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

The author presents two cases of serious trauma of the extremities complicated with lesions of the arteries. Both cases were treated in the cardiovascular surgery clinic in Ljublgana. In the first case besides on osteosynthesis of a fractured femur, a termoterminal anastomosis was performed on the totally severed Superficial Femoral Artery. In spite of the the Thrombectomin that was later performed on the Posterior Tibial Artery, gangrene of the foot set in, and exitus lethalis, due to a cerebral process. In the second case, besides a fractured femur, the patient had an arterial stupor of the popliteal Artery with periarterial hematomas. A revision of the Popliteal Artery was made. The ruptured Femoral Vein was ligated. Despite surgical intervention, gangrene of the foot set in, and a below the leg amputation was carried out. Due to renal insufficiency, this patient had to undergo peritoneal dialysis. The common denominator of both cases was acute ischemia of the distal portions of the lower extremities, and pathological processes throughout the eitire organism and, above all, of the renal function. In the general theapy of such cases, the author insists on adequate; revascularization, and concrrent regulation of hypovolemia, measures in preventing acidosis, and concern for late diuresis.
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PMID:[Revascularization syndrome]. 94 15

1. Posterior body reference thermograms indicate that in general a similar thermal body pattern of humans does exist. 2. The buttocks, hips, and thighs of a nude subject are thermally cool regions, possibly indicating poor vascular circulation and/or large fat concentrations. 3. Thermograms of the same anatomical area on the same subject under controlled environmental conditions are thermally similar. 4. The scapular region is from 1 to 2 deg F hotter than the sacral region for subjects reclining on Mylar. 5. The 1 deg temperature differential thermograms and the reference thermogram while the subject is on Mylar, in many ways, denote the geometrical shape of the underlying bone structure, especially the bones of the scapulae and sacrum. 6. On the degree temperatue differential thermograms, the anatomical regions most accused of being decubitus ulcer prone are the regions of highest temperatures: the scapulae, sacrum, elbows, and calves. 7. During reactive hyperemia, the visible red flare over the sacrum and coccyx becomes very intense in the first few minutes and then gradually diminishes. The thermal flare persists longer than the visible flare. The extended duration of the thermal flare over the visible red flare is attributed to a continued local elevated metabolic tissue rate caused by the previous engorgement of blood. 8. The thermal mottling seen in the first minute after releasing the load is believed to have been caused by the rapid infusion of blood and the dilation of affected vessels responsible for making up the blood flow debt which occurred during the period of ischemia. 9. A posterior body heating effect noticed immediately after the subject left the Mylar film has been attributed to the insulative qualities of the film. The cooling effect is more difficult to explain, but it is thought that the higher than average room temperature caused an increased evaporative cooling rate response of the two subjects either before getting off the film or immediately after getting off and therefore reduced the temperature of the skin. 10. The maximum reactive hyperemic temperature difference, the difference between the initial standing reference thermogram and the maximum flare temperature observed during tissue hyperemia, may be as high as 12 deg F. 11. Males on the average have larger flare patterns than females, 5.7 in.2 and 4.7 in.2, respectively. The flare areas were computed from thermograms taken 2 to 3 minutes after off-loading of tissue. 12. With the average distance from the buttock's fold to the highest and lowest thermal flare indication being lower for females (3.2 and 5.9) than for males (3.8 and 6.4), a relationship between the site or decubitus ulcer formation and the pelvic bone structure of the sexes may well exist. 13. No two thermal flare patterns are similar either in size or in shape. Thermal flare patterns occur along the centerline of the body at the sacrum and coccyx level. 14...
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PMID:Thermographical investigation of decubitus ulcers. 122 84

