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)

The most prominent symptom of Shy-Drager syndrome is the asympathicotonic orthostatic (postural) hypotension, which is associated with a number of additional autonomic and neurological disturbances: disorders of micturition, sphincter disturbances, impotence, anhidrosis, hypokinesia, rigidity, pyramidal symptoms, cerebellar dysfunction and nuclear pareses due to anterior horn cell degeneration. The various disorders are not caused by ischemia or hypotension, but they represent parts of a multisystemic disease of still unknown etiology. According to different extension and neuropathological criteria it has been suggested to distinguish two types of neurogenic (idiopathic) orthostatic hypotension. Moreover, differential diagnosis of the Shy-Drager syndrome has to consider postural hypotension occuring as a symptom in some neuropathies and Parkinson's disease. Symptomatology, course, prognosis and treatment of Shy-Drager syndrome are described, as well as relevant findings of apparative investigations, pharmacological and hemodynamic tests and neuropathological findings in autopsied cases reported in the literature. This review was initiated by two clinically investigated cases of Shy-Drager syndrome.
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PMID:[The Shy-Drager syndrome (author's transl)]. 24 13

Penile systolic pressures, penile volume waveforms, and postischemic reactive hyperemia were measured in 106 patients (38 potent and 68 impotent). With such testing the vascular laboratory can clearly identify those impotent patients in whom penile blood flow is normal and who would not benefit from direct arterial surgery. Unfortunately, abnormal results give no assurance that ischemia is responsible for a given patient's impotence and a multimodal approach is necessary to further evaluate such patients.
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PMID:Role of the vascular diagnostic laboratory in the evaluation of male impotence. 46 31

Translumbar aortographies performed in 91 patients for limiting leg ischemia were reviewed, and stenosis was graded by points from one (normal vessel) to five (complete occlusion) for each vessel. Of 62 nondiabetic patients, 18 (29 per cent) were impotent, while of 29 diabetics, 17 (58.6 per cent) were impotent (p less than 0.01). Significantly greater stenosis (p less than 0.005) was found in the internal pudendal arteries of impotent patients when compared statistically with potent patients. This was true for the group as a whole, for diabetics and nondiabetics, and for patients over 50 years old both with and without diabetes. There was no significant difference in the extent of stenosis of the iliac arteries (common and internal) between potent and impotent patients. There was also no significant difference in the pattern of stenosis between diabetic and nondiabetic patients in the group as a whole and also in the potent and impotent subgroups analyzed separately. Neither diminished femoral pulses nor aortographic evidence of external iliac and common femoral arterial stenosis correlated significantly with impotence. These observations indicate that vascular lesions are as important in diabetics as in nondiabetics in the genesis of impotence. Clinical implications regarding diagnostic investigations and treatment are discussed.
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PMID:Vascular lesions associated with impotence in diabetic and nondiabetic arterial occlusive disease. 70 Feb 61

Penile pulses were palpated and brachial, penile and popliteal pressures were measured with the Doppler technique in 29 normal subjects and in 15 impotent diabetics. The pulses were palpable in all normal subjects but not in 6 diabetics. The penile blood pressure was obtainable in all the normal subjects but not in 2 diabetics. Using the penile pulse data and a comparison of the penile with the brachial systolic pressures, 2 or possibly 3 grades of penile ischemia are definable, providing a measure of pelvic vascular insufficiency.
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PMID:Diagnostic value of the penile pulse and blood pressure: a Doppler study of impotence in diabetics. 112 5

Veno-occlusive priapism may be associated with prolonged corporeal ischemia, subsequent fibrosis of the corpora and impotence. We report on 6 patients who presented with an unusual sequela of veno-occlusive priapism, recurrent episodes of prolonged erections or priapism. In all cases the subsequent episodes were idiopathic and veno-occlusive, occurred with a frequency ranging from several times per day to once per month and were symptomatically disabling. Pharmacocavernosometry ruled out mechanical occlusion of corporeal venous drainage by demonstrating elevated flows to maintain intracavernosal pressures following smooth muscle contraction and markedly decreased flow rates following smooth muscle relaxation. Treatment of the recurrent episodes with intracavernous self-injection of phenylephrine resulted in successful detumescence. The use of oral phenylpropanolamine reduced the frequency and duration of the recurrences, and markedly reduced the need for adrenergic self-injection. It is proposed that this syndrome may develop secondary to the initial ischemic episode, resulting in a functional alteration of the adrenergic and/or endothelial-mediated mechanisms that control penile tumescence and maintain penile flaccidity.
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PMID:Recurrent prolonged erections and priapism as a sequela of priapism: pathophysiology and management. 200 96

