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

Reactive oxygen metabolites (ROM) may play a role in the pathophysiology of inflammatory bowel disease (IBD) and ischemia-reperfusion-induced intestinal injury. Although there are many reports of intestinal mucosal injury associated with neutrophil-derived ROM, free radicals themselves have not been reported to induce intestinal mucosal injury. We administered intrarectally 2,2'-azobis(2-amidinopropane) dihydrochloride (AAPH) to rats, an azo compound that generates free radicals in vitro. Acute mucosal injury was assessed histologically by light microscopy and biochemically by myeloperoxidase (MPO) activity. Intrarectal administration of AAPH (60, 90, 150 mg/kg) caused erythema, edema, and histologically verifiable mucosal inflammation. MPO activity was increased 9- to 18-fold above the control level. The levels of thiobarbituric acid (TBA) reactants and sulfhydryls (SH) were significantly (P less than 0.01) increased and decreased, respectively, by 90 mg/kg AAPH. Sulfasalazine, 5-aminosalicylic acid, the LTB4 receptor antagonist SC-41930, and the antioxidant glutathione prevented the inflammation. This model of mucosal inflammation may be useful in evaluating new therapeutic agents for the treatment of IBD.
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PMID:Induction of colitis in rats by 2-2'-azobis(2-amidinopropane) dihydrochloride. 134 11

A 73-year-old Japanese man with a history of partial gastrectomy due to gastric cancer 4 years previously was admitted because of intermittent fever. The patient developed abdominal pain, erythema, and myalgia in addition to the fever during the final clinical course, and died of acute heart failure. Autopsy disclosed atrophy of the left lobe of the liver and acute myocardial infarction. Neither metastasis nor recurrence of the cancer was observed. Small- and medium-sized arteries of the visceral organs showed various stages of necrotizing vasculitis with narrowing of the lumina. The vasculitis was most prominent in the left lobe of the liver and in the heart. Narrowing of the portal vein due to portal tract inflammation in addition to vasculitis of the hepatic arteries may have induced ischemia and infarction, which had resulted in atrophy of the left hepatic lobe.
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PMID:Polyarteritis nodosa with atrophy of the left hepatic lobe. 136 33

Human loxoscelism was modeled in albino rabbits by injection of brown recluse spider (Loxosceles reclusa) venom, and the effects of daily or twice-daily hyperbaric oxygen treatment on wound healing were investigated. Lesions similar to those seen in humans were produced in rabbits by intradermal injection of 200 microliters of a venom extract (0.21 microgram protein per microliter), including edema and erythema, ischemia and cyanosis in the first 12 hr, extensive purpura by 24 hr, and crateriform ulcer formation by day four, with induration and eschar formation. Hyperbaric oxygen treatments, consisting of two atmospheres absolute (2 ATA) for 60 min, were applied daily (n = 8) or twice daily (n = 8), while control animals (n = 8) received no treatment. Treatments were initiated 72 hr after venom injection (day 3) to duplicate typical clinical treatment delays, and were administered for seven consecutive days. No significant effects of hyperbaric oxygen treatment on lesion healing were seen as measured by lesion area. However, histologic evaluation of wound tissue collected at euthanasia on day 24 showed clear differences between rabbits receiving twice-daily treatments and those receiving daily or no treatment. The former showed complete re-epithelization or slight ulceration, while the latter usually had necrotic cavities extending into the dermis, with myonecrosis and inflammatory cell accumulation. Thus, no superficial differences were seen between groups, but twice-daily treatments resulted in enhanced recovery at the histologic level.
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PMID:Hyperbaric oxygen effects on brown recluse spider (Loxosceles reclusa) envenomation in rabbits. 194 69

