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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The mechanism by which atherosclerotic plaque causes stroke and transient ischemic attack is not fully understood. One possibility is that the plaque stenosis may set up hemodynamic conditions causing local arterial wall collapse. Arterial wall collapse may, in turn, affect the integrity of the plaque. This study was designed to define the effects of stenosis on the production of arterial wall collapse using a latex tube model. Stenoses ranging up to 81% by diameter were tested in a Starling resistor chamber under pulsatile pressure conditions upstream of the tube. Increasing the degree of stenosis progressively decreased the external pressure necessary to produce collapse, from 37 mm Hg with the 0% stenosis to 24 mm Hg for the 81% stenosis. The stenoses greater than 70% produced a new phenomenon of "systolic wall collapse" just distal to the stenosis. The maximum diameter decrease was 2.83 mm from the baseline diameter of 6.41 mm. Cyclic wall motion just downstream of the stenosis increased with the increased degree of stenosis from 0.34 mm at 0% stenosis to -1.28 mm at 75% stenosis. The phenomena are discussed in terms of simplified Bernoulli pressure drops. We conclude that local arterial stenosis can produce conditions favorable for wall collapse and increased wall motion at physiologic pressure and flow. This collapse may be important in the development of atherosclerotic plaque fracture and subsequent thrombosis or distal embolization.
Arteriosclerosis
PMID:Effect of stenosis on wall motion. A possible mechanism of stroke and transient ischemic attack. 259 63

Since March 1986, coronary artery bypass grafting (CABG) by utilizing the right gastroepiploic artery (GEA) has been performed in 60 patients during 3 year period. There were 52 males and 8 females, and age ranged from 34 to 73 year old with the mean of 56.2 year old. Triple vessel disease and the left main disease involved 90% of the patients. There were two patients under hemodialysis for chronic renal failure, one patient with idiopathic thrombocytopenic purpura, one patient with aneurysm of the abdominal aorta, and two patients with arteriosclerosis obliterance, preoperatively. Five patients were second CABG. GEA was used as an in-situ graft in 57 patients and as a free graft in 3 patients and was anastomosed to 3 left anterior descending, 3 diagonal (all "free" graft), 5 circumflex, and 49 right coronary arteries. To bypass the other coronary arteries, the internal mammary artery graft (unilateral 38, bilateral 20, sequential 5) with or without saphenous vein graft was used. The mean number of distal anastomoses was 3.3 (1-5) and the mean number of arterial graft anastomoses was 2.4 (1-4) per patient with the mean aortic cross clamp time of 62.4 minutes (23-137 minutes) and the mean cardiopulmonary bypass time of 120.8 minutes (69-210 minutes). Splenectomy, Y graft replacement of the abdominal aorta, and ascending aorta-bifemoral bypass were concomitantly carried out in each one patient. Two patients (3.3%) died of renal and cardiac failure within 30 postoperative days. One patient (1.7%) died of stroke lately. New Q wave was noted in 2 patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Coronary artery bypass grafting using gastroepiploic artery]. 260 5

The first population-based incident case-control study of temporal arteritis (TA) in the US was conducted using the unique data resources of the Rochester Epidemiology Project. During the period 1950-1985, 88 newly diagnosed cases of biopsy-proven TA were identified among residents of Olmsted County, Minnesota. Cases were each matched to four Olmsted County community controls on age, sex and duration of community medical record. Odds ratios (OR) were calculated for marital status, education, Quetelet index, pregnancy, age at menopause, thyroid disease, diabetes, smoking, hypertension, angina, myocardial infarction, peripheral vascular disease, and stroke. Multivariable conditional logistic regression analysis identified statistically significant adjusted OR for smoking (2.3, 95% CI = 1.3-4.1). Elevated ORs which were not statistically significant were noted for angina, myocardial infarction, and peripheral vascular disease. These data suggest that TA and arteriosclerosis may share a common causal pathway. Alternatively, histopathological misclassification of temporal artery biopsies may have resulted in the observed association. Due to the limited power of this population-based study, multicentre collaboration should be encouraged to more precisely define the epidemiology of TA.
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PMID:A population-based case-control study of temporal arteritis: evidence for an association between temporal arteritis and degenerative vascular disease? 262 Oct 19

