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Query: UMLS:C0022116 (ischemia)
 91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

On the basis of arteriographs in 98 patients with chronic arterial ischemia of lower limbs, degree of osteoporosis was determined in symmetrical femoral and tibial bones using cortical index and statistical calculations. The study demonstrates similar level of mineralization of the examined bones in limbs with similar degree of ischemia. In patients with more pronounced unilateral osteoporotic changes more severe obliterations of the arteries was observed in the respective limb as compared with the opposite limb. The observed differences in cortical index values are statistically significant. Moreover chronic ischemia diminishes the correlation between cortical index and age. The study indicates, that chronic bone ischemia could play a role in the pathomechanism of local osteoporosis.
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PMID:[Studies of the effect of ischemia of the legs on the degree of osteoporosis of the femur and tibia using the cortex-shaft index]. 277 40

The incidence of aseptic necrosis of femoral head in homozygous beta-thalassaemia (Cooley's anaemia)--which is indeed significantly high--is not satisfactorily referred in late literature regarding haemolytic syndromes. Therefore, 4 cases of osteonecrosis of femoral head, recently recognized in a series of 280 patients affected by Cooley's anaemia (14.5 0/00) are presented, and a review of hypotheses about the pathogenesis of the lesions is considered. In Cooley's anaemia, the skeletal lesion (osteoporosis) must be believed as a propitious state, in which some other pathogenetic events (i.e. local ischemia, bony age, etc.) and microtraumas overlap. In any case, characteristic blood circulation of the femoral head is the "conditio sine qua non" in developing osteonecrosis.
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PMID:[Aseptic necrosis of the head of the femur in Cooley's disease]. 370 10

Surgical treatment of varicose veins occasionally can be followed by severe limb ischemia either after surgery or sclerotherapy. We report here two cases with the clinical features and the therapeutic strategy. The first case concerned a woman operated by venous stripping. A post-operative acute ischemia occurred and was treated by femoro-femoral bypass and lumbar sympathectomy. However this procedure did not avoid persistent chronic ischemia, sciatica paralysis and equinus ankle blockage. A secondary arterial procedure associated with intensive physiotherapy and ankle arthrodesis led to a poor functional result, partly because of an irreversible algodystrophia. The second case concerned a woman treated by sclerotherapy. An injection of the drug in the retro-malleolar area was immediately followed by an acute foot ischemia. Heparin, xylocaine and sodium nitroprusside perfusion avoided a foot amputation, however osteoporosis and algodystrophia occurred. A sympathectomy was necessary two years later. These dramatic complications although unusual, may occur even with experienced physicians. Therefore a great attention is always necessary during these simple procedures. In case of acute ischemia, early diagnosis and aggressive treatment are necessary, but prevention remains more secure.
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PMID:[Arterial complications following surgery or sclerotherapy of varices]. 394 17

A histological classification of resorbed bone is reported in this paper. The materials used were 426 human bones in autopsy and surgical cases, ranging from 3-month-od fetus to 95-year-old. The resorbed bones were divided into osteoclasis (osteoclastic resorption) and osteolysis (non-osteoclastic resorption). Osteoclasis was observed in the cases of development, growth, active stage of granulation tissue, and inflammation, and some cases of malignant tumor invasion. Osteolysis was observed in the cases of senile atrophy, osteoporosis, ischemia, radiation damage, hormonal and chemical effects, non-active stage of granulation tissue and inflammation, and some cases of malignant tumor invasion. Based on these findings, human resorbed bones can be classified into three histological types: rapid, slow, and static. Such a classification could be certified through the results of animal experiments. A possibility exists that osteoclasis occurs in rapid resorption and osteolysis is in slow and static resorption. Furthermore, it is suggested that osteoclasis is passive resorption and osteolysis is autolysis.
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PMID:Histological classification of resorbed bone. 713 93

Bearing in mind earlier studies which established a link between arteriosclerosis and mineral loss, or fragility of the bones, and also our recent study showing that patients with arterial disorders of the lower limbs also suffered from osteoporosis, we carried out a histological study of the number and appearance of the intraosseous vessels and trabecular bone volume in the femoral heads of patients undergoing surgery for either fracture of the femoral neck or osteoarthritis of the hip. The number of thick-walled vessels, arterioles or arterial capillaries was significantly diminished in the femoral heads of patients with fractures of the femoral neck (p = 0.007). In addition, in the latter patients, arteriosclerotic vascular lesions (rupture of the internal elastic lamina, medial thickening and fibrosis) were more frequent than in patients with osteoarthritis of hip. The possibility that, through chronic ischemia, arteriosclerosis may lead to disturbance of bone remodelling and loss of the mechanical properties of bone has not been contradicted by these findings.
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PMID:Study of the intraosseous vessels of the femoral head in patients with fractures of the femoral neck or osteoarthritis of the hip. 749 58

