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

Extracorporeal liver surgery has been proposed with the aim to increase the resectability rate in patients with advanced tumors. In order to avoid the inherent section of the hepatic pedicle we propose ex situ-in vivo liver surgery. The surgical procedure comprises complete mobilization and exteriorization of the liver which is rocked on the axis of the porta hepatis following section of the hepatic veins. Protection of the liver parenchyma against prolonged ischemia is obtained through cold portal perfusion (UW solution) and the use of an heat exchanger on which liver resections and vascular procedures are performed. The procedure also encompasses the use of veno-venous bypass during liver vascular exclusion. This procedure was performed in 2 patients with tumoral invasion of the 3 main hepatic veins and in 1 patient whose hemangioma was surrounding the hepatocaval confluence. Duration of hypothermic ischemia was 205, 225 and 230 minutes respectively. Postoperative course was uneventful in the 3 cases with an hospital stay of 25, 28 and 18 days. Ex situ-in vivo liver surgery allows completion of a surgical treatment in patients whose tumor appears unresectable with the use of conventional technics. This procedure may constitute an alternative to liver transplantation in highly selected cases.
 ...
PMID:[Ex situ-in vivo hepatic resection. Technique and initial results]. 128 18

Major liver resections with complex vascular reconstruction require ischemia lasting from 2 h 30 to 5 h thus exceeding hepatic tolerance to warm ischemia. We describe a new technique of "ex situ-in vivo" liver surgery with prolonged ischemia with an intact hepatic pedicle. The surgical procedure encompasses complete mobilization of the liver and inferior vena cava, inferior mesenteric and femoral to axillary vein bypass, complete vascular exclusion of the liver, cold perfusion (U. W. solution), section of the hepatic veins allowing exteriorization of the liver ("ex situ") which remains connected by the hepatic pedicle ("in vivo"). The liver is placed on a heat exchanger at 4 degrees C. This procedure was performed in three patients: one each with hepatocellular carcinoma, huge metastasis of colorectal carcinoma and a "diffuse" hemangioma. Duration of ischemia was 225, 205, and 230 min respectively. The postoperative course was uneventful in all 3 cases and patients are alive at 15, 12, and 6 months. As it improves resecability rate of liver tumors and provides radical margins of resection, this procedure may be a beneficial alternative to liver transplantation for which poor results in cancer therapy with a high rate of recurrence are mainly due to immunosuppression.
 ...
PMID:["Ex situ-in vivo" surgery of the liver: a new technique in liver surgery. Principles and preliminary results]. 166 68

The result of pathological analysis of 76 placentae and their appendices from clinically diagnosed fetal distress in year 1985-1989 is here presented. The findings could be classified into 4 groups; lesions due to disturbance of maternal blood flow and villous ischemia or hypoxia; retardation of development and malformation of villi; lesions due to haematogenous and ascending infection and pathological changes of the umbilical cord. The clinical significance of these pathological changes was discussed. We suggested that some lesions such as villous growth retardation, placental haemangioma, choriangiosis, infection of the placenta, single umbilical artery etc, could cause fetal distress, and villitis, single umbilical artery could sufficiently impair placental function so as to retard fetal growth or cause fetal malformation. The etiology of some placental lesions needs further study.
 ...
PMID:[Pathological analysis of 76 placentae in fetal distress]. 187 56

