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

This presentation reports the light and electron microscopic findings relating to the vascular and glomerular changes in the kidney in a series of 25 patients having malignant hypertension, the hemolytic-uremic syndrome, scleroderma, or toxemia of pregnancy. The pathologic changes were generally similar in each of the diseases studied, the changes being related more to the severity and duration of injury than to the specific disease. Vascular narrowing was due mainly to intimal thickening, and by light microscopy the lesions were categorized as onionskin, mucinous, or fibrous with or without associated elastosis. Intimal erythrocyte extravasation, fibrinoid necrosis, and luminal thrombosis were also seen. Electron microscopy provided additional morphologic information: Myointimal cells were found to be the cellular component in each type of intimal thickening; it was possible to distinguish collagen from large intimal accumulations of basement membrane material; mucinous intimal material was characterized ultrastructurally; and fibrinoid necrosis was identified as a lesion inconstantly associated with cellular necrosis and consisting mainly of fibrinoid material and small deposits of fibrin. It seems likely that there is a common pathogenesis for intimal thickening in a variety of diseases and that this involves endothelial cell damage and increased permeability, leakage of serum and erythrocytes into the intima, and a healing reaction of the vessel wall was developing from migration of smooth muscle cells into the intima with subsequent myointimal cell proliferation and fibrogenesis. A common glomerular change in all diseases studied was a striking accumulation of electron lucent material between the endothelium and the lamina densa of the basement membrane. This lesion was interpreted as a manifestation of acute ischemia.
Hum Pathol 1976 Sep
PMID:Renal proliferative arteriopathies and associated glomerular changes: a light and electron microscopic study. 98 10

Twenty-five patients with 35 severed small arteries of the wrist, calf, or ankle are presented. Included are six cases of total ischemia of the wrist or ankle. Twenty-two repairs and thirteen ligations were performed. There was only one amputation from arterial insufficiency. We recommend repair both to preserve tissue and to restore optimum flow. By use of meticulous interrupted suture technique, optical magnification, and heparin and aspirin administration, a high degree of arterial patency can be achieved.
J Trauma 1976 Sep
PMID:Management of small arterial injuries: clinical and experimental studies. 101 3

The authors conducted a clinico-EMG study of 118 patients with an embolism of the aortal bifurcation and magistral arteries of the lower extremities. Among this contingent 58 were studied in the remote period -- from 2-7 years following a surgical operation. The clinical symptoms of embolism were expressed in severe pain, sensory, motor and vegetative-trophic disturbances in the affected extremities. Three degrees of the nervous system lesions were distinguished in an embolism. It was also demonstrated that there were significant changes in the bioelectrical muscle activity of the extremities. In the remote period following embolectomia, in most of the patients there still were sequalae of acute ischemia of the nervous tissue, the expressiveness of which depended upon the calibre of the occluded vessel, degree of tissue ischemia, the time of treatment and the time following the operation. A retarded restitution may be explained by the degree of the nervous tissue lesion and the persisting insufficiency of circulation in the extremities.
Zh Nevropatol Psikhiatr Im S S Korsakova 1976 Sep
PMID:[Dynamics of neurologic disorders following embolism of the bifurcation of the aorta and major arteries of the lower extremities]. 101 31

