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Query: UMLS:C0022116 (
ischemia
)
91,303
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Hemorrhage to a mean arterial pressure of 41 mm. Hg in ten dogs decreased Heidenhain pouch blood flow to 6 ml. per minute and aminopyrine clearance to 0.93 ml. per minute. Pouch oxygen consumption fell from 1.47 to 0.74 ml./min.-100 Gm. and total body oxygen consumption remained unchanged.
Net
ion fluxes during shock and reinfusion did not change significantly from control values of minus 89.8 muGq./30 min.-100 cm.-2 for H-+ and 88.6 muEq./30 min.-100 cm-2 for Na-+. However, PD decreased from 54 to 24 mv. in parallel with a fall in net Cl-minus flux from 56.8 to minus 11.7 muEq./30 min.-100 cm-2. Nine of ten pouches subjected to shock and instilled acid test solution (ATS) developed superficial mucosal erosions. No ulcerations were found in either seven control dogs (anesthesia + ATS) or in three dogs subjected to shock without ATS. Acid appears to be of prime importance in the production of stress ulcers during or following
ischemia
, even though there is no increase in mucosal ionic permeability.
...
PMID:The role of acid and ischemia in production of stress ulcers during canine hemorrhagic shock. 23 95
Fifteen patients were studied to detect unrecognized intraoperative
ischemia
or necrosis in perioperative myocardial infarction (MI) associated with coronary bypass. Simultaneous arterial and coronary sinus blood samples were analyzed for lactate and both total and MB-CPK. Coronary sinus flow measurements were done coincident with sampling in seven patients. Five had perioperative MI diagnosed by positive pyrophosphate scan and electrocardiogram. Although normal initially (mean 19 +/- 5.0%), lactate extraction after thoracotomy, before aortic cross-clamping, became abnormal in 12 patients with more pronounced abnormality in those with perioperative MI (-19 +/- 9.0%).
Net
efflux of lactate was higher in perioperative MI (mean 0.6 +/- 0.2 vs 0.016 +/- 0.04 mM/L) than in non-MI patients. All patients had detectable total and MB-CPK (mean 295 and 31 IU/L, respectively) and all those with coronary disease had a positive arterial-coronary sinus gradient for MB-CPK (mean 9 IU/L). Perioperative MI patients had a higher gradient than non-MI patients (mean 25 vs 2 IU/L) and with one exception that gradient exceeded 5-7 IU/L. It is concluded that severe
ischemia
before aortic cross-clamping precedes perioperative MI and may contribute to release of CPK into coronary sinus blood. Improvement in the techniques of anesthesia and intraoperative myocardial preservation are suggested.
...
PMID:Coronary sinus blood flow and sampling for detection of unrecognized myocardial ischemia and injury. 30 99
In normal rats, muscle is the major glutamine releasing organ and gut is the major glutamine consuming organ. It has been suggested that enhanced muscle ammonia detoxification and gut ammonia production occurs during liver insufficiency-induced hyperammonemia. Therefore, ammonia and amino acid fluxes across portal-drained viscera and hindquarter, and muscle concentrations were measured in portacaval shunted and acute liver
ischemia
rats. Arterial ammonia and most amino acids were increased after portacaval shunting and increased progressively during liver
ischemia
, but net hindquarter ammonia uptake was not observed.
Net
hindquarter glutamine efflux was increased during portacaval shunting, but it decreased during liver
ischemia
, while muscle glutamine concentrations increased. The comparable net portal drained viscera glutamine uptake in normal and portacaval shunted rats changed during liver
ischemia
from net uptake to release, coinciding with release of most other amino acids. These results cast doubt on the ammonia detoxifying role of muscle during acute liver
ischemia
-induced hyperammonemia in the rat. The portal drained viscera glutamine release during severe hyperammonemia could be due to intestinal damage.
...