The term "angioglioma" denotes a highly vascular glioma, most of which are low-grade lesions associated with a favorable prognosis. The authors encountered an example of this pathology, a cystic oligodendroglioma associated with prominent vasculature which both clinically and histologically mimicked an occult arteriovenous malformation (AVM). This case and reports of the association of AVM and glioma prompted a histological review of 1034 surgically resected AVM's, both angiographically occult and visible, among which no oligodendroglial or astrocytic forms of "angioglioma" were found. Eight cases were observed, however, wherein oligodendroglial cells were increased in number within or about the malformation. Two basic histological patterns of oligodendroglial cell excess were seen; one appeared to be malformative in nature with abnormal disposition of oligodendroglial cells being an integral part of the AVM, whereas in the other an apparent increase in cellularity seemed the result of chronic ischemia with condensation of white matter. It appeared that the areas of increased oligodendrocyte content seen in association with AVM are non-neoplastic lesions that exhibit two rather distinct histological patterns of differing origin. In an effort to determine the frequency of "angioglioma," the authors examined Tissue Registry data for several glioma groups in which highly vascular examples are prone to occur. Tumors selected for study included 104 cerebellar-type (pilocytic) astrocytomas, 82 oligodendrogliomas, and 51 supratentorial pilocytic astrocytomas. Histological hypervascularity mimicking a vascular malformation (that is, an "angioglioma") was encountered in 5%, 4%, and 12% of the cases, respectively. Based upon clinical, radiological, and pathological reviews of these cases, as well as a careful review of the literature, it was concluded that 1) "angiogliomas" are neither rare nor represent a distinct clinicopathological entity; 2) in histological but not necessarily angiographic surgical terms, they represent simply highly vascular gliomas, usually of low grade; and 3) the clinicopathological and angiographic features as well as the prognosis of such lesions do not differ from those of similar gliomas without angioma-like vasculature. Finally, "angiogliomas" must not be confused with gliomas of high-grade malignancy which, due to neovascularity, may be highly vascular at angiography and at surgery.
 ...
PMID:"Angioglioma" and the arteriovenous malformation-glioma association. 188 77

Better, noninvasive, diagnostics, better knowledge of anatomy and of surgical techniques have been responsible for a considerable development of liver surgery during recent years. Primary malignant liver tumours can only be cured by resection. The decision for resectional surgery should be based on different tumor characteristics, of whom the nature of the liver tissue (normal or cirrhotic) in which the tumor develops in of utmost importance. A malignant tumor should be resected with save, tumor-free margins, leaving behind as much normal functional parenchyma as possible. The role of complementary therapies as e.g. chemotherapy, chemo-embolisation and arterial ischemia must be further developed. Liver transplantation will probably play a more important role in the future development of liver cancer treatment. Surgery for benign liver tumors can be restricted most of the time to a limited resection; extended hepatectomies are rarely necessary. The more deliberate use of intraoperative ultrasound and hepatic vascular exclusion as well as the more frequent use of ultrasound dissectors will allow safer liver surgery; this applies especially for the excision of benign solid liver tumors. Because of their degenerative risks, liver adenomas should be excised. Focal nodular hyperplasia and haemangioma remain rare indications for surgery. The low morbidity and mortality of elective liver resections should favour a more widespread use of surgery for the treatment of malignant as well benign liver tumors.
 ...
PMID:[Surgery of benign and malignant primary liver tumors]. 217 70

This study was designed to investigate the hemodynamic characteristics of cavernous angiomas of the brain. Five adult patients with a cavernous angioma underwent local cortical blood flow studies and vascular pressure measurements during surgery for the excision of the cavernous angioma. Clinical presentation included headache in four patients, seizures in four patients, and recurring diplopia in one patient. Magnetic resonance imaging demonstrated the cavernous angiomas in all patients and revealed an associated small hematoma in two. Four patients with a cerebral cavernous angioma were operated on in the supine position and the remaining patient, whose lesion involved the brain stem, was operated on in the sitting position. Mean local cortical blood flow (+/- standard error of the mean) in the cerebral cortex adjacent to the lesion was 60.5 +/- 8.3 ml/100 gm/min at a mean PaCO2 of 35.0 +/- 0.6 torr. Mean CO2 reactivity was 1.1 +/- 0.2 ml/100 gm/min/torr. The local cortical blood flow results were similar to established normal control findings. Mean pressure within the lesion in the patients undergoing surgery while supine was 38.2 +/- 0.5 mm Hg; a slight decline in cavernous angioma pressure occurred with a drop in mean systemic arterial blood pressure and PaCO2. Mean pressure in the cavernous angioma in the patient operated on in the sitting position was 7 mm Hg. Jugular compression resulted in a 9-mm Hg rise in cavernous angioma pressure in one supine patient but no change in the patient in the sitting position. Direct microscopic observation revealed slow circulation within the lesions. The hemodynamic features demonstrated in this study indicate that cavernous angiomas are relatively passive vascular anomalies that are unlikely to produce ischemia in adjacent brain. Frank hemorrhage would be expected to be self-limiting because of relatively low driving pressures.
 ...
PMID:Vascular pressures and cortical blood flow in cavernous angioma of the brain. 239 87

