancer invasion to take place. It was carried out safely without concern for the difficulties described above. In our view, ligamentectomy should be performed in all such cases.
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PMID:Modified hepatoduodenal ligamentectomy for advanced carcinoma of the biliary tract: the importance of preservation of the replaced left hepatic artery. 988 Jul 78

One-stage operations for carcinoma of the esophagus and cardia were performed on 100 patients. The substitution of the resected esophagus was made with a isoperistaltic tube from the greater curvature of the stomach with anastomosis on the neck, in the pleural or abdominal cavities. Palliative interventions were fulfilled on 31 patients with inoperable carcinomas. An analysis of the structure and causes of postoperative complications and postoperative lethality has shown that among the most frequent causes of deaths in the postoperative period were purulent-infectious complications as a result of ischemia of gastric transplants and incompetence of sutures of the anastomoses as well as pleuro-pulmonary complications. Special attention was given to an analysis of complications after operations performed without thoracotomy from the cervico-abdominal access. The amount of postoperative complications was 30%, postoperative lethality 15%. One-year survival after operations made up 57%, 3-year survival--less than 30%, 5-year survival--less than 15%. Some recommendations are given for the surgical policy and methods of prophylactics of certain complications. Endolymphatic infusions of cytostatics used as adjuvant chemotherapy in complex treatment of patients with cardioesophageal carcinoma represent a perspective direction providing longer life of the patients without recidivations. From the oncological viewpoint the operation without thoracotomy are not always thought to be justifiable.
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PMID:[The surgical treatment of cancer of the esophagus and cardia. The complications and hazards]. 991 68

The causes and pathologic changes leading to fibrosis and cirrhosis after orthotopic liver transplantation (OLT) are not fully defined. The computerized pathology files were searched for cases of fibrosis/cirrhosis after OLT. Of 493 grafts from 435 patients, 35 grafts from 32 patients of posttransplantation liver fibrosis/cirrhosis were identified and retrieved (7%). Detailed histopathologic examinations of all post-OLT liver biopsy specimens were performed in conjunction with clinical, virologic, serologic, and molecular diagnostics information. Two cases with subcapsular septa and fibrous tissue close to hilum were excluded as false positives. Fibrosis/cirrhosis was confirmed in the remaining 33 grafts. In 20, the underlying cause was recurrent viral hepatitis, including eight with hepatitis C, 10 with hepatitis B, and two with combined hepatitis C and B. Another two with pretransplantation chronic hepatitis B developed cirrhosis without detectable virologic markers after OLT; these were biliary type secondary to obstruction in one, and chronic changes due to severe graft ischemia in one. Three patients acquired hepatitis C after OLT, with molecular confirmation available in two. In five patients, the underlying causes were Budd-Chiari syndrome and autoimmune hepatitis, recurrent autoimmune hepatitis, recurrent primary biliary cirrhosis, alcohol-induced liver disease, and recurrent bile duct carcinoma. Three cases had centrilobular fibrosis but without bridging septa or cirrhosis as a result of chronic rejection. It was concluded that (1) Cirrhosis after OLT is uncommon (7%). (2) Chronic rejection does not lead to cirrhosis, but it may result in centrilobular fibrosis. (3) In most (70%) cases, cirrhosis after OLT is attributed to recurrent or acquired viral hepatitis.
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PMID:Fibrosis/cirrhosis after orthotopic liver transplantation. 992 25

Microcirculation and molecular biology are the hottest topics in modern surgical research. In familial adenomatous polyposis the incidence of carcinoma can be assessed by the localisation of the PAC-gene mutation. Restorative proctocolectomy with ileoanal pouch represents the procedure of choice. The optimal age for the operation varies between 20 and 35 years according to the localisation of the mutation. RT-PCR directed to recently defined surface antigens allows for the sensitive detection of intraoperative tumor cell liberation. Due to tumor cell detection in the systemic circulation the perioperative administration of monoclonal antibodies must be advocated. A preciser definition of lymphogenic tumor spread underlines the importance of systematic lymphadenectomy in resection of the colon. The understanding of microcirculatory disorders has optimized surgical decision-making intra- and perioperatively: function of renal and hepatic microcirculation is a reliable parameter to predict graft quality already intraoperatively and to monitor therapeutic approaches to ischemia/reperfusion injury. Results in the therapy of acute pancreatitis could be improved by operating less and later. Analysis of pancreatic microcirculation resulted in an improvement of ICU-therapy in the early stages of the disease. Transplantation of the liver is limited to hepatocellular carcinoma when its localisation or the residual hepatic function after resection preclude curative excision. In addition liver transplantation should not be carried out in tumors larger than 5 cm or in patients with more than 3 tumor nodules. Liver resection for colorectal metastases is a standard procedure. A second resection of recurrent metastases is advocated since an identical median survival can be achieved compared to the primary resection (32 mo). The surgical treatment of non-colorectal liver metastases is under evaluation and should be restricted to oncological centers. Special aspects of backwashileitis in ulcerative colitis will be outlined concerning timing of colectomy, pouch construction, and follow-up.
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PMID:[State of the art: gastroenterologic surgery]. 1006 3

Lazaroids, a novel series of 21-aminosteroids without glucocorticoid action, have the properties of free radical scavenging and potent inhibition of lipid peroxidation. U-74389G is one of the Lazaroid compounds. These compounds have shown excellent effect on central nervous system trauma and ischemia in experimental animals. The present study was designed to investigate whether Lazaroid (U-74389G) has a protective effect on Cisplatin (CDDP)-induced toxicity. Fisher 344 rats were used in this study. The animals were divided into three groups: I) CDDP 0.9 mg/kg i.v. alone; II) CDDP 0.9 mg/kg i.v. 1 hr after the p.o. administration of U-74389G 10 mg/kg; III) physiological saline 2.5 ml/kg i.v. instead of CDDP, for 7-10 days. First, the protective effect of Lazaroid (U-74389G) on CDDP-induced ototoxicity was studied. Cochlear damage was evaluated by means of the compound action potential (CAP) and histological examination using scanning electron microscopy. The degree of elevation of CAP thresholds and the rate of missing outer hair cells were significantly reduced in Group II as compared to Group I. These results clearly demonstrate that Lazaroid (U-74389G) has a protective effect on CDDP-induced ototoxicity. Second, the protective effect of Lazaroid (U-74389G) on CDDP-induced nephrotoxicity was studied. Nephrotoxicity was evaluated by means of serum BUN level and histopathological examination. There was no significant difference in serum BUN level and little difference of renal histopathological findings between Group I and Group II. Lazaroid (U-74389G) was not found to ameliorate CDDP-induced nephrotoxicity. Third, the influence of Lazaroid (U-74389G) on the antitumor effect of CDDP was investigated in rats inoculated subcutaneously with SCC-158 squamous-cell carcinoma cells. There was no significant difference of Tumor Growth Rate (TGR) between Group I and Group II. The result suggests that the combined administration does not alter the antitumor activity of CDDP. In conclusion, the combined administration of CDDP with Lazaroid (U-74389G) ameliorates CDDP-induced ototoxicity without decreasing the antitumor activity of CDDP.
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PMID:[An experimental study of the protective effect of lazaroid (U-74389G) on cisplatin-induced toxicity]. 1006 16


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