The Syndrome of Transient Global Amnesia is clinically characterized by a disorder of the ability to form memory engrams, appearing suddenly and lasting for several hours. Since the first papers on this syndrome by Bender (1956) and Fisher and Adams (1964) approximately one hundred cases of transient global amnesia have been described. Symptomatology, course, somatic findings and differential diagnosis are discussed with consideration of the literatur and three own observations. Regarding the etiology most authors discuss a transitory localized ischemia in the circulatory area of the vertebral-basilar artery system. Relapsing episodes occur less frequently than single episodes. In connection with this disorder characterized by the paroxysmal occurence and the episodic course, possible ways of genesis of amnesic syndromes are discussed. Theoretically three types of amnestic syndromes of organic origin may be differentiated: (1) amnesia in the frame of "function psychosis", i.e. of global mental deterioration caused by various diffuse brain function disorders; (2) amnesia caused by a combination of diffuse (function psychosis) and local brain function disorder; (3) purely local type of amnesia without function psychosis. In the combined type of amnesia a dissociation between the severity of memory disorders and relatively mild function psychosis is to be found. The importance of psychopathometric investigations, i.e. of quantitative determination of other mental dysfunctions besides memory disorder, for the interpretation of an amnesic syndrome is emphasized. Unfortunately these have not been possible in the cases described in this paper.
Fortschr Neurol Psychiatr Grenzgeb 1975 Sep
PMID:[Transient global amnesia - a paroxysmal amnestic syndrome (author's transl)]. 104 11

The purpose of this study was (1) to establish the maximal interval between the onset of ischemia and reperfusion that would permit a decrease in the size of infarction, and (2) to evaluate the relation between changes in infarct size and preservation of cardiac function. Studies were carried out in 19 dogs of which 13 had temporary (1 to 3 hours) occlusion of the left anterior descending coronary artery. The hospital course of 15 patients of whom 13 underwent myocardial revascularization within 8 hours of acute infarction was also reviewed. In dogs, the eventual pathologic infarct size was significantly reduced if reperfusion was performed within 2 hours of ischemia. After 2 hours of ischemia, the revascularized segment remained dyskinetic on angiographic assessment and cardiac function was depressed. After 3 hours of ischemia, in spite of a patent coronary artery, the extent of infarct and dykinesia was greater than during ligation of the left anterior descending coronary artery. In patients, small infarcts developed with revascularization performed more than 4 hours after infarction but with revascularization of the left anterior descending coronary artery the size of the dyskinetic area (as assessed with angiography) was similar to that in patients with a closed graft to the left anterior descending coronary artery but with a patent graft to its diagonal branch. In all patients after revascularization the extent of the left ventricular dyskinetic area was smaller and cardiac function was significantly better than in patient who did not receive revascularization for complete occlusion of the left anterior descending coronary artery. In spite of successful revascularization, electrocardiographic evidence of transmural infarction persisted postoperatively. It is concluded that reperfusion of an area of myocardium that has been ischemic for less than 2 hours in dogs or less than 4 hours in man may lead to a significant reduction in the extent of infarction as well as improvement in cardiac function. However, the revascularized area remains angiographically dyskinetic and electrocardiographically abnormal.
Am J Cardiol 1975 Sep
PMID:Myocardial revascularization after acute infarction. 108 Sep 50

Transcatheter therapeutic arterial embolization was employed in 11 patients with gastrointestinal hemorrhage and 8 patients with bleeding from other sites. Hemorrhage was stopped successfully in all of the patients with gastrointestinal bleeding and 6 of the 7 patients with active bleeding from other sites. There were no significant complications or sequelae, although ischemia msy cause problems in such patients. Embolization is of considerable value when pharmacological therapy fails or is not appropriate due to the site of bleeding. In some cases it may represent the definitive treatment, as in pelvic trauma or renal hemorrhage; in others, embolization may serve to halt bleeding long enough to permit surgery. Therapeutic embolization should be considered whenever active extravasation of contrast material is demonstrated.
Radiology 1976 Sep
PMID:Transcatheter therapeutic arterial embolization. 108 9

The rupture of an aneurysm of the sub-renal aorta may give rise to several clinical presentations which it is essential to recognise in order to carry out emergency operation, e.g. attack of pain, retroperitoneal hematoma, hemoperitoneum, rupture into a hollow viscus, infective aneurysm. The special characteristics of the treatment concern resuscitation, site and type of aortic clamping, aorto-caval or aorto-digestive rupture or an infective aneurysm raising special problems. It is the vascular collapse which makes the rupture serious, an aneurysm operated as an emergency without collapse, has a mortality which differs little from a non-ruptured aneurysm, e.g. 3 deaths out of 55 operated cases. On the other hand, out of 44 aneurysms operated in acute collapse, there were 31 deaths. The complications observed are linked to the latter, e.g. cerebro-vascular accidents, acute coronary ischemia, acute ishemia of the limbs, which may also be due to embolism during operation, renal complications due to renal shock. The prevention of these complications has permitted us to reduce mortality by 40 p. 100 the last 5 years.
J Chir (Paris) 1976 Sep
PMID:[Ruptured aneurysms of the sub-renal abdominal aorta]. 108 6