In the management of intracranial vascular malformations, it is important to know the regional cerebral blood flow in its surrounding structure. However, CT scan with contrast medium and angiography have only a limited ability to estimate the rCBF. In this study, stable xenon-computerized tomography scanning by means of the end-tidal gas-sampling method was performed in eleven patients with intracranial vascular malformations. Seven of the patients had arteriovenous malformations, three had venous angiomas and one had aneurysm of the vein of Galen. In two patients with large arteriovenous malformations, in two with "larger" venous angioma and in one with aneurysm of the vein of Galen, rCBF values were significantly reduced, particularly adjacent to the malformations. In contrast, there were no areas showing reduced rCBF in cases where the malformations were small. This indicates development of ischemia correlates with the size of malformations. From the xenon-enhanced CT scan and angiographic findings, the presence of steal phenomenon with venous congestion might be a cause of rCBF reduction in those cases where ischemia exists.
 ...
PMID:[Xenon-enhanced CT CBF measurements in intracranial vascular malformations]. 277 Sep 61

In two adults with cavernous hemangiomas occurred symptoms similar to carpal tunnel syndrome. When the angiomas were removed the pains as well hypaesthesia and hypoalgesia in the median nerve area disappeared completely. While in one patient this result stayed on, in the other the same symptoms reappeared when hemangioma recurred. Ischemia in the median nerve area is supposed to be due to shunts in the hemangioma. Their existence could be noticed angiographically as well as histologically in operation specimens.
 ...
PMID:[Cavernous hemangioma of the palm with symptoms resembling carpal tunnel syndrome]. 625 Feb 98

Only four cases of chaismal syndromes caused by arteriovenous malformations (AVMs) have been reported. We have examined two patients with chiasmal dysfunction caused by an AVM. In one patient, the AVM was suspected only after angiography. However, the presence of an angioma of the lip might have been a clue to the diagnosis. In the other patient, seizures and pulsating proptosis led to the correct diagnosis before angiography was performed. This patient also had episodes of transient bilateral blindness, presumably caused by postictal states or by periodic shunting with ischemia (chiasmal steal).
 ...
PMID:Chiasmal syndrome caused by arteriovenous malformations. 706 62

Venous angioma is a relatively rare vascular malformation of the brain. It is usually asymptomatic and may be an incidental finding at autopsy or on cerebral angiography. We report a very rare case in which TIA-like attack occurred as the initial manifestation. A 59-year-old woman was hospitalized because of a TIA-like attack about 5 months after left putaminal bleeding. Detailed examination allowed us to make a diagnosis of subcortical venous angioma of the left parietal lobe and multiple cerebral aneurysms. The cerebral aneurysms were treated surgically. Since the angioma was localized in an eloquent area, radiotherapy was chosen first. Angioma giving rise to TIAs is very rare. The ischemia may have been caused by transient venous thrombosis or a steal phenomenon due to a decrease in blood circulation in the left cerebrum caused by the putaminal bleeding.
 ...
PMID:[A case of venous angioma complicated by unruptured aneurysm with TIA as the initial manifestation]. 806 42


1 2 3 4 Next >>