Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0042373 (vascular disease)
 17,070 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Postpartum reversible cerebral vasoconstriction syndrome, also known as postpartum cerebral angiopathy, is clinically characterized by headache and focal neurologic deficits, and angiographically by transient, fully reversible cerebral vasoconstriction. A 26-year-old woman was brought to the emergency room with a 3-day history of confusion, agitation, and headache. She was 2 weeks postpartum. She went on to develop right leg weakness two days after admission. A cerebral angiogram showed diffuse irregularities of all intracerebral vessels, and MRI showed multiple acute infarcts. Her clinical condition improved significantly over the next several days without any intervention, and she was discharged. MRA 3 months after initial presentation was normal. It is important to consider this syndrome in the differential diagnosis in patients presenting with headache and focal neurologic deficits in the postpartum period.
 ...
PMID:Postpartum reversible cerebral vasoconstriction syndrome. 1787 40

In clinical practice there are two sorts of measurements, a) arterial oxygen and carbon dioxide partial pressure (PaO2, PaCO2) or arterial oxygen saturation (SaO2), and b) the transfer capacity for carbon monoxide (TLCO). The former measures the output or performance of the lung as a gas exchanger, and the latter estimates the available surface area or potential for gas exchange. As gas exchange deteriorates (PaO2 falls and PaCO2 rises), the body compensates by increasing ventilation and lowering PaCO2). Therefore, a high PaCO2 represents chronic respiratory or "compensation" failure, either chemo-insensitivity ("won't breathe") or neuromuscular weakness/increased work of breathing ("cannot breathe"). Chronic respiratory failure may progress to acute failure in which PaCO2 falls and PaCO2 rises progressively, assisted ventilation is usually required. The TLCO is a laboratory test which measures the integrity of the blood-gas barrier, it is particularly useful in the assessment of emphysema, interstitial disease and pulmonary vascular disease.
 ...
PMID:Assessing gas exchange. 1802 33

A 35-year-old yellow-naped Amazon parrot (Amazona ochrocephala auropalliata) was presented for gradually increasing inappetence, ataxia, weakness, and lethargy. Radiographic and ultrasonographic findings were strongly suggestive of atherosclerosis. Isoxsuprine, a peripheral vasodilator demonstrated to be of benefit in humans with intermittent limb pain, weakness, and lameness secondary to occlusive vascular disease, was selected for treatment. The bird's clinical signs resolved during treatment but recurred after varying periods of time when the medication was stopped intermittently. Nearly 3 years after the initial examination, the parrot was doing well on isoxsuprine therapy, with normal prehension of food with its feet and no recurrence of clinical signs.
 ...
PMID:Use of isoxsuprine for treatment of clinical signs associated with presumptive atherosclerosis in a yellow-naped Amazon parrot (Amazona ochrocephala auropalliata). 1808 39