We adapted a highly sensitive and reproducible ELISA technique for the determination of anti-elastin peptide antibodies of IgG type AEAb-IgG) and IgM type AEAb-IgM) in human sera. The determination was performed in the sera of 265 normal and diseased persons. The pathologies studied included obliterative arteriosclerosis of the legs, ischemic heart disease, stroke, diabetes mellitus, type IIb and IV hyperlipoproteinemia and hypertension. No clearcut correlation could be found between AEAb and age. In contrast, in arteriosclerotic patients and especially in obliterative arteriosclerosis of the legs and ischemic heart disease, the concentration of AEAb-IgG was significantly increased. The AEAb-IgM showed no change in the studied diseases. Both types of AEAb were decreased in type IV hyperlipoproteinemia. Anti-elastin antibodies may be involved in the pathomechanisms of the above diseases and the determination of antibody concentrations may be of some help in obliterative arteriosclerotic diseases.
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PMID:Determination of anti-elastin peptide antibodies in normal and arteriosclerotic human sera by ELISA. 264 31

Impaired glucose tolerance (IGT) constitutes two-thirds of all glucose intolerance in the United States and is a major risk factor for diabetes. Despite these findings, the clinical and epidemiological significance of IGT has not been well investigated. The Second National Health and Nutrition Examination Survey, a cross-sectional study in which 75-g 2-h oral glucose tolerance tests (OGTTs) were performed, has provided an opportunity to examine the characteristics of IGT in the U.S. population. Data from the survey have been extrapolated to represent all U.S. residents. The findings indicate that approximately 11.2% of Americans aged 20-74 yr have IGT compared to 6.6% with diabetes. Rates of IGT increased with age for White men and women and Black men but declined for Black women greater than 54 yr of age, possibly because greater obesity in Black women precipitated earlier conversion of IGT to diabetes. The distribution of 2-h glucose values showed IGT to be part of a continuum of glucose intolerance extending from normal to diabetes. Individuals with IGT had rates of risk factors for non-insulin-dependent diabetes (age, plasma glucose, past obesity, family history of diabetes, physical inactivity) that were intermediate between those of individuals with normal glucose tolerance and those with diabetes, although current obesity was similar for IGT and diabetes. The proportion of people with medical histories of diabetes-related conditions did not differ between IGT and normal glucose tolerance. However, several cardiovascular findings were more prevalent in individuals with IGT than in those with normal glucose tolerance, including hypertension, serum cholesterol, angina, abnormal heart findings, and medical history of arteriosclerosis and stroke. Both obesity and reported family history of diabetes were associated with higher rates of IGT, with the effect of weight gain on the prevalence of IGT occurring at lower levels than for diabetes.
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PMID:Impaired glucose tolerance in the U.S. population. 275 51

Simultaneous recordings of impedance cardiography of the chest and impedance plethysmography of the lower extremity were performed on 105 limbs with or without arteriosclerosis obliterans (ASO) documented by angiography. The ratios of blood flow to the lower extremity--leg stroke volume/cardiac stroke volume--(LSV/CSV) were 11.2 +/- 3.3% in normal male subjects, 11.1 +/- 5.5% in normal female subjects, and 3.1 +/- 1.2% in lower extremities with ASO, respectively. The normal value (range) for LSV/CSV calculated from the normal groups by the percentile method was between 4.9% and 17.8%, and the diagnostic accuracy of this value was 100% for sensitivity and 97.5% for specificity. LSV/CSV is a good index for the diagnosis of ASO and makes it possible to minimize error when expressed as an absolute value.
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PMID:Diagnosis of arteriosclerosis obliterans by impedance technique with special reference to relative blood flow of the lower extremity. 276 7