The amplitudes of photo-electric-plethysmography (PPG) tracings were significantly increased by subcutaneous injections of methacholine (MC) and diminished by injections of atropine (AT) as compared with placebo injections of multi-electrolyte solution (MES) both in 8 normal subjects and 11 patients with diabetic peripheral neuropathy. AT-containing lotion delayed healing compared with placebo in the forearms of 6 normal subjects. MC-containing lotion sped healing compared with placebo in the forearms of 6 subjects with diabetic neuropathy. Thigh incisions in 6 neuropathic patients were shown to heal faster if soaked in MES rather than saline. Healing with the MES solution was shown to be further increased by the addition of MC to the solution and to be decreased by the addition of AT. The addition of MC produced erythema and an increase in the amplitude of PPG tracings. AT solutions produced blanching and a decrease in the PPG amplitude. It was concluded that (1) the slow healing characteristic of neuropathic ulcers is associated with a loss of cholinergic nerve function; (2) cholinergic stimulation will increase capillary blood flow and promote healing while cholinergic blockade has opposite effects; (3) secondary ischemia makes the ulcers susceptible to the deleterious effects of therapeutic agents such as saline; (4) the ischemic tissue will heal faster with a balanced MES than with saline; and (5) the benefits of MES on healing are augmented in patients with diabetic neuropathy by the addition of cholinergic agents to the solution.
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PMID:Role of cholinergic nervous system in healing neuropathic lesions: preliminary studies and prospective, double-blinded, placebo-controlled studies. 195 66

Injection of sonic extracts of Bordetella parapertussis into the shaved backs of guinea pigs produced hemorrhagic necrosis, which previously has been attributed to the action of heat-labile toxin. As heat-labile toxin was purified from this crude mixture, its ability to induce hemorrhagic lesions decreased significantly. However, ischemic lesions were apparent after injection of the purified toxin. These lesions, while not hemorrhagic in nature, were marked by erythema surrounded by a region in which the ischemia was apparent. Exogenous agents were found to alter the nature of the skin lesion induced by heat-labile toxin. The lipid A portion of endotoxin in combination with heat-labile toxin caused hemorrhagic lesions surrounded by a ring of ischemia, whereas bovine serum albumin increased the area of erythema. While the nature of lesions induced by heat-labile toxin was affected by exogenous agents, the diameter of ischemia produced by the toxin was found to be independent of the presence of these agents and was linear with toxin dose. These results indicate that induction of hemorrhagic necrosis may not be a reliable indicator of heat-labile toxin activity. Instead, measurement of the ischemic lesion produced by heat-labile toxin may be a useful assay for the toxin.
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PMID:Effects of exogenous agents on the action of Bordetella parapertussis heat-labile toxin on guinea pig skin. 232 23

One hundred twenty-seven case reports of high-pressure injection injuries have been analyzed, and five patients of our own are reported. The injury usually occurs to young, working males, most often to their nondominant index finger. Without proper surgical intervention, the injected part often progresses to necrosis, debilitating fibrosis, and stiffness. The pathology is that of inflammation and foreign body granulomatous formation. Damage results from impact, ischemia resulting from vascular compression, chemical inflammation, and secondary infection. Recommended treatment has traditionally been early surgical decompression, removal of injected material, and antibiotics. There is some evidence that anti-inflammatory medication is of value. In the patients treated early with steroids and proper antibiotics, infection has not been a problem. We feel that treatment of these injuries should include: 1) Immediate, high-dose, parenteral steroids followed by high-dose oral steroids in tapered doses. Our present regimen consists of initial doses of hydrocortisone sodium succinate 100 mg intravenously every 6 hours until it appears that swelling and erythema have maximized and begun to diminish, then changing to oral prednisone 25 mg twice daily. Prednisone is then slowly tapered in 5- to 10-mg increments per day until stopped. If swelling, pain, and erythema begin to worsen, high-dose steroids are resumed and tapered again. 2) Extensive and complete surgical decompression and drainage of the injured part. 3) Appropriate broad-spectrum antibiotic coverage.
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PMID:High-pressure injection injuries of the hand. 698 11

