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

Hypertensive crises were studied in 80 patients. In severe cases the ECG provided evidence of systolic overloading of the left ventricle with intensification of coronary circulation and development of acute myocardial ischemia. Phase analysis showed prolongation of the mechanical systole with increase of the myocardial index. In more complicated cases there was a more evident hypodynamic syndrome with marked myocardial insufficiency. Hemodynamic disturbance were marked by a sharply increased peripheral resistance with a heterogenous reaction of the cardiac output. Blood supply to the cerebral tissue reduced sharply with an increase in the resistance of cerebral vessels. Renin activity was directly related to the severity of the crisis. A sharp onset of cerebral and cardiac ischemia was marked by changes in the antigen albumin. Timely diagnosis and differentiated treatment made it possible to avoid vascular complications in hypertensive crisis.
Kardiologiia 1979 Dec
PMID:[Clinical aspects of hypertensive crises]. 51 73

Microembolization from an ulcerated carotid artery to both occipital lobes via a persistent trigeminal artery was observed in a patient presenting with episodic bilateral central scotomata. Symptomatic relief was obtained following carotid endarterectomy. This unique pathway which resulted in occipital lobe ischemia has not been previously reported.
Neuroradiology 1979 Dec 12
PMID:Transient bilateral occipital lobe ischemia: microembolization through a trigeminal artery. 51 4

Although the occurrence of an arterial embolus is usually a cataclysmic event prompting emergency presentationand early diagnosis, we have managed 22 patients who presented more than 48 hours after the onset of symptoms. The diagnosis was apparent in only six patients. The remainder had subacute limb ischemia, and arteriography was used to help delineate the diagnosis in 14 of these patients. In most instances arteriograms were atypical of chronic occlusive disease, rather than diagnostic of arterial emboli. Embolectomy was performed a mean of 13 days after the onset of symptoms, with retrieval of thromboembolic material in all instances. Two patients died (mortality rate of 9%), and the limb salvage rate for the 25 limbs explored was 88%. Among 22 lower extremity embolectomies, foot pulses were restored in 13 patients (59%), and four patients (18%) had viable extremities without pulses. Adjunctive arterial reconstruction was required in three patients.
Surgery 1979 Dec
PMID:Late appearance of arterial emboli: diagnosis and management. 51 54

Recurrences of CNS infarction often lead to progressive neurologic disability in sickle cell anemia. To prevent such reccurrence, a periodic blood transfusion program was begun in 1969. Currently, 27 patients are on this regimen. Before inclusion in the program, 12 patients had had one to nine CNS recurrences each. Since the program was started, two patients have had transient CNS ischemia. There were no other recurrences and none of the patients have shown progression of neurologic abnormalities. In addition, there was a striking decrease in bacterial infection and pain. We conclude that periodic transfusions are effective in preventing recurrent CNS infarction in sickle cell anemia. The benefits must be weighed against the potentially serious problem of iron overload, as evidenced by moderately elevated serum ferritin values.
Am J Dis Child 1979 Dec
PMID:Periodic transfusions for sickle cell anemia and CNS infarction. 51 76

Eighteen patients with idiopathic optic neuropathy lacked symptoms and signs of cardiovascular and cerebrovascular disease, especially when compared to three groups of patients with sudden visual loss caused by retinal infarction, transient ischemia, and cerebral infarction. Many patients in the latter groups had hypertension, carotid bruits, heart disease, transient ischemic attack, and stroke. But among the patients with ischemic optic neuropathy, hypertension was the only evidence of cardiovascular disease, affecting 44% of the patients. We argue that, in many cases, ischemic optic neuropathy represents a direct and early complication of hypertension arterial disease affecting small arterioles supplying the anterior part of the optic nerve. The pathologic process may thus be similar or identical to lacunar infarction of the brain.
Am J Ophthalmol 1979 Dec
PMID:Ischemic optic neuropathy as a possible early complication of vascular hypertension. 51 8

Cold blood with potassium, 34 mEq/L, was compared with cold blood and with a cardioplegic solution. Three groups of 6 dogs had 2 hours of aortic cross-clamp while on total bypass at 28 degrees C with the left ventricle vented. An initial 5-minute coronary perfusion was followed by 2 minutes of perfusion every 15 minutes for the cardioplegic solution (8 degrees C) and every 30 minutes for 3 minutes with cold blood or cold blood with potassium (8 degrees C). Hearts receiving cold blood or cold blood with potassium had topical cardiac hypothermia with crushed ice. Peak systolic pressure, rate of rise of left ventricular pressure, maximum velocity of the contractile element, pressure volume curves, coronary flow, coronary flow distribution, and myocardial uptake of oxygen, lactate, and pyruvate were measured prior to ischemia and 30 minutes after restoration of coronary flow. Myocardial creatine phosphate (CP), adenosine triphosphate (ATP), and adenosine diphosphate (ADP) were determined at the end of ischemia and after recovery. Changes in coronary flow, coronary flow distribution, and myocardial uptake of oxygen and pyruvate were not significant. Peak systolic pressure and lactate uptake declined significantly for hearts perfused with cold blood but not those with cold blood with potassium. ATP and ADP were lowest in hearts perfused with cardioplegic solution, and CP and ATP did not return to control in any group. Heart water increased with the use of cold blood and cardioplegic solution. Myocardial protection with cold blood with potassium and topical hypothermia has some advantages over cold blood and cardioplegic solution.
Ann Thorac Surg 1979 Dec
PMID:Cold blood as the vehicle for potassium cardioplegia. 51 80