PMID:Altered glutamine metabolism in rat portal drained viscera and hindquarter during hyperammonemia. 134 32
Studies were conducted in extracorporeally perfused, intact, working pig hearts to determine whether, in heart muscle, trace-labeled deoxyglucose serves as an accurate marker of glycolytic flux in reperfusion after exposures to mild to moderate regional
ischemia
. In the main study, two groups of hearts were compared, as distinguished by levels of glucose in the whole-blood perfusate (euglycemic hearts [group I], blood glucose of 7.4 +/- 0.2 mumol/ml, n = 7; hyperglycemic hearts [group II], blood glucose of 12.9 +/- 0.5 mumol/ml, n = 8). Both groups were subjected to a 60% reduction in anterior descending coronary flow for 30 minutes followed by reperfusion for 40 minutes. Modest and comparable regional mechanical stunning during reflow was noted in both groups. Glucose utilization, as estimated from the release of 3H2O from the steady-state infusion of [5-3H]glucose during aerobic perfusion, was modest but during reperfusion was noted to increase significantly above aerobic values in each of the two groups, with a doubling of rates in group II hearts compared with group I hearts (p less than 0.041 or p less than 0.090).
Net
lactate extraction was comparable in reflow in both groups, suggesting in this specific instance a preferential enhancement of glucose oxidation in hyperglycemic group II hearts. Shifts in accumulation of tissue radioactivity of [U-14C]2-deoxyglucose in reperfused myocardium were not able to track these trends. The variability of 14C-labeled radioactivity among animals was marked and essentially masked any ability to discern trends in glycolysis as described by tritiated glucose between the aerobic and reperfusion intervals. When the data were arrayed by linear regression analysis, the slopes derived from 14C-labeled deoxyglucose were either discordant or insensitive to those described by 3H-labeled glucose. Tissue glycogen levels were slow to recover in early reflow and at end reperfusion were still significantly depressed from aerobic levels. The present data indicate that coronary reperfusion and hyperglycemia have influence in determining glycolytic flux in myocardium. Labeled deoxyglucose, considered solely as a marker of exogenous glucose utilization, appears to be an insensitive agent in describing these events at conditions of relatively low glucose flux.
...
PMID:Correlation between [5-3H]glucose and [U-14C]deoxyglucose as markers of glycolysis in reperfused myocardium. 149 11
Effects of no-flow
ischemia
(NFI) and reperfusion (RPF) on myocardial extraction and retention of technetium-99m hexakis(2-methoxyisobutylisonitrile) (sestamibi) and thallium-201 were investigated in 12 isolated, blood-perfused rabbit hearts with isotope dilution studies at constant coronary perfusion. After a control injection of tracers, NFI was induced for 30-60 minutes. After coronary reflow, repeat tracer injections were given at early RPF (5-15 minutes of RPF) and late RPF (40-60 minutes of RPF). After NFI-RPF, maximal fractional extraction and capillary permeability-surface area product increased for sestamibi (from +39% to 69%) and decreased for thallium (from -14% to -68%).
Net
extraction was 33% lower for sestamibi than for thallium at control, 13% lower at early RPF, and 90% higher than thallium at late RPF. Interstitial-myocyte exchange estimates were always higher for sestamibi than for thallium and increased for both with NFI-RPF (sestamibi, from 57.4 to 122.4 ml/min/g; thallium, from 3.1 to 22.3 ml/min/g). Intramyocyte volumes of distribution were higher for sestamibi than for thallium (greater than 200% at control, 800-1,000% with RPF), and NFI-RPF had opposite effects on the two tracers (late RPF vs. control: +28% for sestamibi, -50% for thallium). Our results suggest that sestamibi and thallium have different transport or sequestering mechanisms and that NFI-RPF had opposite effects on myocardial capillary-tissue exchange and tissue retention of sestamibi and thallium. Therefore, myocardial perfusion might be overestimated with sestamibi and underestimated with thallium during early RPF.
...
