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

The progressive microvascular changes occurring during unmodified renal allograft rejection were studied in 22 dogs utilizing post-mortem barium sulfate perfusion microangiography. Sixteen dogs (7 autografts, 8 ischemia controls and 1 hydronephrotic animal) made up a control group. The microradiographic findings were correlated with intravenous urography, coagulation profiles and histopathologic studies. Vascular obstruction and obliteration occur from the outer cortex inward and involve sequentially, capillaries, efferent arterioles, glomeruli, afferent arterioles and interlobular arteries. A-V communications develop late and are due to a loss in vascular integrity. Medullary vascular obliteration occurs subsequent to cortical changes. The microangiographic changes mirror the hstologically evident cellular infiltrate, vascular damage and eventual hemorrhagic necrosis. The appearance of fibrin split products in the plasma late in rejection and the dramatic vascular occlusive changes seen microangiographically suggest that localized intravascular coagulation occurs during rejection.
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PMID:Microvascular changes in canine renal allograft rejection: a correlative microangiographic and histologic study. 32 Jan 51

Blood flow disturbances in the gastrointestinal tract can lead to serious illness. They can be acute or chronic, their cause may be arterial or venous occlusion or hypotonia. Lesions of the gastrointestinal tract caused by ischemia depend on localisation, acuteness and degree of the blood flow disturbance. They may reach from focal and segmental ischemic lesions to extensive necroses of the entire intestinal tubes. The most serious ischemic disease is the embolic and thrombotic occlusion of the arteria mesenterica superior due to previous arterosclerotic damage. Infarction of a large part of the intestines and peritonitis can be the consequence. These patients' only chance of survival is early diagnosis--as a rule exclusively via angiography--and immediate surgery. Chronic occlusion of the arteria mesenterica superior leads to angina abdominalis which mainly occurs after food intake and can last for hours. The reason may also be a general arteriosclerosis. Men are affected more frequently and at a younger age than women. As a consequence of lowered intestinal blood flow these patients suffer from malabsorption and heavy weight loss. Conservative therapy is not effective. These patients, too, will have to be treated surgically after previous angiography. Vascular disease with decreased blood flow as its consequence can be found in a number of inflammatory diseases, in malign hypertensian, in collagen disease and in other more rare diseases as pseudoxanthoma elasticum or Ehlers-Danlos-syndrome. In the case of ischemic colitis arterial and more rarely venous occlusions cause decreased blood flow in the big bowel. A frequent consequence is colitis in the left colon which is characterized by acuteness, pain in the left side of the abdomen and by heavy rectal bleeding. Diagnosis is established by means of endoscopy, barium enema and angiography. Primarily therapy of ischemic colitis is of the conservative type. In severe cases with gangrene and peritonitis the colon has to be resected.
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PMID:[Disorders of the blood circulation in the gastrointestinal tract]. 32 26

Thirty-four patients with intermittent lower gastrointestinal bleeding were diagnosed angiographically as having angiodysplasia of the cecum and right colon. Repeated barium and endoscopic examinations were negative. Right colectomy was performed on 17 patients, who were followed postoperatively for up to 7 years. Of these, four patients rebled, two of whom had angiographic evidence of related lesions involving other parts of the colon and terminal ileum. Silicone rubber injection and tissue-clearing techniques on the specimens have facilitated the pathologic identification of these lesions. Histologically, they are dilated submucosal veins and arteries associated with areas of overlying mucosal thinning and occasional ulcerations. Although the pathogenesis of the lesion is unknown, we think they are acquired rather than congenital and result from chronic submucosal arteriovenous shunting secondary to mucosal ischemia. Of the 34 patients, 17 had a history of cardiac disease.
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PMID:Angiodysplasia of the right colon: a cause of gastrointestinal bleeding. 41 Feb 41

