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)

Twenty patients with primary cardiac tumors were operated on during the past ten years. The age of 15 female and 5 male patients ranged from 17 to 73 years. Eighteen patients had myxomas, 16 of which located in the left atrium and 2 in the right atrium. Systemic embolism occurred in 8 patients, subsequently caused cerebral infarction in 4, ischemia of extremities in 2, myocardial infarction in 1 and pulmonary infarction in 1. Emergency operation was performed in 5 patients because of severe congestive heart failure. In all cases, removal of myxoma was performed together with the excision of the wall to which the pedicle attached with the use of cardiopulmonary bypass. One patient with pulmonary infarction underwent resection of the infarcted lung simultaneously. Only one patient with severe heart failure died of pulmonary insufficiency one month after the operation. Another patient with cerebral infarction underwent clipping of cerebral aneurysm which appeared later in the infarcted area. The 17 patients including the latter patient showed a good recovery and no local recurrence during the follow-up period of 1 to 120 months. Two patients had malignant tumors, which were malignant fibrous histiocytoma of the left atrium and leiomyosarcoma of the pulmonary artery, respectively. Both of these rare tumors were resected noncuratively and led to the death because of their local recurrence with distant metastasis, though they received adjuvant chemotherapy. The symptoms, complications, diagnoses, surgical treatment and outcome of the primary cardiac tumors are reviewed in this study.
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PMID:[Surgical treatment of primary cardiac tumors]. 143 1

Much of the morbidity and mortality in sickle cell disease (SCD) is caused by tissue ischemia and infarction resulting from vascular occlusion. Research in this area has been dominated by the hypothesis that vascular occlusion in SCD is due primarily to microvascular obstruction by sickle erythrocytes (SS RBC), yet there is no direct evidence that microvascular occlusion is responsible for any of the vasocclusive complications of SCD. In this paper an alternate hypothesis is proposed: that thrombotic occlusion of larger arteries and veins is an important factor in many of the vasocclusive complications of SCD. Large-vessel cerebral arterial disease (intimal hyperplasia with superimposed thrombosis) has clearly been established as the most important cause of stroke in SCD, and considerable evidence suggests that pulmonary arterial thrombosis/embolism is a major cause of pulmonary infarction and hypertension. The involvement of large-vessel thrombosis in painful crisis, aseptic necrosis of bone, priapism, leg ulcers, retinopathy, and miscarriage has not been adequately investigated. Large-vessel occlusion in SCD is probably a consequence of the abnormal adhesive and procoagulant properties of SS RBC, which produce endothelial damage, secondary intimal proliferation, and thrombosis. Techniques currently used to treat large-vessel occlusion in other disorders (antiplatelet and anticoagulant agents, thrombolytic therapy, angioplasty, endarterectomy, and vascular bypass surgery) should be considered in sickle cell subjects with large-vessel occlusion, especially in the cerebral vasculature.
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PMID:Large-vessel occlusion in sickle cell disease: pathogenesis, clinical consequences, and therapeutic implications. 189 Sep 82

We studied the usefulness of the pulmonary capillary wedge pressure (PCWP) tracing for the detection of intraoperative myocardial ischemia. Both PCWP wave forms and 7-lead electrocardiogram were monitored in 109 patients undergoing coronary artery bypass graft surgery. Measurements were made six times in each patient. Myocardial ischemia was identified in 99 (27%) of the 366 measurements, and among them, 68 (69%) developed abnormal PCWP wave forms (AC wave greater than 15 mmHg, or V wave greater than 20 mmHg). Although these results were consistent with those of Kaplan et al (1981), we could not agree with their conclusion that PCWP tracing can be helpful in the early diagnosis of subendocardial ischemia. It was not possible to record PCWP continuously because of the risk of pulmonary infarction, and PCWP was influenced by noncardiac factors such as sympathetic reaction to surgical stimuli. We think that PCWP tracing would be of benefit in detecting intraoperative serious ischemia; serious myocardial ischemia was likely to have occurred when abnormalities in both PCWP tracing and ST segment changes were identified. The incidence of both PCWP changes and ECG ischemia was highest in the postbypass period, suggesting that the risk of serious myocardial ischemia is highest in the post-bypass period.
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PMID:[Evaluation of pulmonary capillary wedge pressure tracing for the detection of intraoperative myocardial ischemia]. 192 Jul 78