This study was aimed at assessing the MR patterns of transient osteoporosis of the hip and, consequently, the role of MRI in the diagnosis and follow-up of this condition. Even though this condition was originally observed in pregnant women, young or middle-aged men are most frequently affected. There is a spontaneous onset of pain, usually progressing over several weeks. The patients have no risk factors for osteonecrosis; they may have a history of minor trauma and there is a possible relationship to the third trimester of pregnancy. Laboratory values are negative. Pain may be severe enough to cause the patient to limp and to impair joint function. The possible causes of transient osteoporosis have been debated by many authors and include trauma, synovitis, neurovascular dysfunction and transient or reversible ischemia. Transient osteoporosis is a self-limiting disease which does not require surgical treatment. The differential diagnosis of transient osteoporosis of the hip is very important because this condition may simulate cancer, septic arthritis, osteomyelitis or avascular necrosis. We report the initial and follow-up features of transient osteoporosis of the hip on the MR images of 6 patients (M/F = 5/1; age: 37-49 years, mean: 41.8 years). The right side was involved in 3 patients, the left side in 2 patients. The patient with bilateral transient osteoporosis was a woman in the 3rd trimester of pregnancy. In all patients, MRI was performed with an 0.5 T MR unit. The MR changes in our 6 patients were rather uniform and included heterogeneous decrease in the signal intensity of the affected bone marrow on T1-weighted images and increased signal intensity on T2-weighted and STIR images, with no evidence of focal lesions. This pattern is known as the "bone marrow edema" (BME) pattern. All the patients received conservative treatment. The clinical symptoms and the MR abnormalities regressed completely within 6-10 months, with no late sequelae. To conclude, this follow-up MR study demonstrates the transient, reversible character of transient osteoporosis of the hip. Until the natural history of the BME pattern is better understood, we suggest a conservative management of this condition, especially in the patients with no risk factors for osteonecrosis. Radiographic and MR follow-up is recommended.
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PMID:[Transient osteoporosis of the hip in magnetic resonance imaging]. 750 20

A thrombotic etiology has been suggested as the cause of idiopathic avascular necrosis of the hip, although the underlying pathophysiological mechanisms are unknown. Transient osteoporosis of the hip has also been suggested to represent bone marrow edema that may be related to ischemia. We evaluated four patients with idiopathic avascular necrosis and one patient with transient osteoporosis of the hip for thrombotic potential placing a special emphasis on the fibrinolytic system. All five patients had identifiable abnormalities of fibrinolysis. Four patients had elevated levels of plasminogen activator inhibitor (PAI-1) and one patient had an inadequate increase in tissue plasminogen activator (tPA) post venous occlusion. Serum triglycerides were increased in three of the patients. These findings suggest an association between decreased fibrinolytic potential and the subsequent development of avascular necrosis and transient osteoporosis of the hip. These patients should have an evaluation of the fibrinolytic system with tPA and PAI-1 levels as well as a lipid profile.
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PMID:Decreased fibrinolytic potential in patients with idiopathic avascular necrosis and transient osteoporosis of the hip. 823 94

E.Z. former world champion and holder of several gold and silver medals from Olympic Games as long-distance runner, underwent at the age of 71 comprehensive investigations. In 1993 following methods were used to establish E.Z. body build and health: Family, personal and sports history, anthropometry, somatotype, body composition posture values, sports medicine examination, ECG at rest, X-rays of the lung and heart, echocardiography at rest, systolic time intervals at rest, spirography at rest, hematology, biochemistry, X-rays of bones, exercise ECG changes and spiroergometry. Today, a typical feature of E.Z.'s bodybuild is a great amount of body fats, flabby musculature, faulty posture, restricted mobility of the spinal column and surprisingly good foot arches. The clinical findings are appropriate for his age, on his ECG at rest are signs of subendocardial ischemia above the left ventricle, atrial fibrillation and ventricular extrasystoles (Lown 1 a-b). Exercise ECG resulted in a deepening of the ischaemic changes already at a working load of 50 W. Hematology revealed normochromic macrocyt anaemia, biochemistry a borderline mineralogram, hyperuricaemia, higher S-GMT and HDL-C, T-C at the limit of normal values. X-rays of the bones were remarkable in two findings of that age. The pelvis, lumbar spine and knee joints were free of the usual pathological findings (osteoarthrosis), but presented with an exceptionally advanced osteoporosis.
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PMID:Medical and anthropological study of a world and Olympic champion, long-distance runner, 35 years after the end his racing career. 864 15

A certain number of elements suggest a link between arteriosclerosis and osteoporosis. Generally, osteoporosis in women is considered to result from altered secretion of sexual hormones after menopause and in elderly subjects from hyperparathyroidism secondary to calcium and vitamin D deficiency. As for the heart, the brain, the kidney or muscle, bone tissue could also be altered by vascular aging and arteriosclerosis. Large epidemiological studies have demonstrated a relationship between bone mineral density, measured by monophotonic absorptiometry and mortality due to cerebral vascular events. Several hypotheses have been proposed to explain this relationship including lower endogenous estrogen levels and arteriosclerosis of the renal vessels favoring perturbed vitamin D metabolism. Arteriosclerosis could also have a direct effect on bone tissue via an ischemic mechanism. The pathophysiolojical mechanisms are not fully understood, but could involve hormone and cytokine-dependent bone remodeling and the complementary actions of bone tissue and the hematopoietic bone marrow functioning as an unit. Further epidemiological studies would be useful to confirm the relationship between arteriosclerosis and osteoporosis. The efficacy of vasodilator drugs on osteoporosis could be tested and histology and immunochemical studies could help in our understanding of the effect of ischemia on bone metabolism.
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PMID:[Arteriosclerosis and osteoporosis]. 874 17

We describe two patients with clinical, radiological and laboratory findings consistent with transient regional osteoporosis. In both cases antinuclear and antiphospholipid antibodies were found with no evidence of any other autoimmune disease. Both patients were smokers. We suggest transient ischemia caused by antiphospholipid antibodies as a possible etiological factor in this rare and poorly understood syndrome, and hypothesize that anticoagulants and abstinence from smoking may play a role in the prevention of recurrence in these patients.
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PMID:Transient regional osteoporosis with antiphospholipid antibodies: a report of two cases. 897 67


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