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)

A randomized, single-blind trial of repeated intravenous infusion of Brinase was carried out in 70 petients with severe chronic limb ischemia, who were candidates for lumbar sympathectomy or amputation. The enzyme caused s significant increase in calf and ankle pressure index. At six months follow-up, the clinical results were statistically significant in favour of Brinase when all patients were considered, but not if 10 patients with Buerger's disease were omitted from the analysis. Patients treated with a combination of Brinase and coumarins had a better clinical outcome than patients receiving either treatment on its own.
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PMID:Clinical trial of brinase and anticoagulants as a method of treatment for advanced limb ischemia. 38 20

From January 1985 through January 1990, 244 patients (168 males, 76 females, mean age: 69 +/- 14 years) received epidural spinal cord stimulation for the treatment of advanced, nonreconstructable, peripheral vascular disease of the lower limbs due to atherosclerosis in 180 patients, atherosclerosis and/or diabetes in 49, and thromboangiitis obliterans in 15 patients: previous surgery included 101 bypass-grafts in 70 patients, 51% of which below the knee, and 117 sympathectomies in 113 patients as the last resource in face of distal peripheral vascular disease of the lower limbs. Mean ankle-to brachial systolic pressure ratio was .31 +/- .34 on symptomatic limbs; due to pain and advanced disease, walking capacity was assessed in only 151 patients, either on treadmill in 25, or in a metered corridor in 126; angiogram of the lower limbs was performed in every patient unless one not older than three months was readily available; pain at rest was assessed after an analogical scale; partial transcutaneous oxygen tension was measured on the dorsum of the fore-foot of 77 symptomatic limbs (mean: 13.35 +/- 14 mmHg). According to clinical and functional evaluation, 18 patients had exertional ischemia (group I), 87 had permanent ischemia with pain at rest and no tissue loss (group II), and 139 had chronic tissue loss (group III), including 93 ischemic ulcers (mean surface: 3.7 cm2, mean duration: 3.5 months) in 88 patients, 27 limited gangrene, and 24 previous limited non-healing distal amputation. After temporary spinal cord stimulation at T12-L1 level (mean duration: 9 +/- 4 days) with a percutaneous quadripolar electrode lead had allowed for selection of responders, 212 patients received an implantable neurostimulator.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Electric stimulation of the spinal cord in arterial diseases of the legs. A multicenter study of 244 patients]. 143 7

The most characteristic pathophysiologic change in Buerger's disease or thromboangiitis obliterans (TAO) is considered the breakdown of microcirculation in the extremity, but this has not yet been proven. The purpose of this study is to examine the damage of microcirculation in TAO objectively, by means of intra-arterial injection of two kinds of radioisotope. In 7 TAO and 4 infrainguinal arteriosclerosis obliterans (ASO) patients, thallium 201 chloride (201Tl) and 99mTc macroaggregated human serum albumin (99mTc-MAA) were administered through bilateral common femoral artery injections. In the planar image of the foot, rectangular regions of interest (ROIs) were placed on the foot muscles and toes. Normalized counts of 99mTc-MAA in each ROI were divided by that of 201Tl, and the result was defined as the microcirculation damage index, based on their different kinetics. The damage index of the foot muscle was not different between ASO and TAO, but that of the toe was lower in TAO than ASO patients. Lumbar sympathectomy was performed in 5 TAO patients, but it did not improve the damage index. It is concluded that there is breakdown of the microvascular defense system from the beginning of the disease, and critical ischemia make the regional cell function deteriorate as if a precursor to a trophic lesion. Lumbar sympathectomy did not immediately improve microcirculation.
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PMID:Microcirculatory characteristics in patients with Buerger's disease. 155 16

Thromboangitis obliterans, or Buerger's disease, is a progressive vascular disorder that affects the distal extremities of young, otherwise healthy patients. The authors present two case histories of Buerger's disease with spontaneous digital ischemia and gangrene, leading ultimately to digital amputation. A review of the literature is also presented. The natural history of Buerger's disease, current diagnostic techniques, and management of these patients are discussed with emphasis on prevention of the acute attack and long-term sequelae.
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PMID:Distal ischemia with digital gangrene secondary to Buerger's disease. 177 Feb 4

The authors describe their experience with two patients who presented with clinical extremes of popliteal entrapment syndrome. One patient presented with acute ischemia and the second patient presented with a chronic Buergerian-like syndrome. The common denominator for both of them was embolic phenomena originating at the site of entrapment. Discussion is centered on pathogenesis of the embolic phenomenon, prevalence of distal arterial degradation and its clinical manifestation. The clue for differentiation from true Buerger disease is the angiographic pattern demonstrating apparently healthy distal arterial segments, confirmed by mandatory arterial biopsy. It is emphasized that in cases having acute embolic presentation the primary pathology should be treated concomitantly to revascularization.
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PMID:The embolic type of popliteal entrapment syndrome. 234 59

