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Query: UMLS:C0042373 (vascular disease)
 17,070 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Homocysteine is an amino acid considered to cause vascular injury, arteriosclerosis, and thromboembolism. Total plasma homocysteine (free and protein-bound) was found to be twice as high in asymptomatic vitamin B12-deficient subjects (23.8 +/- 3.8 mumol/L, means +/- SEM, n = 20) as in controls (11.5 +/- 0.9 mumol/L, P less than .0001, n = 21), and higher than in heterozygotes for homocystinuria due to cystathionine beta-synthase deficiency (13.8 +/- 1.6 mumol/L, P less than .01, n = 14), who were recently shown to be much more common among patients with premature vascular disease than expected. Eight (40%) vitamin B12-deficient and two (14%) heterozygote subjects had significant homocysteinemia (greater than mean +2 SD for controls). After administration of hydroxycobalamin to vitamin B12-deficient subjects, homocysteine levels decreased to normal (-49%, 12.2 +/- 1.5 mumol/L, P less than .0001, n = 20). Thus, if homocysteine does cause vascular injury, theoretically vitamin B12-deficiency might be associated with an increased frequency of vascular disease.
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PMID:Higher total plasma homocysteine in vitamin B12 deficiency than in heterozygosity for homocystinuria due to cystathionine beta-synthase deficiency. 334 5

Morphological methods, especially scanning electron microscopy, were used in mini-pigs to prove that locally and systemically acting angiopathic stimuli caused an initial adhesion of platelets with altered shape to apparently intact arterial endothelium in a highly reproducible manner. These angiopathy models imitate the risk factors for human arteriosclerosis. Transmission electron microscopic studies, on the other hand, showed very early changes in endothelial and media cells subjected to suitable stimuli. The effective stimuli for angiopathy were local contact of the arteries with ice or epinephrine, the inhalation of cigarette smoke or carbon monoxide, a high-cholesterol diet, renovascular hypertension, and insulin-dependent diabetes. On acting over a longer period these stimuli caused intimal thickening, formation of microparietal thrombi consisting of platelets and fibrin on the endothelium. Within half a year the stimuli led to the formation of lipid-containing plaques of the intima. Several of these stimuli led to increased platelet aggregation. According to these findings we see the decisive mechanism for the pathogenesis of all stenosing, obliterative arteriopathies in a disturbed interaction between vessel wall and arterially circulating blood. Adherence of platelets to the arterial endothelium appears to play a key role in the initial phase of atherogenesis. This concept is supported and augmented by a multitude of partly very recent findings cited in the literature.
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PMID:Ultrastructural findings on platelet depositions in initial atherogenesis. 351 48

Patients with long survival following cervical irradiation are at risk for accelerated carotid atherosclerosis. The neurologic presentation in these patients mimics naturally occurring atheromatous disease, but patients often present at younger ages and with less concurrent coronary or systemic vascular disease. Hypercholesterolemia also contributes to this accelerated arteriosclerosis. Angiographic findings in this disorder include disproportionate involvement of the distal common carotid artery and unusually long carotid lesions. Pathologic findings include destruction of the internal elastic lamina and replacement of the normal intima and media with fibrous tissue. This article describes two surgical patients with radiation-induced accelerated carotid atherosclerosis who typify the presentation and characteristics of this disease.
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PMID:Management of radiation-induced accelerated carotid atherosclerosis. 359 60

The participation of vascular disease in elderly dementia has been clarified to a significant degree in the past decade. The term multi-infarct dementia implies that severe mental impairment can result from thrombosis of large and medium arteries or from multifocal emboli of either cardiac or arterial origin. This is markedly different from the concept, which, unfortunately, is still the generally current view in the lay press, in some medical journals, and in advertisements of pharmaceutical companies, that gradual narrowing of cervical and cerebral arteries produces chronic hypoperfusion of the brain and is the basis of mental deterioration. This concept of generalized cerebral arteriosclerosis or arteriosclerotic dementia is no longer acceptable. Most patients with MID can be distinguished from those suffering from other types of dementia by employing a clinical ischemic score supplemented by electrophysiologic studies, CCT, and neuropsychological testing. Furthermore, the association of MID with severe hypertension and thromboembolism makes early diagnosis imperative, because appropriate treatment may arrest progression and even provide some improvement.
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PMID:Multi-infarct dementia. 371 68

A stepwise diagnosis using objective and reproducible methods of examination makes it possible to distinguish between psychogenic and organic causes of impotence. Among 104 men who had organic disorders of erection half were due to local penile disease, the remainder to vascular disease (diabetic angiopathy, arteriosclerosis, abnormal venous drainage). Cavernosal through-flow measurements revealed differences among the various groups of disorders with regard to the flow rates required for achieving and maintaining an artificial erection and made it possible, in conjunction with other tests (Doppler perfusion measurements and papaverine response), to arrive at a precise diagnosis and plan for surgical intervention. Of 91 men who had been operated upon 79 had good results (87%). Largely noninvasive diagnostic measures thus achieved effective treatment and thus contributed to an improved feeling of self-esteem.
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PMID:[Diagnosis and therapy of organic impotence]. 378 Apr 48