Peculiarities of collateral circulation following isolated and combined ligations of the femoral vessels were studied in experiments on 62 dogs through physiologic and anatomic investigation methods. It has been shown that the ligation of the vein prevents the exsanguination of the limb, arising from an injury to the main artery, favours an accelerated anatomic reconstruction of the arterial collaterals, but increases microcirculatory disturbances, aggravates tissue ischemia and disorder of the acid-base balance, which as a whole evidences a detrimental effect of concomitant venous insufficiency upon the process of the restoration of the circulation in the limb.
Vestn Khir Im I I Grek 1979 Dec
PMID:[Anatomical and physiological assessment of the collateral circulation in experimental femoral artery ligation in venous insufficiency]. 52 87

The effect of two dopaminergic agonists (apomorphine and bromocriptine) on electrical activity and oxygen supply of the brain was investigated in cats submitted to hypovolemic oligemia (mean arterial blood pressure: 45 mmHg). While both drugs stimulated the brain by prolonging the oligemia-induced seizures in the caudate nucleus and in the cerebral cortex, only apomorphine improved the pO2 distribution in the cortical tissue after 120 min oligemia. Bromocriptine, in contrast, had a beneficial effect of shorter duration. These data show that under conditions of incomplete ischemia the brain can still be activated. Furthermore, these results provide additional support for the biochemically founded hypothesis of different dopamine receptors in the brain.
Eur J Pharmacol 1979 Dec 07
PMID:Dopaminergic agonists and their influence on the oxygenation and function activity of underperfused brain tissue. 52 54

A total of 289 carotid endarterectomies were performed in 204 patients. A decision to place a temporary shunt during carotid endarterectomy in this series was made entirely on the basis of intraoperative EEG monitoring. Retrospectively, the correlation between stump pressures and the results of intraoperative EEG monitoring in each case was determined. Evidence of ischemia developed in 6% of the total series on intraoperative EEG monitoring despite a stump pressure of greater than 50 mm Hg. The degree of disagreement between stump pressure and EEG varied according to clinical category in this series. In those endarterectomies performed for completed stroke, all cases requiring shunting had stump pressures less than 50 mm Hg. In those cases performed for symptoms of vertebral basilar insufficiency, however, 77% of the cases requiring an intraoperative shunt had stump pressures greater than 50 mm Hg. A review of the complication rate in the various study groups indicates that the use of intraoperative EEG is a safe indicator of cerebral ischemia during carotid endarterectomy regardless of stump pressure.
Arch Surg 1979 Dec
PMID:Failure of carotid stump pressures. Its incidence as a predictor for a temporary shunt during carotid endarterectomy. 53 56

We measured ventilatory responses to CO2 (delta VI/delta PCO2) and transient hypoxia (delta VI/delta SaO2) during reductions of brain blood flow (BBF) to 70% and 50% of control in unanesthetized goats. Increase in inspiratory volume per change in CO2 tension (delta VI/delta PCO2) was measured during rebreathing with sampling of both arterial and cerebral venous blood; increase in inspiratory volume per fall in arterial oxygen saturation (delta VI/delta SaO2) was assessed by the transient N2 inhalation method. Delta VI/delta SaO2 did not significantly change at 70% BBF, but was depressed at 50% BBF. Delta VI/delta PCO2 increased (0.94 +/- 0.18 to 1.29 +/- 0.24 l . min-1 . Torr-1) at 70% BBF if arterial CO2 tension were used to represent the CO2 stimulus but was unchanged if venous CO2 tension were used. At 50% BBF, delta VI/delta PCO2 was depressed (0.38 +/- 0.13 l . min-1 . Torr-1) for both representations of the CO2 stimulus. Brain ischemia increased blood pressure and heart rate but blunted the increase in BBF caused by hypercapnia. We conclude that 1) moderate brain ischemia (70% BBF) does not affect chemosensitivity to hypoxia and CO2, 2) delta VI/delta PCO2 may not be accurately determined from PaCO2 during brain ischemia because cerebrovascular reactivity to CO2 is depressed, and 3) severe brain ischemia (50% BBF) blunts delta VI/delta SaO2 and delta VI/delta PCO2, probably as a consequence of hypoxic depression of the respiratory neurons.
J Appl Physiol Respir Environ Exerc Physiol 1979 Dec
PMID:Effects of graded reduction of brain blood flow on chemical control of breathing. 53


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