Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0022116 (ischemia)
 91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The changes in local cerebral glucose utilization (LCGU) following a fluid-percussion injury were studied in 23 rats using the 2-deoxyglucose (2-DG) technique in order to determine the critical period for neuronal damage. Three rats were used as controls. All the rats received a moderate impact of 4.8-5.6 atm from a fluid-percussion device using the University of California, San Francisco, method. LCGU was studied at 15, 30, 45, 60, and 120 min and 24 hours after injury. The optical density on autoradiographs was measured at the site of the brain contusion, in the rim around the contused brain, and in the bilateral cerebral cortex, hippocampus, and thalamus. Decreased 2-DG uptake was observed in the contused brain. However, increased 2-DG uptake was seen in the rim around the contused brain from 15-60 min after injury. The changes in 2-DG uptake noted in this study were very similar to those caused by permanent focal ischemia in a previous study, which suggests that the pathophysiologic phenomena occurring after fluid-percussion injury in the rat brain are based on ischemic changes.
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PMID:[A study on local cerebral glucose utilization in the acute phase of experimental head injury in rat]. 837 Jul 14

Donor-recipient histocompatibility, as evaluated by the HLA matching results, plays an important role in the outcome of renal transplants, although much controversy surrounds the benefit of kidney allocation based on HLA typing. In this report HLA matching and survival data on 1,342 transplants performed at the University of California at San Francisco between 1984 and 1992 and treated uniformly by quadruple immunosuppression were analyzed in relation to the recipient's age. With respect to the influence of the increasing number of mismatches from 0 to 6, the analysis revealed decreasing 3-year graft survival rates as follows: 85.4%; 87.3%; 71.3%; 78.2%; 75.8%; 70.9% and 67.5%. Whereas the impact of cold ischemia time and histocompatibility was equally important during the 3-year postoperative period, the essential positive influence of good HLA matching on the long-term graft survival was demonstrated. The children aged between 5 and 18 years were identified as a high-risk group by the analysis, HLA-A incompatibility being attributed to poor graft survival in this age group. With respect to the effect of HLA-A histoincompatibility, the data provide evidence that HLA-A matching results seem to play an important role in graft survival in children, whereas transplants well matched in terms of HLA-B did well in adult recipients. No age difference in the impact of HLA-DR could be detected. In conclusion, HLA matching is still essential. It seems that there are differences in the impact of HLA loci in relation to the recipient's age.
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PMID:[Effect of HLA compatibility on the transplanted kidney in relation to recipient age]. 865 Aug 46

Arbutamine (Gensia, Inc., San Diego, CA) is a newly-developed sympathomimetic agent specifically designed for cardiovascular stress testing. It has been successfully used for the detection of coronary artery disease in conjunction with electrocardiography, echocardiographic and radionuclide techniques. Arbutamine increases heart rate and contractility, thus provoking ischaemia in a manner analogous to that of physical exercise. Ischaemia becomes manifest by reproduction of typical angina, diagnostic electrocardiographic changes, the development of a wall motion abnormality on two-dimensional echocardiography or of a perfusion defect on thallium scintigraphy. Thus far in clinical trials it has shown an acceptable side-effect profile and a level of diagnostic accuracy for the detection of patients with coronary disease equivalent to or exceeding that seen with physical exercise.
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PMID:Clinical and diagnostic utility of arbutamine for cardiovascular stress testing during echocardiographic monitoring. 886 20

The causes of perioperative ischemia and myocardial infarction (MI) in coronary artery bypass graft (CABG) patients are almost certainly multifactorial, although not well understood. Ultimately, outcome after CABG is dependent on myocardial preservation and prevention of further myocardial ischemia. The largest number of ST-T-wave events come immediately after protamine is given, suggesting that re-establishment of coagulation function after cardiopulmonary bypass (CPB) may be an important event. CPB induces an inflammatory state that involves platelet-endothelial-cell interactions and vasospastic responses that result in low flow states in the coronary vasculature. The fibrinolytic system is activated during CPB, with raised tissue plasminogen activator (tPA) levels and related falls in plasminogen activator inhibitor (PAI-1). PAI-1 levels rise during the postoperative period. There is a huge variability in human response. However, the patients with the highest tPA surge are not the same patients who have the highest PAI surge. It could be postulated that patients with high PAI-1 levels are at highest risk for early ischemia. New data just being evaluated from the Multicenter Study of Perioperative Ischemia (McSPI) Research Groups' database in San Francisco may support the hypothesis that coagulation influences perioperative ischemia. The study of approximately 2,400 patients undergoing CABG surgery at 24 major institutions in the United States revealed that intensive care unit (ICU) entry hematocrit was significantly related to the risk for postoperative MI. Patients entering the ICU with hematocrits below 24% had the lowest MI rate (3.7%), whereas those with hematocrits greater than 34% had the highest rate (8.1%). Patients with ICU entry hematocrits below 18% had a zero incidence of perioperative MI. One possible explanation for these findings is that platelets are involved. As red cells stream down vessels, they marginate the smaller formed elements of the blood. As hematocrit is increased, the number of platelets moved to the outer sides of the vessels increases. Therefore, the number of endothelial-platelet interactions would increase over time with higher hematocrits.
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PMID:Ischemia--a coagulation problem? 893 82

