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

Myocardial pH was measured continuously with a micro pH electrode inserted into the left ventricular wall in dogs. Anterior descending coronary flow was reduced to about 1/3 of the original flow by partial occlusion of the coronary artery. Myocardial pH decreased from 7.50--7.60 to 7.06--7.24 after partial occlusion. Drugs were injected intravenously during ischemia of the heart caused by partial occlusion. l-Propranolol (1 mg/kg) reduced heart rate and increased the pH from 7.06 +/- 0.04 to 7.48 +/- 0.04 (P less than 0.01). d-Propranolol (1 mg/kg) reduced heart non-significantly and increased the pH from 7.24 +/- 0.05 TO 7.56 +/- 0.05 significantly (P less than 0.05). In other studies, the effect of l- and d-propranolol on both heart rate and metabolic responses to isoproterenol (500 micrograms/kg i.p.) was studied. Isoproterenol increased heart rate and also elevated the blood levels of glucose and lactate. l-Propranolol inhibited these responses to isoproterenol. d-Propranolol did not inhibit the heart rate response but inhibited the blood lactate response to isoproterenol significantly. The blood glucose response to isoproterenol was inhibited by d-propranolol non-significantly. The action of both l- and d-propranolol on ischemic myocardial pH may be related to their action on cardiac metabolism as well as to their local anesthetic action.
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PMID:Increase of myocardial pH by 1- and d-propranolol during ischemia of the heart in dogs. 624 50

To assess various factors associated with anterior S-T segment depression during acute inferior myocardial infarction, 47 consecutive patients with electrocardiographic evidence of a first transmural inferior infarction were studied prospectively with radionuclide ventriculography an average of 7.3 hours (range 2.9 to 15.3) after the onset of symptoms. Thirty-nine patients (Group I) had anterior S-T depression in the initial electrocardiogram and 8 (Group II) did not have such "reciprocal" changes. There was no difference between the two groups in left ventricular end-diastolic or end-diastolic volume index or left ventricular ejection fraction. Stroke volume index was greater in Group I than in Group II. There were no group differences in left ventricular total or regional wall motion scores. A weak correlation existed between the quantities (mV) or inferior S-T segment elevation and reciprocal S-T depression. No relation between anterior S-T segment depression and the left ventricular end-diastolic volume index could be demonstrated; the extent of left ventricular apical and right ventricular wall motion abnormalities, both frequently associated with inferior infarction, did not correlate with the quantity of anterior S-T depression. These data show that anterior S-T segment depression occurs commonly during the early evolution of transmural inferior infarction, is not generally a marker of functionally significant anterior ischemia and cannot be used to predict left ventricular function in individual patients. Anterior S-T segment depression may be determined by reciprocal mechanisms.
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PMID:Clinical implications of anterior S-T segment depression in patients with acute inferior myocardial infarction. 628 33

Anterior segment ischemia (ASI) is a potentially blinding complication of extensive eye muscle surgery. Eyes have been described with this complication following surgery on as few as two rectus muscles, especially in patients with thyroid dysfunction or other medical illnesses. In an attempt to assess the risk of ASI, we have reviewed the records of 34 eyes in 26 patients who underwent surgery on three or four rectus muscles. Seven eyes of six patients with thyroid ophthalmopathy which underwent two-or three-muscle surgery were also studied. Evidence of clinically significant ASI was apparent in only one patient during a follow-up period of seven months to eleven years. This case was mild and no visual loss resulted. Our findings suggest that surgery on three or four rectus muscles in healthy patients is probably safe when performed in a staged fashion.
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PMID:Anterior segment ischemia following strabismus surgery. 650 7

Anterior ST segment depression, found in 13 of 17 patients with acute inferior myocardial infarctions, resolved promptly in all 11 patients whose occluded right coronary arteries were opened with an infusion of streptokinase. Failure of streptokinase to open the artery produced no change in the electrocardiogram. Five of the patients with anterior ST segment depression had normal left anterior descending coronary arteries. In the other patients opening the right coronary artery normalized the anterior ST segments without resulting in collateral flow to the anterior wall, or changing blood pressure or heart rate. Anterior ST depression was a manifestation of the inferior infarction and was not due to anterior ischemia.
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PMID:Mechanism of anterior ST segment depression during acute inferior myocardial infarction. Observations during coronary thrombolysis. 669 65