A patient with severe hand ischemia due to Buerger's disease was treated by a rapidly effective modification of percutaneous catheterization. Accelerated mechanical and pharmacologic thrombolysis of an occluded palmar arch with 200,000 U urokinase and subsequent small vessel angioplasty abolished pain and restored digital perfusion within 40 min.
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PMID:Accelerated thrombolysis and angioplasty for hand ischemia in Buerger's disease. 252 19

Thromboangiitis obliterans (TAO; or Buerger's disease) is a nonarteriosclerotic, segmental, occlusive inflammatory disease of medium-sized and small arteries and veins of unknown cause, occurring predominantly in young male habitual tobacco users. Less than 2% of the patients with TAO are women or elderly persons. TAO is a treatable disease when diagnosed early and if strict abstinence from tobacco is observed. Otherwise progression and exacerbation of limb ischemia may lead to multiple and repeated amputations, and rarely visceral or cerebral ischemia. Over a 40-year period, 1947 to 1986, the prevalence rate of the diagnosis of TAO has declined steadily from 104/100,000 in 1947 to 13/100,000 in 1986 (an 8-fold decrease) where clinical and pathologic criteria for the diagnosis of TAO have remained unchanged. A similar pattern of decline was observed in two other major medical centers. Twelve women and 97 men with TAO were identified in the 5-year period 1981-1985. The 11% (12 of 109) incidence of female TAO was 10-fold that was previously reported. All 12 women were heavy smokers; 8 (67%) had thrombophlebitis and 6 (50%) had upper limb ischemia. Nine (75%) of 12 women required amputations; delay in diagnosis contributed to additional amputations in 2 patients. The increased prevalence of TAO in women may be attributed to the smoking habit in young women overall, which has increased significantly rather than decreased (as in males) since 1965.
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PMID:The rise and fall and resurgence of thromboangiitis obliterans (Buerger's disease). 266 3

We are presenting the results of a multicenter retrospective study including 203 patients with arterial disease of the lower extremities, treated with epidural stimulation. The indications were: stage III or IV ischemia of the Leriche-Fontaine classification, arteriosclerosis or diabetic arteriopathy and untractable pain, or presence of necrosis as in Buerger's disease, Raynaud's phenomenon, frost-bite, Sudeck's disease and ergotamin poisoning. 47 p. cent of the patients had undergone a sympathectomy. The evolution was excellent in 47 p. cent of arteriosclerosis and/or diabetes cases, 100 p. cent of cases of Buerger's disease, 78 p. cent of cases of Raynaud's disease, and good in 33 p. cent of patients with arteriosclerosis and 12 p. cent of cases of Raynaud's disease. The plethysmography curves were improved and there was a statistically significant increase of the transcutaneous PO2 as well as of the isotopic results of muscular and cutaneous perfusion with 201TL and 125I antipyrin. These results demonstrate the capabilities of epidural stimulation in the treatment of arterial diseases of the extremities.
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PMID:[Epidural stimulation in arteritic patients]. 268 35

The arteriograms of sixty-two patients with chronic ischemia of the hand and fingers were reviewed. Twelve patients were considered to have Raynaud's disease. Thoracic outlet syndrome caused ischemic symptoms in thirteen patients. Arteriosclerosis obliterans affected twenty-two patients. The signs of arteriosclerosis are described including irregular constrictions, multiple occlusions and the corkscrew pattern of the collateral arteries. The differential diagnosis includes thromboangiitis obliterans and collagen vasculitis.
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PMID:[Arteriographic data in chronic ischemia of the hand. Study of 62 cases]. 286 65

A 26-year-old male shortly after an acute respiratory disease was affected by a thrombophlebitis of the left leg. After a few days he had two syncopal attacks. Later on, a myocardial ischemia was diagnosed. Subsequently the patient began to complain of a bilateral claudication of the calves; after an attack of fever, the ischemia of the lower limbs worsened with recurring pain at rest. At the same time, in absence of any symptom, a myocardial ischemia occurred again and the presence of a thrombus was observed in the right atrium. After surgical removal of it, the ischemic troubles of the lower limbs once again began to worsen with the occurrence of bilateral gangrene of the feet. An amputation of both the legs was promptly performed at the level of the thighs. The histological examination of the arteries of the amputated legs showed segmental arteritis with partially recanalized thrombi of the popliteal, left femoral and tibioperoneal arteries. In the meantime, the titres for Coxsackie virus B2 and B6 were found slightly increased. One month later, the left radial pulse disappeared for a few days. The histopathological findings may relate this arteritis to a form of Buerger's disease even if a systemic thromboangiitis obliterans is not commonly accepted. In case that the acute respiratory infection represented the true onset of the sickness, it seems conceivable that the hypothesis of a viral infection gave raise to arteritis with morphological features recalling those of Buerger's disease.
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PMID:An uncommon systemic arteritis--a case report. 286 78


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