During a 14-month period 73 satisfactory fluoroscopic studies were done on 59 kidney transplant recipients. Ureteral peristalsis was seen in 90 per cent of these studies and there was no difference between patients receiving living related donor kidneys and those receiving cadaveric kidneys. When ureteral activity was studied during rejection episodes only 54 per cent of the studies showed activity. An effort was made to relate aperistaltic ureteral activity to renal function, warm ischemia time, urinary tract infection, number of rejection episodes and tissue matching but no positive correlation could be made except the concurrent clinical diagnosis of rejection.
J Urol 1975 Sep
PMID:Cine-fluoroscopic studies of ureteral function in the human renal transplant. 109 85

A series of heterotopic cardiac allografts from ACI strain rat donors to ACI skin-presensitized Lewis strain recipients was examined by light and electron microscopy at intervals from 1 minute to 24 hours for a sequential morphologic study of hyperacute rejection. Syngeneic Lewis hearts grafts in ACI skin-presensitized Lewis recipients provided controls. Extensive platelet aggregation throughout the vasculature of the allografts in the presence of a largely intact endothelium was the initial morphologic event, which was present by 1 minute posttransplant and absent in all syngeneic controls. This was followed by widespread endothelial damage. Endothelial damage preceded neutrophil margination and emigration in the graft. Neutrophil degranulation or evidence of phagocytosis was not observed within the 1st hour. At 6 and 24 hours, degranulated forms were common and apparent extrusion of granule contents with progressive ischemic injury. Segmental occlusion of the vasculature by platelet plugs and progressive disruption and loss of capillaries combined with an increase in permeability may result in myocardial ischemia. Neutrophil-derived agents do not appear to be of major significance in hyperacute rejection during the early posttransplant phase, but may play a role in mediating myocardial injury if the allograft survives for alonger period. However, on morphologic grounds, it is suggested that microcirculatory hypoperfusion with resultant ischemia is a major determinant of myocardial damage and graft function. No significant change was noted over the observation period in peripheral neutrophil or platelet counts when compared to syngeneic controls, and a slight reudction in specific cytotoxic antibody titer in the allografts was immediate but very transient.
Lab Invest 1975 Sep
PMID:A controlled sequential morphologic study of hyperacute cardiac allograft rejection in the rat. 109 37

Cerebral blood flow, electrical activity, and neurological function were studied in rabbits subjected to either 15 minutes of oligemia (20 torr cerebral perfusion pressure) or complete cerebral ischemia produced by cisterna magna infusion. During oligemia, flow was reduced from 68.4 +/- 4.2 ml/100 gm/min to 26.3 +/- 4.4 (p less than .01), and during ischemia animals had no proven flow. By 5 minutes after oligemia or ischemia significant symmetrical hyperemia occurred and there was no evidence of the no-reflow phenomenon. The electroencephalogram became isoelectric significantly later and returned significantly sooner in oligemia than in ischemia. Oligemic animals had earlier and better return of neurological function than their ischemic counterparts, although postinsult hypocapnia improved functional recovery in both groups. These experiments do not support the concept that oligemia is a more severe insult than complete ischemia. In intracranial hypertension produced by this model, the no-reflow phenomenon does not occur.
J Neurosurg 1975 Sep
PMID:Experimental cerebral oligemia and ischemia produced by intracranial hypertension. Part 1: Pathophysiology, electroencephalography, cerebral blood flow, blood-brain barrier, and neurological function. 115 66


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