The histologic studies of the decubitus ulcer spectrum, which include blanchable erythema, nonblanchable erythema, decubitus dermatitis, decubitus ulcer, and the black eschar/gangrene reveal a dynamic process. The initial change occurs in the vessels of the papillary dermis. This is followed by necrosis of skin structures. The eschar/gangrene represents a full-thickness defect due either to prolonged ischemia and anoxemia or a sudden large vessel occlusion caused by shearing injury.
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PMID:Histopathology of the decubitus ulcer. 709 63

Lower limb critical ischemia is a clinical condition typical of patients with severe chronic obstructive arterial disease (Fontaine's IIIb and IV degree). This condition often leads to amputation of the limb involved. The authors present to the use PGE1 in 50 patients with Fontaine's IIIb-IV degree chronic obstructive arterial disease of lower limbs in which the indication of amputation was done. All the patients, admitted to the emergency ward, complain of rest pain and distal ulcers. The administration of PG5(1) was given as follows: 40 mg/bid/e.v./20 days. A 6 months long follow-up was installed with the instrumental evaluation of: Transcutaneous oxygen pressure; Distal blood perfusion with Doppler; cardiac pulse; blood pressure. Eighteen patients became to a Fontaine's II degree during the next 2 months after therapy, 25 patients came back to a severe claudicatio: of them 18 underwent successfully vascular surgery, 7 underwent amputation of the lower limb. In 7 patients the PGE1 did not influence the natural progression of the disease. Among the side-effects of therapy we can mention: headache (4%), erythema and pain of injected vein (8%), sick (4%). All the side effects were transient and never led to interruption of therapy.
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PMID:[Use of PGE1 in severe ischemia of the lower extremities. Clinical study]. 756 37

Synovial perfusion was quantified in milliliters per minute per knee by two quite different clearance methods based on (1) counting tritiated water in serial aspirates of intraarticular saline, and (2) external counting of joints injected with free radioiodide. In each case, the serial counting data determine a rate constant that is multiplied by a distribution volume to provide the clearance in flow terms of milliliters per minute. This report updates and summarizes these data and compares the two methods to each other and to alternative assessments of synovial blood flow. Available methods such as laser Doppler flowmetry (with data output measured in volts) and solute clearance constant determinations (in min-1) are useful for selected purposes but cannot be used to quantify the articular flux (in milligrams per minute) of any solute. Radiolabeled microspheres provide data (in milliliters per minute per g of tissue) but are unsuitable for human use. The two clearance methods provide comparable results, but the free iodide technique seems most suitable for physiologic investigations. The latter potentially includes critical evaluations of synovial blood flow in relation to issues such as palpable warmth, visible erythema, articular ischemia, the permeability of synovial vessels, the genesis of effusions, the delivery and removal of therapeutic agents, and the concentration of every synovial fluid solute from micronutrients through cytokines, plasma proteins, and molecular markers of cartilagenous injury.
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PMID:Synovial perfusion in the human knee: a methodologic analysis. 852 91

Expected outcomes for a correctly fitted ostomy prosthetic device include sustained, predictable wearing time, protection of the stoma from injury, and maintenance of peristomal skin integrity. To accomplish this, the pouching system must be properly sized and maintain continuous contact with the peristomal skin. Continuous contact is achieved when the faceplate provides a mirror image of the topography of the peristomal plane. Varying degrees of support and convexity of the faceplate are used to fit the unique characteristics of the patient's peristomal plane and stoma. Support can be absent, soft or firm. Convexity is some degree of outward curving of the faceplate. Characteristics of the stoma (i.e., flush, retracted, loop), peristomal plane (i.e., creases, hernia, scarring) and abdomen (i.e., flaccid, soft, or firm) may indicate the need for convexity. Potential problems include mucocutaneous separation, ischemia, laceration, erythema, ecchymosis, and pain if convexity is used inappropriately. Alternatives to convexity include the use of an ostomy belt or surgery. Ongoing, intermittent assessment of the prosthetic is essential to evaluate that the convexity and support have achieved the expected outcomes.
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PMID:Principles and techniques in the use of convexity. 870 88


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