PMID:Myocardial transport of hexakis(2-methoxyisobutylisonitrile) and thallium before and after coronary reperfusion. 214 May 39
Rupture of plaques followed by thrombosis and thrombo- or atheroembolism mark the clinical horizon of ischemic organ lesions in atherosclerosis. Initiation and development of lesions precede these often dramatic events by decades. Precursor lesions arise within the first, irreversible ones may develop from the second decade of life onwards. Two concurring or succeeding pathogenetic mechanisms dominate: 1. Discrete or functional endothelial injury (in conjunction with hemodynamic wall stresses and effects of endogenous or exogenous toxic factors such as hormones, immune- and other mediators, components of tobacco smoke, etc.) induces increased flow of low density lipoprotein (LDL) into arterial tissue. Immigrating monocytes capture LDL and accumulate its cholesterol as ester droplets becoming foam cells.
Net
flux and accumulation of cholesterol probably correlate with plasmatic LDL-cholesterol levels. 2. Endothelial denudation, also occurring under the influence of mechanical wall stresses and in particular over precursor lesions, incites platelet aggregation and clotting mechanisms. As a consequence, arterial smooth muscle proliferates in the sense of repair of injury, resulting in the formation of scar tissue. Lipid-rich lesions with scanty scars seem to be particularly prone to rupture and thus important complications. Plaque rupture is probably the most common complication leading to ischemic disease, whereby the extent of formation and organisation of thrombi might determine whether infarction or chronic
ischemia
is the outcome.
...
PMID:[Current concepts of the pathogenesis of atherosclerosis]. 259 58
Sodium derived from the blood is known to accumulate in brain tissue during the early stages of incomplete
ischemia
. Our present studies were undertaken to determine the relation between blood-brain barrier sodium transport and the development of ischemic brain edema. Incomplete cerebral ischemia was produced in gerbils by ligation of the left common carotid artery under ether anesthesia. Following recovery from the anesthetic, the gerbis were evaluated for the presence of neurologic symptoms and were divided into symptomatic (n = 77) and asymptomatic (n = 94) groups. Tissue water, sodium, and potassium contents, tissue plasma volume, and brain uptake of 22Na were measured in both groups 1.5, 3, 6, 12, and 24 hours after carotid ligation. There was a progressive accumulation of sodium and water in the ipsilateral cerebral cortex of the symptomatic group compared with either the corresponding contralateral cortex of the same gerbils or with the asymptomatic group.
Net
changes in brain sodium and potassium concentrations appeared to be the main determinants of fluid accumulation. Brain edema was not due to opening of the blood-brain barrier because the unidirectional transport of 22Na remained low and was even reduced by 35-55% in the ischemic cortex. Nevertheless, this sodium transport activity appeared to be rate-limiting in the development of brain edema during the first 3 hours of
ischemia
because the rate of sodium accumulation in the tissue was the same as the rate of 22Na transport from the blood to the brain. We conclude that blood-brain barrier sodium transport is an important factor in the formation of ischemic brain edema.
...
PMID:Blood-brain barrier sodium transport limits development of brain edema during partial ischemia in gerbils. 277 85
With the use of duplex sonography, quantitative vertebral artery flow measurements have been made in 283 patients who had nonlocalizing symptoms of cerebral ischemia suggestive of vertebrobasilar insufficiency.
Net
vertebral artery flow was calculated by adding flows from the right and left sides. When net vertebral flow was greater than 200 ml/min, 89 of 148 patients (60%) were found to have a significant stenosis (greater than 50% diameter reduction) in one or both internal carotid arteries. Conversely, when net flow was less than 200 ml/min, 101 of 135 patients (75%) had normal or only mildly diseased carotid system (p less than 0.001). When compared with otherwise matched groups of asymptomatic patients or patients with lateralizing hemispheric symptoms, those with nonlocalizing symptoms were much more likely to have net flow less than 200 ml/min. For the nonlocalizing symptom group this was 135 of 283 patients (48%) compared with only 72 of 208 asymptomatic patients (35%, p = 0.005) and 110 of 310 patients with hemispheric symptoms (35%, p = 0.003). Duplex sonography appears to offer a noninvasive technique for the functional hemodynamic evaluation of patients with suspected vertebrobasilar insufficiency, with the capability to distinguish those patients whose symptoms may be related to thromboembolic carotid artery disease, true vertebrobasilar
ischemia
, or some other cause.