The frequency of the iatrogenic priapism complicating the intracavernous injections of drugs for impotence has greatly improved the conceptions about priapism resulting in several novelties: a. definition: priapism may be defined as a pathological erection provoked by various anomalies of the erectile hemodynamics; a. pathogeny: at first, priapism is only the penile symptom of various diseases. Secondary and inconstantly, the priapism symptom become a priapism disease featured by an acute cavernous ischemia; c. physiopathology with two different priapisms: an unusual high flow priapism due to an acquired arteriocavernous fistula. A most usual stasis priapism due to a neuromuscular or hematological blockade of the cavernous detumescence of several origin; d. treatment: the stasis priapism alone is an genuine emergency. Puncture must be always the first treatment. If unsuccessful, the choice between pharmacological detumescence (new treatment for priapism) and surgery depends from both the physiopathological mechanisms and mainly the severity of the cavernous tissular suffering.
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PMID:[Physiopathologic aspects of priapism. Disease or symptom?]. 218 30

Appropriate preoperative vascular assessment of patients presenting with aortic aneurysms and arterial occlusive disease is essential to obtain the optimal results from aneurysm repair. The renal arteries should be evaluated in patients with hypertension or renal dysfunction, and stenosis must be addressed when seen on arteriograms. Hemodynamically significant lesions are candidates for bypass concomitant with aortic replacement. The stump pressure of a patent inferior mesenteric artery should be assessed intraoperatively, and bypass or reimplantation should be performed if colon ischemia might result from internal mesenteric artery ligation. If vasculogenic impotence is suggested by preoperative studies, meticulous nerve-sparing dissection and revascularization of the internal iliac arteries may result in recovery of erectile function in some patients. In all cases of aneurysm repair, the hypogastric circulation must be maintained through either direct revascularization or bypass to major collateral arteries. Iliac occlusive disease may be evaluated with several modalities, including physical examination, noninvasive laboratory testing, arteriography, and the papaverine test, to determine whether critical or subcritical stenoses are present. Aortic bifurcation grafts should be used to construct the distal anastomoses beyond areas of significant disease. The extent of lower-extremity occlusive disease directly affects the long-term patency of aortic replacement, and diligent follow-up is necessary for timely intervention to maintain patency of vascular reconstructions.
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PMID:Repair of abdominal aortic aneurysms in patients with renal, iliac, or distal arterial occlusive disease. 266 50

The technique described uses a composite prosthesis to combine infrarenal aortic resection with aorto-bifemoral bypass while preserving pelvic circulation. Its short-term objective is to prevent colic ischemia and its long-term objective to avoid impotence and gluteal claudication. This technique has the advantages of being simple, rapid and less aggressive than other procedures. It was applied in 6 cases over the last 2 years and was successful in all of them.
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PMID:[Composite arterial prosthesis for aortofemoral reconstruction with preservation of hypogastric flow]. 315 7

Patients with recurrent buttock claudication and/or impotence occurring after aortoiliac reconstruction, whose resting and postexercise vascular laboratory values are normal, represent an uncommon and poorly recognized problem resulting from occlusion of the bypassed iliac segments and ischemia isolated to the distribution of the hypogastric artery. This paradox and its solution are exemplified by two patients reported herein. In each instance flow was reestablished after thromboendarterectomy of the proximal hypogastric artery by connecting the artery to the functioning bypass.
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PMID:Isolated hypogastric artery revascularization after previous bypass for aortoiliac occlusive disease. 350 2

Angiographic evaluation of impotent men revealed a frequent association between penile arterial disease and veno-occlusive insufficiency of the corpora cavernosa. In order to evaluate a possible cause-and-effect relationship, we investigated the competence of the cavernosal veno-occlusive mechanism in a canine model at various intervals after onset of cavernosal ischemia. In most dogs, the veno-occlusive mechanism could no longer be activated by papaverine after about 30 minutes of ischemia. If ischemia was relieved shortly thereafter, veno-occlusive competence returned after a further delay of one or two hours. The evidence suggests that veno-occlusive failure is not simply a hemodynamic consequence of loss of arterial inflow, but instead secondary to some ischemic injury. We conclude that arterial insufficiency may be one of the causes of cavernosal veno-occlusive insufficiency in humans.
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PMID:Production of penile veno-occlusive insufficiency by arterial occlusion in a canine model. 358 74


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