Sheng-Mai-San (SMS), a traditional Chinese formulation used for the treatment of coronary heart disease, is comprised of Radix Ginseng, Fructus Schisandrae and Radix Ophiopogonis. Pretreatment with a lignan-enriched SMS (17 g/kg/day x 3, p.o.) was found effective in protection against isoproterenol-induced myocardial injury in rats, and in ischemia-reperfusion injury in isolated perfused hearts prepared from pretreated animals. Results obtained from pretreatment studies using extracts prepared by mixing various combinations of the three component herbs indicate that the major myocardial protective component in SMS is the lignan-enriched extract of Fructus Schisandrae.
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PMID:Schisandra chinensis-dependent myocardial protective action of sheng-mai-san in rats. 898 37

The protective activity of Shengmai San, a traditional Chinese herbal medicine, was studied in cerebral ischemia-reperfusion injury in rats. Shengmai San consists of three herbal components, Panax Ginseng, Ophiopogon Japonicus and Schisandra Chinensis and is routinely being used for treating coronary heart disease. When Shengmai San was injected directly into rat duodenum 2h before cerebral ischemia by bilateral carotid artery occlusion, thiobarbituric acid reactive substance (TBARS) formation during reperfusion following ischemia was almost completely suppressed in the brain. The loss of glutathione peroxidase activity after the ischemia-reperfusion was also effectively prevented by the Shengmai San pre-administration whereas the activity was considerably decreased in the damaged brain. It was found that Shengmai San also effectively suppressed the TBARS formation even when it was administered after 45 min reperfusion following ischemia, indicating that Shengmai San improves the oxidative damage already established in the brain. Likewise, the decrease of glutathione peroxidase activity was minimized in the damaged brain by the post-administration of Shengmai San. On the other hand, none of the Shengmai San components were active in protecting the ischemia-reperfusion brain damage when they were independently administered. These experiments suggest the potential of Shengmai San in both preventive and therapeutic usages for cerebral ischemia-reperfusion injury.
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PMID:Prevention and repair of cerebral ischemia-reperfusion injury by Chinese herbal medicine, shengmai san, in rats. 1054 89

Clinical experience suggests that patients treated with the glycoprotein (GP) IIb/IIIa inhibitor abciximab (ReoPro , Eli Lilly and Company, Indianapolis, Indiana) may be at increased risk of thrombocytopenia. This case report details the successful use of the GP IIb/IIIa inhibitor eptifibatide (Integrilin , COR Therapeutics, South San Francisco, California) in a patient who developed acute thrombocytopenia (platelet count: 67,000/mm3) approximately 10 hours after initiation of abciximab therapy. Five hours after abciximab was discontinued, platelet count returned to normal (191,000/mm3) and eptifibatide was started because of persistent electrocardiographic evidence of ischemia. The patient underwent diagnostic catheterization during eptifibatide therapy, which was administered for approximately three days. Four days after the initial course of therapy with eptifibatide was discontinued, percutaneous revascularization with adjunct eptifibatide was performed. During both courses of eptifibatide therapy, platelet counts remained in the normal range (> 100,000/mm3) and no adverse ischemic or bleeding events occurred.
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PMID:Platelet receptor glycoprotein IIb/IIIa inhibition with eptifibatide in a patient with thrombocytopenia after treatment with abciximab. 1102 16