Ischemic colitis has been previously described in three forms: transient, strictured, and gangrenous. A fourth form of presentation in the elderly is characterized by signs of an acute abdomen, massive colonic dilatation, and systemic toxicity. Bloody diarrhea may be seen prior to the onset of dilatation. Ischemia should be considered as an etiologic factor in "colitis" in the elderly patient with segmental dilatation particularly if it follows a "low flow state." The rectum is usually uninvolved. Barium enema may confirm segmental involvement and later demonstrate stricture. Three patients with ischemic megacolon are presented. The diagnosis was suspected preoperatively in only one. In contrast to ulcerative colitis, these patients show a more abrupt onset and run a fulminant course. In patients who recover, there is lower relapse rate than young patients with ulcerative colitis. When resection is indicated, all attempts should be made to spare the rectum. Loop ileostomy and decompressive colostomy offer an excellent temporizing measure to assist the patient through the acute phase of the illness.
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PMID:Megacolon in the elderly. Ischemic or inflammatory? 46 76

A case report of subacute, reversible ischemic colitis associated with use of oral contraceptives (OCs) is reported. A 19-year-old woman was admitted to the hospital with chief complaints of abdominal cramps, nausea, vomiting, diarrhea, and rectal bleeding of 2 days' duration. Past medical history and family history were noncontributory. The patient was receiving no medication other than Norinyl 2 (2 mg of norethindrone and .1 mg of mestranol), which she had been taking for 6 months. 2 days before admission the patient had taken 100 mg of dimenhydrinate and 2 ExLax tablets (90 mg of phenolphthalein) for constipation. Colonic roentgenograms revealed impaired mesenteric circulation and bowel ischemia; OC-induced ischemic bowel disease was diagnosed. Patient symptoms subsided within 96 hours of discontinuing the OC and initiating supportive therapy (including intravenous fluid infusion, nasogastric suction, analgesics, and antiemetics). When a repeat barium enema was performed, it showed resolution of the ischemia. In a short review following the case report, these drugs were indicted in causation of colitis-like syndrome: amoxicillin, ampicillin, cephazolin, chloramphenicol, chlorpropamide, clindamycin, cloxacillin, cotrimoxasole, cyclophosphamide, digitalis, ergotamine tartrate, flucytosine, fluorouracil, gold salts, laxative and cathartic abuse, mercurous chloride, methyldopa, penicillin V, and tetracycline. Ischemic bowel disease secondary to OC use is a rare but important complication because of its significant morbidity and potential mortality, and because of the widespread use of the drugs. The case report emphasizes the need to consider the differential diagnosis of acute vascular insult with bowel ischemia when acute abdominal pain progressing to bloody diarrhea occurs in young women taking OCs.
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PMID:Oral contraceptive-induced ischemic bowel disease. 48 72

Nonischemic intussusception is defined as a variant of acute intussusception exhibiting less acute symptoms of abdominal pain, vomiting, and diarrhea in the older child, longer duration of symptoms (usually 4-14 days), signs of imcomplete bowel obstruction, and absence of intestinal ischemia. Over a 10 yr period (1964-1973) 20 children with this disease were treated without mortality or recurrence at three children's hospitals in Chicago, Illinois. The higher incidence of diarrhea, the lower incidence of a palpable abdominal mass, and the lower incidence of blood per rectum in nonischemic intussusception predispose to diagnostic errors and delays in treatment. Despite the longer duration of symptoms, this variant of intussusception can be treated initially with a careful attempt at barium hydrostatic reduction. If this fails, easy operative manual reduction is the rule.
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PMID:Nonischemic intussusception. 89 56

Cortical mouse astrocytes in culture were impaled with two-channel microelectrodes. These mouse astrocytes have the same responses to different K+ concentrations, ouabain, and glutamate as cultured rat astrocytes, with the exception that a large barium-sensitive K+ conductance clamps the membrane potential at the K+ equilibrium potential. Glycolytic and mitochondrial inhibitors have little effect on the mouse astrocytes. Total blockade of energy metabolism leads to an irreversible, calcium-dependent depolarization, but only if applied for longer than 45 min. Increasing the extracellular K+ concentration to 60 mM increases the intracellular K+ concentration by 43 mM and the bicarbonate concentration by 22 mM and leads to a concomitant fast swelling. Together with the 20 mM increase in Cl- concentration reported in the literature this is a good indication for a Boyle- and Conway-mediated K(+)-anion influx with water. This influx is accomplished by the depolarization-induced opening of Cl- channels as reported in the literature. In conclusion, ischemia-like conditions have little direct, immediate impact on astrocytes. In contrast, ischemia-induced release of substances from neurones, such as K+, produces an immediate and fast response.
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PMID:Coupling of metabolism and electrical activity in cortical astrocytes. 129 68