It is unclear whether the protective effects of calcium antagonists on reperfused myocardium are secondary to increased blood flow during ischemia (anti-ischemic action) or reperfusion (Gregg phenomenon), or are mediated through altered calcium kinetics in ischemic or reperfused myocardium. To study the effect of the calcium antagonist nisoldipine on the functional recovery of stunned myocardium, 32 enflurane-anesthetized dogs were subjected to 15 min of occlusion of the left circumflex coronary artery and subsequent 4 h of reperfusion. Eight dogs served as placebo controls (group I), and eight dogs received nisoldipine (5 micrograms/kg i.v.) before occlusion (group II), eight dogs at 10 min of occlusion (group III), and eight dogs at 4 min of reperfusion (group IV). The mean aortic pressure was kept constant with an intra-aortic balloon, and the heart rate did not change. In group I, posterior systolic wall thickening (WT, sonomicrometry) decreased from 18.3 +/- 2.4% (mean +/- SD) during control conditions to -3.0 +/- 2.0% at 13 min of occlusion. At 10 min of reperfusion, WT was 1.7 +/- 3.9% and did not recover further (-1.2 +/- 3.7% at 4 h of reperfusion). Posterior transmural blood flow (BF, colored microspheres) decreased from 1.42 +/- 0.43 ml/min/g during control conditions to 0.26 +/- 0.08 ml/min/g at 13 min of occlusion. BF was 2.07 +/- 0.93 ml/min/g at 10 min and 0.95 +/- 0.31 ml/min/g at 4 h of reperfusion. In groups III and IV, the WT and BF were not different from those in group I throughout the experimental protocol. In group II, however, the WT, although similar to the WT of group I before and during ischemia, recovered from 2.7 +/- 4.3% at 10 min to 11.8 +/- 6.0% at 4 h of reperfusion (p less than 0.05 vs. groups I, III, and IV). The BF in group II decreased from 2.52 +/- 0.66 ml/min/g after administration of nisoldipine to 0.22 +/- 0.14 ml/min g at 13 min of occlusion. The BF was 1.31 +/- 0.51 ml/min/g at 10 min and 1.33 +/- 0.43 ml/min/g at 4 h of reperfusion. Nisoldipine exerts no beneficial effect when given immediately before or after the onset of reperfusion. The improved functional recovery of reperfused myocardium in dogs pretreated with nisoldipine cannot be attributed to an increased regional myocardial blood flow during ischemia or reperfusion. The better myocardial recovery, therefore, appears to be related to an attenuated myocardial calcium overload during the first few minutes of ischemia.
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PMID:The calcium antagonist nisoldipine improves the functional recovery of reperfused myocardium only when given before ischemia. 138 32

A case of a patient, with acute arterial ischemia at the upper limb is reported. On this case, ischemia was caused by humeral arterial embolism. The embolic origin was focused on the proximal end of a thrombosed axillofemoral bypass. After a rude manipulation during surgical procedure, part of the thrombus, following the sanguineous current, occluded the humeral artery. Patient underwent an emergent surgery. Posterior course was good. Histology showed a re-epithelialized, ancient thrombus. Cardiologic studies and angiography showed no others embolic focuses.
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PMID:[Embolism of the humeral artery originating in a thrombosed axillo-femoral bypass]. 163 26

Dissecting aneurysms of the intracranial arteries display vascular pathological features that appear sporadically, generally affecting young adults. The clinical features of this condition may involve both ischemic episodes and hemorrhages. Posterior circulation is affected less than the rest of the intracranial arteries, and it is extremely rare to find the posterior cerebral arteries only affected. Mortality is high in patients where the lesion is located in the posterior intracranial circulation, although dissecting aneurysms limited to the posterior cerebral arteries may, to a certain extent, be benign. We report the case of a young woman with ischemia in the territory of the posterior cerebral artery that occurred subsequent to a dissecting aneurysm that resolved spontaneously to a complete remission, both clinically and as demonstrated by angiography. A review of the literature is made, analyzing the pathogenic, clinical, angiographic, and therapeutic characteristics of such lesions.
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PMID:Dissecting aneurysm of the posterior cerebral artery: spontaneous resolution. 188 73

Fourteen mongrel dogs were anesthetized and instrumented to measure arterial pressure (AP), left ventricular pressure (LVP), aortic blood flow, and heart rate (HR). Hydraulic occluders were placed around the left anterior descending (LAD, n = 9) and left circumflex (LCC, n = 14) coronary arteries. A bilateral carotid occlusion (BCO) was made before and during either anterior (LAD occlusion) or posterior (LCC occlusion) ischemia. Posterior ischemia significantly (P less than 0.01) reduced the BCO-induced increases in mean AP (by 44.3 +/- 7.3%), systolic LVP (by 65.5 +/- 6.9%), first derivative of LVP (dLVP/dt, by 95.7 +/- 44.3%), and aortic resistance (by 117.7 +/- 26.9%). In contrast, anterior ischemia failed to alter significantly the hemodynamic response to BCO. Bilateral vagotomy attenuated or eliminated many of the effects of posterior ischemia on the BCO response. In fact, the change in aortic resistance was no longer affected by the ischemia and increased to the same extent, as noted during the control BCO. However, mean AP (38.7 +/- 6.8%), systolic LVP (40.3 +/- 8.7%), and dLVP/dt (62.4 +/- 11.0%) remained significantly reduced when compared with the control (no coronary occlusion) response. These data suggest that 1) posterior ischemia elicits a greater reduction in the BCO response than anterior ischemia, and 2) vagal afferents as well as depression of contractile function may both contribute to the BCO response inhibition noted during posterior ischemia.
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PMID:Effect of myocardial ischemia on hemodynamic response to carotid occlusion. 292 33

