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

Microvessels of the right atrium endothelium were investigated with electron microscope for patients with congenital heart disease receiving surgical treatment under deep perfusionless hypothermia and various methods of pharmaco-cold cardioplegia. In group 1, pharmaco-cold cardioplegia was performed, with hyperosmolar normopotash solution cooled down to 2-4 degrees C. In group 2, the same solution combined with isoptin, a potash-ion blocker, was applied. It has been shown that during global ischemia, stability of ion gradients on plasmalemma of endothelial cells is impaired, irrespective of the composition of cardioplegia solution. Alongside with this, ultrastructural reactions in group 1 proceed towards hyperosmia of endothelium accompanied by building up a large group of cells following coagulation necrosis. In group 2, by contrast, an intracellular edema progresses. The cardioprotective effect of isoptin, which is able to block Ca2+, manifests itself most vividly at reperfusion, when the blocking of cell potash overload prevents the development of dystrophic and destructive changes in endothelium of coronary microvessels, which present one of the most severe consequences in the process of blood flow recovery in ischemic tissues.
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PMID:[Endothelium of myocardium microvessel under conditions of hypothermia, ischemia, reperfusion and pharmaco-cold cardioplegia with calcium antagonist]. 1660 37

Vascular calcification is common among hemodialysis (HD) patients and contributes to the development of peripheral arterial disease. A 57-year-old Japanese man who had been on HD for 30 years was referred to us for severe pain with multiple ulcers on his toes and fingers. He was an ex-smoker and had no diabetes mellitus. On admission, he had ulcers on his big toes bilaterally and right 2nd - 4th fingers. Peripheral pulses were strong and his ankle-brachial pressure index was above 1.3. Laboratory data were as follows: calcium 9.9 mg/dl, albumin 3.3 g/dl, phosphate 3.0 mg/dl, Ca x P product 30, and parathyroid hormone 98 pg/ml. He had a parathyroidectomy in 1998 and 1999. X-rays of his hands and legs showed diffuse subcutaneous arteriolar calcification. Angiography revealed no local stenotic lesions. Despite intensive therapies including hyperbaric oxygen therapy, painful gangrene developed on his right big toe and the pain was so intense that he could not go to sleep in a supine position. We infused intravenous sodium thiosulfate (20 g) 3 times weekly, based on previous reports. Within 4 - 5 days, he experienced rapid and dramatic symptom relief. The score of the visual analogue pain scale improved from 10/10 - 2/10. The signs of ischemia, measured by transcutaneous partial oxygen pressure and thermography, improved significantly. During the infusion of sodium thiosulfate, the patient complained of nausea, vomiting and hyperosmia. These adverse symptoms were resolved after discontinuation of the infusion. Pain relief was sustained and he could walk after 2 weeks of infusion. Our case supports the use of sodium thiosulfate as a novel therapeutic choice for critical limb ischemia with severe vascular calcification in chronic HD patients.
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PMID:Successful management of critical limb ischemia with intravenous sodium thiosulfate in a chronic hemodialysis patient. 1693 72