Twenty of approximately 1000 patients attending the arteriosclerosis clinic at MIT during a 13 year period were treated simultaneously with aspirin and warfarin for symptomatic atherosclerotic (19) or rheumatic (1) heart or vascular disease. The average duration of therapy was 5.8 years. Thirteen patients suffered from familial hyperlipoproteinemia; only one patient had none of the major risk factors for arteriosclerosis. Refractory symptoms were related to the central nervous system in 13, peripheral vascular system in 5 and the heart in 2. All twenty patients became asymptomatic or showed marked clinical improvement on aspirin plus warfarin therapy. While on this therapy, complications, both thrombotic and hemorrhagic, occurred in 7 of the 20 patients (graft embolus in 1, and bleeding in 6; with one death as a result of intracranial bleeding) and sudden death, probably from acute myocardial ischemia, in a further 2 patients. We conclude that when alternative therapies are impossible or have proven to be of no avail in patients suffering from the complications of advanced atherosclerosis, the simultaneous administration of aspirin and warfarin may be a therapeutic alternative, although very close and careful followup of the patients' prothrombin times and clinical status is essential.
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PMID:Simultaneous therapy with antiplatelet and anticoagulant drugs in symptomatic cardiovascular disease. 387 67

After years of episodic monocular visual loss, two migraineurs suffered sudden, persisting loss of vision from retinal vascular occlusion. One was a 34-year-old woman with systemic lupus erythematosus who showed abnormalities of the cilioretinal arterial and retinal venous circulations. The other was a 62-year-old man with hypertension and arteriosclerosis who had a central retinal vein occlusion. Persisting monocular visual loss is a rare consequence of migraine. Our cases suggest a role for venous lesions. Occlusion of retinal vessels in some migraineurs may result from the synergistic effect of another vascular disorder with the migraine.
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PMID:Vascular retinopathy in migraine. 394 97

In order to evaluate the prevalence of common and/or internal carotid stenoses together with metabolic abnormalities in dementia nineteen patients were investigated. Dementia and differential diagnosis between Alzheimer type (DAT) and multi-infarctual (MID) dementia were performed on the basis of Computerized Tomography scan, behavioural anamnesis, neurological and neuropsychological examinations. Eight patients were diagnosed as MID and 11 as DAT. Noninvasive study of neck arteries was performed in supine position by a Duplex Scanner, able of detecting a wide range of stenosis, even when very mild. Arterial hypertension, hyperlipidemia, diabetes and high hematocrit level were present in both groups, although to a higher extent in MID (p 0.05). Results from Duplex Scanner demonstrate 12 vascular stenoses 16-49% and one between 50-99% (13/76), being vascular abnormalities equally distributed among DAT and MID patients. These data suggest that patients with metabolic abnormalities and arteriosclerosis can develop dementia not necessarily of vascular type. On the other hand, MID patients do not present higher number of stenosis as compared to DAT, indicating that vascular disease of carotid arteries is not prominent in the clinical context of dementia.
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PMID:Non invasive study of carotid arteries by echo-doppler and metabolic abnormalities in patients with dementia. 402 28

Premature arteriosclerosis and thromboembolic events are well-known complications of homozygous homocystinuria due to cystathionine synthase deficiency. It is unknown whether heterozygosity for homocystinuria predisposes to premature vascular disease. We explored the frequency of excessive homocysteine accumulation after standardized methionine loading in 75 patients presenting with clinical signs of ischemic disease before the age of 50:25 with occlusive peripheral arterial disease, 25 with occlusive cerebrovascular disease, and 25 with myocardial infarction. In seven patients in each of the first two groups but in none of the patients in the third group, heterozygosity for homocystinuria was established on the basis of pathological homocysteinemia after methionine loading and cystathionine synthase deficiency in skin fibroblast cultures. Because the frequency of heterozygosity for homocystinuria in the normal population is 1 in 70 at the most, we conclude that this condition predisposes to the development of premature occlusive arterial disease, causing intermittent claudication, renovascular hypertension, and ischemic cerebrovascular disease.
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PMID:Heterozygosity for homocystinuria in premature peripheral and cerebral occlusive arterial disease. 188 23

A total of 594 patients admitted for cerebrovascular disease (CVD) and for peripheral vascular disease (PVD), were examined in a study aimed at clarifying by a simple, inexpensive out-patient method, a) the relationship existing between the different locations of the vascular disease: brain, lower limbs, coronaries; b) the prevalence in the patients studied of risk factors such as hypertension, hyperlipidaemia and diabetes, and of migraine. The results were as follows: a) of the patients admitted for CVD, 44% also presented arteriosclerosis in other locations; this figure was 32% for PVD cases; b) hypertension was found in 38.5% of CVD and 27% of PVD cases; diabetes in 11.5% of CVD and in 18% of PVD cases; hyperlipidaemia in 31% of CVD and 24% of PVD cases; migraine in 11% of CVD and 1% of PVD cases.
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PMID:Validity of out-patient screening in arteriosclerosis to identify multiple lesions. 406 67


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