A 6-year-old girl with sickle cell disease was admitted to the hospital with the diagnosis of the acute chest syndrome. The laboratory findings and the radionuclear lung scan supported a diagnosis of pulmonary infarction rather than pneumonia. She improved with intravenous fluids, oxygen, penicillin, and theophylline. The most likely explanation for the rapid resolution of the clinical syndrome, the chest x-ray, and lung scan abnormalities is that masses of sickled cells caused transient pulmonary vascular occlusion leading to perfusion defects and ischemia, and that the sickled cell thrombi were dislodged before the infarction occurred. To our knowledge, this phenomenon has not been described as a cause of the acute chest syndrome in sickle cell disease in children.
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PMID:Acute reversible pulmonary ischemia. A cause of the acute chest syndrome in sickle cell disease. 406 60

The purpose of this case presentation is to discuss right upper quadrant pain as an atypical presenting symptom in pulmonary infarction and review the typical computed tomography (CT) imaging features of pulmonary infarction to improve diagnostic accuracy. Pulmonary infarction results from occlusion of distal arterial vasculature within the lung parenchyma leading to ischemia, hemorrhage, and ultimately necrosis. Patients with lung infarction typically present with pleuritic chest pain and may have associated signs or symptoms of pulmonary thromboembolism or deep vein thrombosis. In this case study, a 34-yr-old female devoid of any symptoms indicative of either pulmonary embolism or deep vein thrombosis presented with right upper quadrant pain 1 mo status post open reduction internal fixation for a left ankle fracture. Multiple clinic visits spanning approximately 7 d were significant for a right lower lobe opacity seen on CT of the abdomen which was presumed to represent community acquired pneumonia as a source for the patient's RUQ pain. The patient presented to the emergency department 1 wk later (6 wk following her initial surgery) complaining of left lower extremity swelling and was subsequently diagnosed with a left lower extremity DVT via ultrasound. CT of the pulmonary arteries was negative for PE but identified a right lower lobe opacity which in retrospect was consistent with pulmonary infarction.
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PMID:Pulmonary Infarction: Right Upper Quadrant Pain as a Presenting Symptom With Review of Typical Computed Tomography Imaging Features. 2988 60

Hydrophilic polymer coatings are now widely applied to catheters and other intravascular devices used in neurovascular, cardiovascular, and peripheral vascular procedures. Emboli consisting of these materials have been previously identified in biopsies and autopsies following pulmonary infarction, stroke, gangrene, or death. We report a case involving a nonhealing foot ulcer that appeared following cardiac catheterization, stenting, and automatic implanted cardiac defibrillator (AICD) implantation in a patient without other evidence of significant peripheral artery disease. An 85-year-old woman with chronic atrial fibrillation, aortic valve stenosis, and coronary artery disease underwent coronary stenting and AICD implantation for ventricular tachycardia and syncope. She developed a toe ulcer shortly thereafter, which did not respond to standard treatment. A histological examination following amputation of the toe found amorphous basophilic material in capillaries adjacent to the edge of the ulcer, which was similar to material associated with hydrophilic polymer coatings. Ischemia and infarcts following endovascular procedures should not be presumed to result from thrombus or vascular disease, even if intravascular devices appear intact or properly placed after the procedure. To help establish the incidence of ischemia caused by hydrophilic polymer device coatings, if excision of ischemic or infarcted tissue after endovascular procedures using coated devices becomes necessary, the tissue should be evaluated microscopically. Surgeons should also consider the tolerance of distal organs to infarct or ischemia when selecting coated intravascular devices.
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PMID:Ischemic Toe Ulceration Due to Foreign Body Embolus From Hydrophilic Polymer-Coated Intravascular Device. 3127 3

Lobar torsion is an extremely rare complication after elective lung surgery. Rotation of the bronchovascular pedicle results in airway obstruction and vascular compromise with lobar ischemia and pulmonary infarction. Rapid reoperation with untwisting of the pedicle is usually proposed. We report a case of an upper lobe torsion occurring at postoperative day one after a full thoracoscopic combined middle lobectomy and S6 segmentectomy. Lung detorsion resulted in a fatal cerebral infarction.
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PMID:Fatal Stroke After Reoperation for Lobar Torsion. 3186 94