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

Clinical and pathologic changes in 87 patients who could not be resuscitated from an episode of sudden cardiovascular collapse are described and compared with observations from patients in the same community who were successfully resuscitated from ventricular fibrillation. Findings in patients who died suddenly generally did not differ when the patients were groups by electrocardiographic rhythm on arrival of the mobile coronary aid unit. The pathologic changes of acute thrombosis and recent myocardial infarction did not occur with sufficient frequency in the entire group to be considered causally related to the sudden collapse, occurring in 10 and 5 percent of cases, respectively. Although most patients had evidence of obstructive coronary disease and old myocardial infarction, 8 percent had no significant vascular disease, acute thrombosis, myocarditis or valve disease that might be implicated as a factor in sudden death. There was no relation between age and severity of obstructive coronary disease or frequency of old myocardial infarction in patients who died suddenly. Complete atherosclerotic occlusion in one or more coronary vessels occurred in 51 of 87 (59 percent) and old myocardial infarction in 48 of 87 (55 percent). Although the mean age of this autopsy population was similar to that of all patients in the community who have had ventricular fibrillation on arrival of the aid unit, the nonsurvivors had a greater incidence of myocardial infarction and symptomatic heart disease (73 of 87) than did survivors. Comparison of this autopsy group with persons from the community who were resuscitated from ventricular fibrillation and subsequently had coronary angiograms indicates that the severity of coronary stenosis does not distinguish between survivors and nonsurvivors of an episode of ventricular fibrillation and suggests that other factors influence the outcome of an episode of ventricular fibrillation.
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PMID:Pathology of the heart in sudden cardiac death. 87 Nov 13

A pressure-sensitive probe, specially developed for this purpose, is built into a contact lens in such a manner that when adjusted to the patient's eye the probe registers the intraocular pressure whilst the observer compresses the eyeball and observes the arterial collapse phenomenon on the disc over the contact lens on the slit-lamp microscope. The standard deviation of a clinical measurement is 1.5 mm Hg. Derived from measurements on 65 eyes of patients without signs of vascular disorder, the correlation of the systolic and diastolic ophthalmic artery-pressure (y) to that of the ipsilateral brachial artery (x) is given by Y =0.79x-1.33 (r=0.96) and the correlation of their median pressure by Y=0.93x-17.2 (r=0.94).
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PMID:[The Stepanik arteriotonograph (author's transl)]. 94 59

An autopsy case of an enormous shunt between intrahepatic portal vein and hepatic vein in a 57-year-old man who showed an Inose's type of hepatocerebral disorder for 6 years is described. The shunt measuring up to more than 1 cm in diameter was located in the right-upper angle of the right liver lobe. The wall of the shunt lacked both the muscular layer and the elastic lamellae. Based upon the histopathology and the clinical history, this shunt was considered not to be a congenital malformation but a vascular disorder resulted from the parenchymal collapse of the liver.
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PMID:An enormous intrahepatic shunt between portal vein and hepatic one. 111 38

Spontaneously occurring surface wrinkling retinopathy occurreed in 17 eyes of 16 patients and was not related to pervious surgery, retinal vascular disease, or obvious ocular inflammation. Visual symptoms were not severe and follow-up suggests that the usual course of surface wrinkling is usually benign. However, 2 eyes progressed to 20/300, so that there is a chance of considerable visual deterioration in some cases. The vitreous may or may not be detached. The ophthalmoscopic features of a wrinkled shagreen, tortuous vessels pulled toward a nidus, and intraretinal hemorrhages were seen. The leakage of fluorescein into the retina is emphasized in this series and may be fairly marked. The possible causes and mechanism of wrinkling are discussed with emphasis on mild chronic ischemia and posterior vitreous collapse.
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PMID:Spontaneous surface wrinkling retinopathy. 113 79