Although adenosine triphosphate-magnesium chloride (ATP-MgCl2) has demonstrated cytoprotective effects in a variety of adverse pathophysiologic conditions, its ability to alter radiation injury is unknown. The purpose of this study, therefore, was to assess the effects of ATP-MgCl2 on colorectal radiation injury after preoperative pelvic radiotherapy. Mixed-breed pigs (n = 36) received 4250 cGy preoperative external-beam pelvic radiotherapy (350 cGy fractions three times per week for 4 weeks). During radiotherapy, animals were randomly assigned to one of three treatment groups: (1) intravenous infusions of normal saline during radiotherapy, (2) intravenous ATP-MgCl2 (30 mumol/kg) during radiotherapy, or (3) intravenous ATP-MgCl2 (60 mumol/kg) during each radiotherapy session. After completion of radiotherapy and a 4-week rest period, animals underwent colorectal resection by either the two-layer hand-sewn (n = 18) or stapled end-to-end anastomosis technique (n = 18). Laser Doppler velocimetric readings were obtained to assess mural colonic blood flow after completion of anastomosis. A second laparotomy on postoperative day 5 or 11 was done to examine the following anastomotic parameters: (1) repeat laser Doppler velocimetry, (2) gross inflammatory scoring, (3) bursting pressure, (4) preoperative barium enema to identify leak or stenosis, (5) analysis of anastomotic hydroxyproline content, and (6) incidence of cutaneous injury in the radiation portals. ATP-MgCl2 administered intravenously at 60 mumol/kg led to (1) diminished colorectal seromuscular ischemia evidenced by laser Doppler velocimetric readings, (2) decreased skin and subcutaneous tissue injury in the treatment portals, (3) significantly decreased perianastomotic inflammatory reaction, and (4) increased early hydroxyproline content. There was no significant difference in the incidence of leakage or stenosis between the study groups, nor was the anastomotic bursting strength significantly different between the treatment groups. Therefore the administration of ATP-MgCl2 (60 mumol/kg) appears to offer significant cytoprotection from preoperative pelvic radiation therapy.
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PMID:Adenosine triphosphate-magnesium chloride in radiation injury. 144 Feb 47

We perfused 16 human femora with a 50% barium sulphate suspension and studied the intra-osseous vessels by microfocal radiography and histology. There were few anastomoses between the vessels of the greater trochanter and those of the adjacent cancellous bone of the shaft. Ischaemia of the trochanter may contribute to nonunion after trochanteric osteotomy.
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PMID:The blood supply of the greater trochanter. 154 68

We report a case of ischemia of the distal esophagus with secondary odynophagia that occurred as a result of a type III aortic dissection. A 56-yr-old hypertensive male presented with acute chest pain radiating to his back. A dissection of the descending aorta was found to begin just distal to the left subclavian artery and end in the region of the iliac arteries. The patient was treated medically and remained stable, but then developed odynophagia to solids. Upper endoscopy showed erythematous friable esophageal mucosa, and biopsies were consistent with ischemia. Aortography and barium fluoroscopy provided further evidence of foregut ischemia. The patient recovered on oral omeprazole with no residual symptoms. Ischemic compromise of the esophagus secondary to aortic dissection has not been previously described, nor have the associated endoscopic findings. Knowledge of this rare condition may help in the recognition and management of esophageal mucosal ischemia.
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PMID:Foregut ischemia and odynophagia in a patient with a type III aortic dissection. 159 Mar 23


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