Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Five patients with advanced arteriosclerosis obliterans of the lower extremities, as evidenced by resting pain, ischaemic ulcers, and focal necrosis, received intra-arterial infusions of prostacyclin at doses of 5--10 ng/kg/min for 72 h. Within 2 days of termination of the infusion, pain at rest had disappeared in all patients. In three of the five, the necrosis had completely regressed and the ischaemic ulcers healed within 2 months. The other two patients showed considerable improvement. Prostacyclin therapy was not associated with changes in the radiographic appearance of the major blood-vessels. However, muscle blood-flow, as measured by xenon-133 clearance, was significantly increased both during prostacyclin infusion and for the 6 weeks of measurement after its termination.
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PMID:Successful therapy of advanced arteriosclerosis obliterans with prostacyclin. 8 35

A case of acute thrombosis of the aorta is described; it extended from the superior mesenteric artery to the bifurkation and was probably due to oestrogen medication. The clinical features and diagnosis of this rare condition are described. The condition usually develops against a background of advanced arteriosclerosis and is initiated by certain haemodynamic factors such as intimal damage from blunt trauma, emboli or the thrombogenic effect of oestrogens. The symptoms, such as pain, absent pulses etcetera are the result of ischaemia and depend on the extent of the lesion. A definite radiological diagnosis can only be made by means of aortography, if necessary with oblique projections. The Seldinger technique with a femoral or axillary approach is the method of choice. Aortography shows a filling defect and occasionally a collateral circulation.
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PMID:[Acute aortic thrombosis (author's transl)]. 15 7

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

Reactive and exercise hyperemia were compared in healthy men and in patients with PAD. In both patients and normals the calf blood flow of reactive hyperemia was recorded after a 5-minute ischemia. Exercise hyperemia was measured in normals after variable work loads (30 and 50 kg) and immediately after the occurrence of pain in patients with PAD. In healthy limbs the first and peak flows of exercise and reactive hyperemia are similar. The recovery time for basal flow is prolonged after exercise. However, reactive and exercise hyperemia differ significantly when arterial obstruction due to arteriosclerosis obliterans is present. First flow and peak flow are higher and recovery time more prolonged after exercise. It is also likely that the control mechanisms of the two hyperemic reactions are different. Muscular exercise, when protracted until pain occurs, can produce a metabolic and circulatory adjustment other than that of ischemia. There is experimental evidence to support this hypothesis.
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PMID:Comparison between reactive and exercise hyperemia in normal subjects and patients with peripheral arterial disease. 42 19

O2 and CO2 tensions were measured in the gastrocnemius muscles of patients submitted for reconstructive arterial surgery due to obstructive arteriosclerosis (37) or abdominal aortic aneurysm (5). Four patients without signs of arterial ischaemia served as controls. Measurements were carried out by means of implanted silastic tonometers during breathing of air and 100% O2 and immediately after walking on a treadmill. Peripheral blood pressures in the ankles were recorded with a Doppler apparatus. Baseline tissue gas tensions showed no essential differences between the various groups of patients: intermittent claudication, pain at rest, praegangrene, abdominal aortic aneurysm and controls. In contrast, baseline ankle pressures correlated well with the severity of the disease. During breathing of oxygen, the smallest increases of muscle PO2 were observed in extremities with pain at rest or praegangrene and the highest responses were recorded in controls and aneurysm patients. Muscle PCO2 values showed no alterations during oxygen breathing. In physical exercise, muscle PO2 and PCO2 levels as well as ankle blood pressures remained unchanged in controls and patients with aneurysm but no claudication. However, in all groups with arterial ischaemia, the exercise test resulted in a profound fall of muscle PO2 and ankle blood pressure and an increase of muscle PCO2.
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PMID:Tissue gas tensions in the calf muscles of patients with lower limb arterial ischaemia. 43 76

Chest outlet syndromes are characterized by pain symptomatology caused by (congenital or acquired reasons) compression of the vasculo-nervous bundle. After a brief mention of the anatomy of the question, the indications and angiographic technique are reported, special reference being made to certain positions and dynamic tests which increase symptomatology and highlight arteriographic findings. These are clearly identifiable in the pictures and offer documentary evidence of the cervical rib syndrome, scalenus syndrome, small pectoral syndrome, the hyperabduction syndrome and the costoclavicular syndrome. Differential diagnosis should consider a number of painful syndromes of the upper extremity of purely neurological interest (involvement of the brachial plexus). Vascular diseases such as arteriosclerosis, Takayasu's disease, etc., osteo-myo-articular and ORL sector diseases should also be taken into account. Arteriography is able to identify with precision the causes of the clinical syndrome and to guide surgical exploration of the supraclavicular fossa with excellent chances of success.
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PMID:[Thoracic outlet syndromes. Arteriographic aspects]. 46 May 95

The conservative therapy of the arteriosclerotic obstructive disease demands a complex approach. The basis therapy, the symptomatic treatment of the haemodynamics of the extremity with ill vessels, the pathogenetically oriented therapy as well as the treatment of other localisations of the arteriosclerosis should be used combined. At stage III and IV additional measures, such as combat against pain, therapy with antibiotics and local treatment of tissue lesions are necessary. The results of the therapy should be critically tested not only on the basis of the clinical picture, but also on the basis of the course of the vascular processes.
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PMID:[Conservative treatment of arteriosclerosis obliterans]. 48 43

Sixteen patients with arteriosclerosis and pre-gangrene of a lower limb were treated for 5 days by intravenous injection of Arvin. The effects of the injection on plasma fibrinogen, the viscosity of blood and the patient's symptoms were measured. There was a 90 per cent reduction in plasma fibrinogen and a significant reduction in the viscosity of blood. Five patients experienced some relief of pain during the treatment. In only one patient were the symptoms relieved permanently.
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PMID:A report on the use of Arvin in patients with pre-gangrene of the lower limb. 83 51

Thirty patients with 43 ischaemic limbs were treated by profundal revascularization. 10 patients had impending gangrene preoperatively; the limbs were saved in 8 cases, and four have not had postoperative claudication symptoms. None had postoperative rest pain. In 53% of the whole material the results were evaluated as excellent with no ischaemic symptoms, and in 30% as good with only slight claudication. Profundal revascularization is a valuable method of saving pregangrenous limbs in advanced arteriosclerosis and a worthwhile alternative to femoro-popliteal bypass in suitable cases.
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PMID:The profunda femoris artery in reconstructive vascular surgery. 84 50

In a 27-year-old man blunt chest-wall trauma after a car accident gave rise to several retrosternal pain. Coronary angiography demonstrated severe generalised coronary arteriosclerosis. The history revealed heavy smoking (60 cigarettes daily for ten years). Although it must be assumed that there was severe generalised coronary arteriosclerosis without angina pectoris before the accident, the infarction was considered to be a direct consequence of it: it prematurely precipitated the infarction. In a second case, of a 37-year-old woman, severe precordial pressure and contusion of the thorax occurred after a collision. Cardiac symptoms developed two months later and two weeks after this acute myocardial infarction occurred. Coronary angiography demonstrated isolated sub-total occlusion of the anterior interventricular branch in the upper third of the septum without other abnormalities. Because of the two month symptom-free interval, trauma and subsequent myocardial infarction are thought not to be causally related, especially as the patient was a heavy smoker and taking oral contraceptives.
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PMID:[Myocardial infarction after accidents (author's transl)]. 97 12


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