...
PMID:Vertebrobasilar insufficiency: evaluation by quantitative duplex flow measurements. A preliminary report. 295 31
The role of
ischemia
in the induction of ventricular tachycardia during programmed stimulation was studied in 19 patients who survived a cardiac arrest and were found to have a significant stenosis in at least one branch of the left coronary artery. The arterial-coronary sinus lactate difference was measured during electrophysiologic testing, before the induction of ventricular tachycardia. Ventricular tachycardia was induced in 15 patients; it was sustained and unimorphic in 6 patients and polymorphic in 9. Myocardial ischemia, as reflected by net myocardial lactate production, was present within 60 seconds before the induction of ventricular tachycardia in 8 of the 15 patients with inducible ventricular tachycardia. In 9 of the 15 patients, programmed stimulation was repeated after a 15 minute rest period, with the same coupling intervals that had induced ventricular tachycardia previously.
Net
myocardial lactate production was not present in any patient during this repeat attempt. In three patients without evidence of
ischemia
during the first induction of ventricular tachycardia, the arrhythmia was induced again by the specific coupling intervals that had induced it previously. However, in five of six patients with net myocardial lactate production during the first induction of ventricular tachycardia, the same coupling intervals that had induced the arrhythmia in the presence of
ischemia
no longer induced it in the absence of
ischemia
. The results of this study suggest that myocardial ischemia may be a requirement for the induction of ventricular tachycardia in some patients with coronary artery disease who survive a cardiac arrest.
...
PMID:Role of myocardial ischemia during programmed stimulation in survivors of cardiac arrest with coronary artery disease. 295 99
Pretreatment of the ischemic myocardium with verapamil protects against mitochondrial respiratory depression observed during ischemic arrest as well as during reperfusion. Since ischemic mitochondrial function appears not to be altered further by reperfusion, the purpose of this study is to identify a biochemical event affecting mitochondria that is specifically associated with reperfusion injury. It has been proposed that increased cellular Ca2+ influx and oxygen toxicity may result from reintroduction of coronary flow. Increased cytosolic Ca2+ is transmitted to the mitochondria with subsequent activation of Ca2+-dependent events, including phospholipase A2.
Net
production of lysophospholipids (and loss of total diacylphospholipids from the mitochondria) will proceed when reacylation mechanisms are inhibited. Since acyl-CoA:lysophospholipid acyltransferase is a sulfhydryl-sensitive enzyme and since increased activity of glutathione peroxidase shifts the levels of the mitochondrial sulfhydryl buffer, glutathione, towards oxidation, levels of glutathione and its oxidation state were measured during reperfusion in the absence or presence of verapamil pretreatment.
Ischemia
lowers total glutathione and reduces the redox ratio (reduced glutathione: oxidized glutathione) by 85%. Reperfusion partially returns the redox ratio to control by causing oxidized glutathione to disappear from the matrix. Verapamil maintains both the concentration and the redox potential of glutathione at control levels. Concomitant with alterations in reduced glutathione:oxidized glutathione is a decrease in ischemic mitochondrial phospholipid content. During reperfusion, phosphatidylethanolamine and its major constituent fatty acids (C 18:0 and C 20:4) are specifically lost from the mitochondrial membrane. Accompanying the significant loss of arachidonic acid during reperfusion is the decreased content of 11-OH, 12-OH, and 15-OH arachidonate. These lipid peroxidation products are not increased in
ischemia
. It is proposed that oxidation of matrix glutathione to glutathione disulfide during
ischemia
results in formation of glutathione-protein mixed disulfides and inhibition of sulfhydryl-sensitive proteins, including acyl-CoA lysophosphatide acyltransferase. Thus, metabolic events occurring within the ischemic period set the stage for prolonged dysfunction during reperfusion.
...
PMID:Protection by verapamil of mitochondrial glutathione equilibrium and phospholipid changes during reperfusion of ischemic canine myocardium. 362 93
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