It has been hypothesized that some cases of sudden infant death syndrome (SIDS) are a result of neck extension and/or rotation that causes vertebral artery (VA) compression and brain stem ischemia. There is a paucity of relevant literature on this topic. Therefore, our aim was to compare neck rotation and extension in SIDS and other natural infant deaths. Cases of SIDS and other natural infant deaths within the San Diego SIDS Research Project database were analyzed retrospectively with respect to neck and body position as reported by the trained, experienced scene investigators and/or the caretakers who discovered the infants. Information was used from 246 SIDS cases and 56 cases of other natural deaths. Simultaneous neck extension and rotation was not reported in either group. When data regarding neutral/flexed/extended position and rotation of the neck were combined, no significant differences were found between the two groups (P = 0.94); 40% of the SIDS cases and 41% of the other natural death cases were found with the neck either extended or rotated (odds ratio [OR] 0.97, [reference group = neck either neutral or flexed, and not rotated], 95% confidence interval [CI] 0.45, 2.11). There were also no significant differences between the groups when neck rotation and neck extension were analyzed independent of one another. Neck rotation among cases found in the prone position was common and was not significantly different between the two groups (49% of 146 SIDS cases, 58% of 24 other natural death cases, P = 0.38, OR 0.68, 95% CI 0.28, 1.62). Neck rotation among infants found in the supine position occurred one-third as often in the SIDS group (9% of 33 cases) as in the other natural death group (29% of 14 cases); however, the difference was not significant (P = 0.17; OR 0.25, 95% CI 0.05, 1.31). Although our analysis does not exclude VA compression and brain stem ischemia in some cases of SIDS, we found no evidence to affirm its importance. This study demonstrates the importance of meticulous scene descriptions, including neck position.
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PMID:Neck extension and rotation in sudden infant death syndrome and other natural infant deaths. 1117 31

The electrocardiogram continues to be the gold standard for the diagnosis of cardiac arrhythmias and acute myocardial ischemia. The treatment of arrhythmias in critical care units has become less aggressive during the past decade because research indicates that antiarrhythmic agents can be proarrhythmic, causing malignant ventricular arrhythmias such as torsade de pointes. However, during the same period, the treatment of acute myocardial ischemia has become more aggressive, with the goal of preventing or interrupting myocardial infarction by using new antithrombotic and antiplatelet agents and percutaneous coronary interventions. For this reason, critical care nurses should learn how to use ST-segment monitoring to detect acute ischemia, which is often asymptomatic, in patients with acute coronary syndromes. Because the electrocardiographic lead must be facing the localized ischemic zone of the heart to depict the telltale signs of ST-segment deviation, the challenge is to find ways to monitor patients continuously for ischemia without using an excessive number of electrodes and lead wires. The current trend is to use reduced lead set configurations in which 5 or 6 electrodes, placed at convenient places on the chest, are used to construct a full 12-lead electrocardiogram. Nurse scientists at the University of California, San Francisco, School of Nursing are at the forefront in developing and assessing the diagnostic accuracy of these reduced lead set electrocardiograms.
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PMID:Celebrating the 100th birthday of the electrocardiogram: lessons learned from research in cardiac monitoring. 1210 39

The preventive effects of Shengmai San (SMS), a traditional Chinese herbal medicine (TCM), was studied on cerebral ischemia-reperfusion injury in rats as a model of antioxidant-based composite therapy. Two biochemical indicators of oxidative damage, thiobarbituric acid reactive substance (TBARS) formation and glutathione peroxidase (GPX) loss were measured in the brain after forebrain ischemia-reperfusion treatment and both were inhibited in all rats administered SMS (15 g original herbs/kg) 2 h before the ischemia-reperfusion. Histochemical study of the brain slice using TTC staining revealed that the SMS effectively reduced infarct area caused by the cerebral ischemia-reperfusion. The antioxidant potentials of SMS preparations were determined in vitro by five different assay methods and were related to the in vivo effectiveness of SMS in protection against brain damage. Inhibitory effect on TBARS formation in vivo showed better correlation with superoxide radical scavenging and DPPH quenching activity in vitro rather than with the other in vitro antioxidant indicators. On the other hand, the in vivo prevention of GPX activity loss showed better correlation with in vitro crocin bleaching inhibition than with the other in vitro antioxidant indicators. It was also suggested that the in vitro TBARS inhibitory activty of SMS is not a good indication to predict the in vivo effectiveness of SMS on inhibition of either TBARS formation or GPX activity loss.
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PMID:In vitro antioxidant potentials of traditional Chinese medicine, Shengmai San and their relation to in vivo protective effect on cerebral oxidative damage in rats. 1213 65


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