20 cases with homolateral ataxic hemiparesis caused by stroke were reported in this article. The main clinical manifestations were: 1. Only mild motor weakness could be found, lower limb was more severe than upper arm for most of the patients; 2. There was a definite cerebellar ataxia which was out of proportion to the mild degree of weakness; 3. The incidence of facial palsy was more frequent than tongue palsy; 4. Most of these patients had heminumbness of the limb. According to the finding of CT, the localization was in the outside of the body of lateral ventricle for 8 cases; in the posterior limb of internal capsule and superior portion of it for 3 cases; in the ventral portion of pons for 1 case and superior portion of anterior limb of internal capsule for 1 case. The main cause of this disease was hypertensive arteriosclerosis, and the prognosis of these patients was benign.
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PMID:[Homolateral ataxic hemiparesis]. 280 80

The prevalence of atherosclerotic vascular disease (ASVD) and its risk factors were investigated in 263 insulin-treated diabetic patients, ages 45 to 64 years, who were older than 30 years when their diabetes was diagnosed. The patients were divided into two groups based on the degree of endogenous insulin secretion capacity: Group A: glucagon-stimulated plasma C-peptide less than 0.20 nmol/l and Group B: C-peptide greater than or equal to 0.20 nmol/l. The age-adjusted prevalence of definite myocardial infarction was significantly higher in Group B than in Group A (16.8% vs. 5.2%, p less than 0.01). A similar difference between Groups A and B was found for definite or possible coronary heart disease (54.6% vs. 32.9%, p less than 0.001) and stroke (9.3% vs. 2.0%, p less than 0.05). In multivariate analysis, high glucagon-stimulated plasma C-peptide level (greater than or equal to 0.20 nmol/l) was positively associated with definite or possible coronary heart disease independently of other cardiovascular risk factors. Our results indicate that among insulin-treated patients with a late onset of diabetes, the prevalence of ASVD is markedly higher in those with persistent endogenous insulin secretion (noninsulin-dependent diabetes) than in those with low or no insulin secretion (insulin-dependent diabetes).
Arteriosclerosis
PMID:Atherosclerotic vascular disease in middle-aged, insulin-treated, diabetic patients. Association with endogenous insulin secretion capacity. 328 22

In order to further investigate the role of the immune system in the arteriosclerotic process, we investigated the anti-elastin peptide antibodies (AEAb) of the IgG and IgM types by DOT immunobinding assay in the sera of patients suffering from various arteriosclerotic diseases. In total 232 control and pathological sera were studied. In obliterative arteriosclerosis of the legs 90%, ischemic heart disease 67% and hypertension 60% of sera were positive for AEAb of the IgG type independent of age. In the case of diabetes mellitus, however, the duration of the disease was determinant. In rheumatoid arthritis, the results were negative. No clear-cut positivity could be demonstrated in stroke patients either. These results indicate that AEAb can be detected in some diseases and DOT appears to be an appropriate method for the AEAb screening in various diseases.
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PMID:Immunology of elastin: study of anti-elastin peptide antibodies by DOT immunobinding assay. 331 75

The presented material comprised 17 cases observed in four Warsaw hospitals in a period of 20 years. Nine patients with the pseudotumour syndrome were diagnosed correctly and referred to neurosurgical services. The remaining eight cases died in neurological hospital departments with the following clinical diagnoses: cerebral stroke 3, subarachnoid haemorrhage 1, comatose state preceded by dementia 1, chronic meningoencephalitis 1, status epilepticus 2 cases postmortem investigations demonstrated cerebral cysticercosis in all cases. In four patients with predominant symptoms of cerebrovascular disease lesions were found of the type of residual vasculitis cysticercosa, the sequelae of which might have caused secondary complications independent of concomitant arteriosclerosis. Dementia appeared in a patient with huge hydrocephalus consequent to numerous cysticerci. The patient with the diagnosis of meningoencephalitis had an inflammatory reaction of the ependyma and meninges caused by a cysticercus floating in the IV ventricle. Of the patients dying in status epilepticus attention is called to a 6-year-old girl with a solitary cysticercus localised subcortically in the motor area. The authors suggest that the possibility of cysticercosis should be kept in mind, despite its rarity, in cases with a not completely clear clinical manifestations of cerebrovascular disease, chronic meningoencephalitis and epilepsy or dementia.
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PMID:[Neuropathologic analysis of 8 undiagnosed cases of cerebral cysticercosis]. 344 11


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