We evaluated the recently proposed concern that ECG anterior ST segment depression in patients with acute inferior wall myocardial infarction represents an additional area of ischemia and therefore implies worsened prognosis. We studied patients enrolled in the Aspirin Myocardial Infarction Study (AMIS), ages 30 to 69 years, who sustained an inferior myocardial infarction within 6 months from the start of the study. Two hundred nineteen patients who met those criteria were followed for an average of 38.2 months. One hundred ten patients had significant anterior lead ST depression (greater than or equal to 0.1 mV) during their acute inferior infarction and their 3-year mortality rate was 9.1%. One hundred nine patients had no anterior ST abnormality and a mortality rate of 10.1% (p = ns). Only one patient with significant depression had a subsequent anterior wall myocardial infarction. Anterior ST depression correlated closely with the magnitude of inferior ST segment elevation. Since ST depression does not alter long-term mortality but relates to magnitude of ST elevation, it probably represents a reciprocal change.
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PMID:Anterior ST segment depression during acute inferior myocardial infarction: evidence for the reciprocal change theory. 688 Oct 25

A 74-year-old woman with secondary glaucoma underwent cyclocryotherapy. Ten weeks later anterior segment necrosis and dehiscence in the area of the cryotherapy lesions resulted in an expulsive choroidal hemorrhage. Anterior segment ischemia following cyclocryotherapy has previously been described, but this is the first reported case of anterior segment necrosis as a complication of this procedure.
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PMID:Anterior segment necrosis following cyclocryotherapy. 716 42

Six consecutive patients with early Fuchs' heterochromic cyclitis (FHC) were examined with anterior segment 10% fluorescein sodium angiography. Anterior segment perfusion defects and iris vasculature leakage were seen in all patients. Chronic anterior segment ischemia may be an integral feature of FHC, which predisposes these eyes to rubeosis and, in some cases, to neovascular glaucoma.
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PMID:Anterior segment ischemia in Fuchs' heterochromic cyclitis. 718 15

Transcranial color-coded sonography (TCCS) was used to assess primary willisian collaterals in 100 patients with extracranial internal carotid artery (ICA) stenosis. Their importance was determined during carotid endarterectomy (CEA) by transcranial Doppler measurement of blood flow velocity in the ipsilateral middle cerebral artery (MCAV) before and after carotid clamping. All patients had unilateral ICA disease of at least 60% stenosis. Twenty-nine ICAs (14.5%) were occluded, 70 vessels (35%) were stenosed by 80 to 99%, 43 vessels (21.5%) were stenosed by 60 to 79%, and 53 ICAs had stenosis of less than 60%. Temporal hyperostosis precluded TCCS in 15 patients (15%). Anterior cerebral/communicating artery collaterals were detected in 40 patients (49%) and posterior cerebral/communicating artery collaterals were detected in 22 patients (27%). No patients with ICA stenosis of less than 80% had established collateral pathways. Patients with willisian collaterals showed higher postclamp MCAVs as a proportion of the preclamp value during CEA (72% [62-81]; median with 95% confidence interval) than did those without primary collaterals (46% [34-58], p = 0.02). TCCS allows noninvasive assessment of intracranial primary collaterals whose functional importance is recognized during abrupt hemodynamic challenge. It may determine which patients are at greatest risk of ischemia during cerebral revascularization.
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PMID:Assessment of intracranial primary collaterals using transcranial color-coded real-time sonography. 757 60

Surgery on the extraocular muscles of the eye is generally consisted a safe procedure which is associated with low morbidity and mortality. While infrequent, intra-operative complications occasionally occur. Tenotomy of multiple rectus muscles can result in interruption of the vascular supply to the anterior segment of the eye. Anterior segment ischemia (ASI) may result. This article reviews the complication of anterior segment ischemia as a result of strabismus surgery and its potential for producing permanent visual loss.
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PMID:Anterior segment ischemia after strabismus surgery. 800 29

Anterior migration of an encircling element through a rectus muscle is an unusual complication of scleral buckling surgery. We describe two patients with migration of a solid silicone encircling element through the insertions of all four rectus muscles after retinal detachment surgery. Buckle migration was associated with elevated intraocular pressure and glaucomatous optic atrophy. Rectus muscle function was preserved in both patients. Despite transsection of the anterior ciliary blood supply, anterior segment ischemia did not develop.
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PMID:Migration of solid silicone encircling element through four rectus muscles. 823 34


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