Vascular disease increases in incidence with age and is the commonest cause of morbidity and mortality among elderly people. Hypertension is associated with hypertrophy of the arterial media. This study was designed to investigate changes in arterial structure that may occur with age independent of blood pressure. Collapsed sections of human mesenteric arteries (external diameter 2-3 mm) were measured using a semi-automatic image analysis system. There was a nonlinear increase in both the wall/lumen area ratio and the relative intimal area with age. There were no significant relationships between blood pressure and either the wall/lumen ratio or the relative intimal area.
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PMID:Age-associated changes in mesenteric arteries. 141 68

1. Eleven infants and children (mean age 4.3 years, range 0.2-12 years) with pulmonary vascular disease secondary to congenital cardiac anomalies (n = 6) or bronchopulmonary dysplasia (n = 5), were studied during cardiac catheterization while ventilated on 100% oxygen. 2. All had a raised pulmonary vascular resistance (mean 11.8 units, range 4.1-26.0 units, normal value less than 3 units) and a raised anatomical intrapulmonary right to left shunt (mean 22%, range 8-50%, normal value less than 5%). The elevated shunt was attributed to the effects of 100% oxygen and general anaesthesia causing alveolar collapse, with only partial compensation for impairment of gas exchange by compensatory local hypoxic vasoconstriction. 3. When prostacyclin was infused, pulmonary vascular resistance fell by 3.2 +/- 1.8 units (mmHg litre-1 min m2), and pulmonary blood flow rose by 1.0 +/- 0.7 litre min-1 m-2 (mean +/- 95% confidence intervals). 4. Intrapulmonary right to left shunt fraction increased in eight of 11 patients, with a maximal rise for the group of 5.9 +/- 4.6% (mean +/- 95% confidence intervals). However, even at doses of prostacyclin sufficient to cause systemic vasodilatation and tachycardia, there was no evidence for a selective increase in shunt fraction. 5. We suggest that studying the effects of therapeutic interventions on intrapulmonary shunt fraction may be a useful model in vivo of human hypoxic pulmonary vasoconstriction.
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PMID:Effects of infusion of prostacyclin on anatomical intrapulmonary right to left shunt: a useful model of human hypoxic vasoconstriction? 264 64

Lung scanning with radiolabeled macroaggregated albumin (MAA) has caused cardiovascular collapse and death in patients with extensive pulmonary vascular disease. These adverse reactions have been suggested to be secondary to MAA embolic occlusion of a significant portion of the remaining pulmonary circulation. The single breath diffusing capacity for carbon monoxide (SBDLCO) is heavily dependent on the status of the pulmonary microcirculation and is reduced in clinical pulmonary embolism. The effect of MAA particles on the lung microcirculation was measured by SBDLCO in 11 patients undergoing clinically indicated lung perfusion scanning. SBDLCO was measured before and immediately after injection of 256,000 to 448,000 20-40 micron particles of [99mTc]MAA. Mean SBDLCO prior to injection was 18.9 +/- 1.7 (s.e.m.) and immediately after injection was unchanged at 19.0 +/- 1.6 ml/min/mmHg. The lowest pre-injection SBDLCO values were 11.5 and 6.2 ml/min/mmHg (54% and 28% of predicted, respectively); in neither of these patients was there a detectable change in SBDLCO measured after injection of MAA. Thus occlusion of as many as 448,000 20-40 micron pulmonary vessels by MAA is without detectable impact on the transfer of carbon monoxide even in patients with sufficient pulmonary disease to lower the SBDLCO to 28% of predicted.
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PMID:Diffusing capacity is not measurably affected by routine lung perfusion scanning. 339 86