Experimental studies of embolic cerebral ischemia using the rat are limited by variability in the location, size, and frequency of lesions produced. A technique is described herein which improves the reliability of an established model. Eight male Sprague-Dawley rats underwent injection of the cervical internal carotid artery with 0.1 ml of 1-h-old fragmented autologous blood clot through an external carotid artery cannula. The pterygopalatine artery was ligated prior to embolization. At killing 2 h after embolization, clot was observed in the proximal middle cerebral and posterior cerebral arteries in all animals. Areas of reduced blood flow at 2 h postembolization were assessed by digital image processing of iodo-[14C]antipyrine autoradiographic images. No-flow and low-flow areas were measured for each of approximately 25 serial brain sections with a computerized bit-pad. Volumes were calculated and lesions localized by anatomical reconstructions. No animal sustained a hemorrhagic lesion. One animal sustained only a very small area of ischemia in the internal capsule. Of the remaining seven, all had large regions of ischemia in the middle cerebral distribution involving cortex and basal ganglia. Posterior cerebral involvement was observed in six of the seven animals as well. The contralateral hemisphere was unaffected. Volume values could be calculated for primary vascular distributions. Most variability occurred in the pattern of posterior cerebral involvement. The technique described produces a relatively consistent region of ischemia in the middle and posterior cerebral artery distributions in the rat and is a useful model for the study of cerebral ischemia.
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PMID:A model of embolic cerebral ischemia in the rat. 356 63

Posterior alveolar osteotomies were performed on six mongrel dogs. The segments showed early transient ischemia, followed by complete revascularization and osseous healing. Results of the study indicate that this posterior segment will maintain its vascularity if a lingual nutrient pedicle is maintained.
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PMID:Revascularization after posterior mandibular alveolar osteotomy. 616 20

Posterior circulation in 82 children of "moyamoya" disease are studied. Two aspects of "moyamoya" disease, (ie; occlusive lesion of cerebral vessels and the development of abnormal vascular network as collateral channel,) are also detected in the vertebrobasilar system. Among 82 cases, 49 cases showed the occlusion of posterior cerebral artery at their quadrigeminal segment. Twenty-three showed the more proximal occlusive lesions. Vertebral artery occlusion were found in 3 cases. As the occlusive lesion progresses, abnormal vascular network at the posterior portion of skull base developed. This network consists mainly of thalamogeniculate artery, posterior choroidal artery, and also of other thalamoperforators. Visual field defect as an ischemic symptom of occipital lobe was detected in 9 cases (11%). Superficial temporal artery-middle cerebral artery anastomosis and encephalo-myo-synangiosis (temporal muscle graft), which were not considered to be so effective to the ischemia of the posterior circulation, were shown to exert indirect redistribution effect upon the vertebrobasilar system. However, this effect is such an indirect one that these surgical treatments cannot prevent the occurrence of ischemic stroke in the vertebrobasilar system. For this purpose, omentum transplantation to the occipital lobe may be needed as a method of direct revascularization.
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PMID:[Study on the vertebro-basilar system in "moyamoya" disease]. 674 16

We quantitated hemorrhage associated with reperfusion after varying periods of myocardial ischemia and examined the flow characteristics that accompany reperfusion hemorrhage. Anesthetized dogs were reperfused after 2, 6 or 24 hours of circumflex occlusion. A control group underwent coronary occlusion without reperfusion. Radioactive microspheres were injected before and 5 minutes and 24 hours after reperfusion. The papillary muscles were analyzed for hemoglobin content, flow during myocardial ischemia and flow early and 24 hours after reperfusion. Myocardial creatine kinase activity was assayed to determine the severity of myocardial necrosis in the papillary muscles. Hemorrhage into the posterior papillary muscle was dependent upon the duration of coronary artery occlusion. Posterior papillary hemoglobin averaged 14 mg/g in the 2-hour group, 28 mg/g in the 6-hour group and 36 mg/g in the group reperfused 24 hours after occlusion, compared with 8.7 mg/g in the control group. Myocardial hemorrhage was associated with severe depression in myocardial CK and marked depression in flow to the ischemic area (i.e., collateral flow) during the occlusion. Early reflow averaged 112 ml/min/100 g in the 2-hour group, 61 ml/min/100 g in the 6-hour group and only 5.8 ml/min/100 g in the 24-hour group. Therefore, myocardial hemorrhage induced by reperfusion of the acutely ischemic myocardium is associated with severe ischemia during occlusion and severe myocardial necrosis, but does not depend upon the magnitude of early reflow. Myocardial hemorrhage may occur even though initial reflow values are markedly decreased.
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PMID:The time course and characterization of myocardial hemorrhage after coronary reperfusion in the anesthetized dog. 683 66


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