The objectives of preventive medicine are to prolong life and to reduce disability. Improvements in the standard of living and in medical treatment and specific measures to reduce the incidence of disease have greatly reduced mortality over the last century. The distribution of deaths by age has altered dramatically and, at current rates, the great majority of deaths will occur at 80-85 years of age. Improvement has continued to the present and is still not slackening. It seems unlikely that many deaths can be postponed much beyond 100 years, but a realistic objective would be to raise the median age of death to about 90 years. This would require a substantial reduction in mortality from three groups of diseases that are now the main cause of life lost under 85 years of age: neoplasms, ischaemic heart disease, and other vascular disease. Watch will also need to be kept on diseases that threaten to become more common, so that we can abort new epidemics. Whether a reduction in age-specific mortality rates will also bring a reduction in the prevalence of disability at each age is unclear. Some believe that it will, so that if we concentrate on reducing age-specific mortality, everyone will eventually survive to such an age that failure of homeostasis will bring about a sudden collapse. Others suspect that postponing death will lead to a greater prevalence of pre-terminal disability, due to the prevalence of diseases that are largely independent of or even inversely related to mortality. The objectives of preventive medicine are realizable only in so far as they are perceived to be desirable by society. The perception of what is desirable depends not only on objective quantification, but also on a variety of subjective assessments. Preventive medicine must, therefore, allow for the factors that produce these assessments and educate the public to give them appropriate weight.
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PMID:Preventive medicine: the objectives. 384 84

Pulmonary arteries were counted per surface area of lung sections, with a correction for the degree of lung collapse, in 31 subjects who had congenital cardiac defects and pulmonary hypertension. Arterial diameters were also established, as were the degrees of any pulmonary vascular lesions. In comparison with control cases, the density of the smallest muscularized arterioles was significantly increased in those subjects without advanced pulmonary vascular disease. With increasing intimal fibrosis, the number of small arteries decreased. In the presence of severe alterations (eg, plexiform lesions), the numbers were distinctly reduced. The density of arteries larger than 100 micrometer in diameter was hardly affected, independent of the severity of vascular changes. Our results indicate that congenital underdevelopment of the pulmonary arterial tree is uncommon and certainly not the rule in cases of congenital cardiac defects.
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PMID:Density of muscularized arteries in the lung: Its role in congenital heart disease and its clinical significance. 668 48

Bowel obstruction is an acute alarming situation with limited diagnostic conditions. Therapeutic decisions must be taken in time. Diagnostic differentiation between incomplete or complete bowel obstruction, intestinal obstruction and paralytic ileus is often uncertain and the underlying cause difficult to detect. Besides plain films in acute abdomen the ultrasound examination presents important additional informations: 1st Dilated intestinal loops and gas caps correlate with the characteristic x-ray finding, i.e. erected dilated intestinal loops with fluid levels. The location of the obstruction is defined in small bowel obstruction by differentiation between jejunum (with Kerckring folds) and ileum (without Kerckring folds). In large bowel obstruction the caecum is dilated and a collapse of the distal colon is detectable. 2nd Additional sonographical findings are: oedema of the intestinal walls, hyperpendulum peristalsis or absence of peristalsis, sedimentation of intestinal contents, pearlstring-like lined up gas bubbles under the ventral intestinal walls, and concomitant ascites. Duplex sonographical studies of the intestinal peristalsis may help to differentiate between mechanical obstruction and paralytic ileus. 3rd In bowel obstruction stenoses can be detected as a result of tumour, Crohn's disease diverticulitis, invagination, strangulated hernias or gall stone ileus. Intestinal adhesions cannot be found by ultrasound. Small and large bowel is dilated in paralytic ileus. Numerous causes like acute pancreatitis, ureteral colic, free gastrointestnal perforation and so on can be diagnosed. 4th In ileus of vascular disorder early diagnosis is high important, but inspite of colour flow imaging diagnostic possibilities are limited. 5th Sonographical diagnosis is of special interest when the x-ray plain films is "empty". The lack of massive fluid collection and meteorism allows an optimal ultrasound examination. In this early phase disorders of peristalsis and intestinal walls are reliably found, and it is easier to find the cause of bowel obstruction. In this way the definitive diagnosis can be arrived at earlier, because it still takes up to 6 hours to obtain the classical x-ray finding. There is a rule that the earlier ultrasound is done, the more findings one will get.
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PMID:[Ultrasound ileus diagnosis]. 1002 58


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