Three patients (of two unrelated Polish families) with early-adult onset dementia were subjects of the study. Two cases, previously diagnosed as familial Alzheimer's disease (FAD) with cerebral amyloid angiopathy (CAA), were confirmed by genetic and neuropathological studies, and one case of CADASIL was ultrastructurally confirmed by the presence of vascular granular osmiophilic material. Now the brain autopsy material has been reinvestigated using immunohistochemical (IHC) markers for vascular smooth muscle cells, paying special attention to collagen markers for extracellular matrix components and ultrastructural microvascular changes. In both diseases, IHC examination showed a reduction or loss of expression of smooth muscle actin (SMA) in tunica media of the cerebral arterioles. Fibrous thickening of the wall of the small meningeal arteries, intracerebral arterioles and numerous capillaries, with amyloid or granular deposits, drew our attention. In these vessels, marked expression of fibrillar collagen type III as well as strong immunoreactivity of the basement membrane (BM) component collagen type IV were found. The most damage was observed in the FAD/CAA double-barrel vessel wall and in some CADASIL arterioles changed by fibrinoid necrosis. The fibrous changes of the small vessels were more distinct in CADASIL t han in FAD/CAA. In FAD,electronmicroscopic examination revealed both amyloid and collagen fibres within the thickened BM of capillaries and the small arterioles. Clusters of collagen fibres between lamellae of BM, frequently in a pericyte position,were observed,and some were seen in the degenerated pericytes as well. Typical changes of the pericytes were accumulation of lipofuscin-like material and their degeneration. The mitochondria of the pericytes and of the endothelium were rare and swollen, with damaged and reduced cristae. The VSMCs of the arteriolar walls exhibited degenerative changes with atrophy of the cellular organelles. The fibrous,collagen-richCADASILsmallcerebralvessels,despite the weakness of the vessel wall due to reduction of VSMCs, appeared to be stronger than in FAD/CAA. These findings may suggest an accelerated process of transformation of the small cerebral vessels in which early onset of VSMCs loss is a predominant feature of the vascular changes in both presented diseases.
 ...
PMID:Small cerebral vessel disease in familial amyloid and non-amyloid angiopathies: FAD-PS-1 (P117L) mutation and CADASIL. Immunohistochemical and ultrastructural studies. 1817 93

In a recent study, Bos et al. (JAMA 2007) showed that patients with nonfocal transient neurological attacks (TNA) have a higher risk of major vascular disease, comparable to patients with focal TNAs. This may prompt GPs to take a more active approach when dealing with patients experiencing short-lasting attacks of dizziness, paraesthesia and weakness. However, the category of nonfocal TNAs in the abovementioned study was very broad, and subgroup analysis for specific symptoms was not possible. Moreover, a third of nonfocal TNAs consisted of loss of consciousness or decreased consciousness, which might be responsible for the heightened risk of cerebrovascular accident. Also, a quarter of patients with nonfocal TNA had not presented their symptoms to a physician and reported the symptoms during a follow-up meeting, leaving room for recall bias. Since symptoms like dizziness are very frequent among elderly patients and nonfocal TNAs are difficult to recognize, both physicians and education campaigns should be careful not to arouse anxiety without good reason.
 ...
PMID:[Dizziness, tiredness and the risk of a stroke]. 1855 61

Hemiparetic stroke leads to major skeletal muscle abnormalities, as illustrated by paretic leg atrophy, weakness, and spasticity. Furthermore, the hemiparetic limb muscle shifts to a fast-twitch muscle fiber phenotype with anaerobic metabolism. This study investigated whether skeletal muscle genes were altered in chronic hemiparetic stroke. The nonparetic leg muscle served as an internal control. We used Affymetrix microarray analysis to survey gene expression differences between paretic and nonparetic vastus lateralis muscle punch biopsies from 10 subjects with chronic hemiparetic stroke. Stroke latency was greater than 6 months. We found that 116 genes were significantly altered between the paretic and non paretic vastus lateralis muscles. These gene differences were consistent with reported differences after stroke in areas such as injury and inflammation markers, the myosin heavy chain profile, and high prevalence of impaired glucose tolerance and type 2 diabetes. Furthermore, while many other families of genes were altered, the gene families with the most genes altered included inflammation, cell cycle regulation, signal transduction, metabolism, and muscle contractile protein genes. This study is an early step toward identification of specific gene regulatory pathways that might lead to these differences, propagate disability, and increase vascular disease risk.
 ...
PMID:Human genome comparison of paretic and nonparetic vastus lateralis muscle in patients with hemiparetic stroke. 1856 45

A thoracic aortic aneurysm is a potentially life-threatening condition that involves a structural weakness of the aortic wall, which can lead to aneurysm, rupture, or dissection. Optimal treatment strategies for lesions of the thoracic aorta are still controversial. Open surgery is complex and is associated with significant morbidity and mortality. Endovascular stenting has emerged as an alternative to open repair in patients requiring surgery for thoracic aortic pathology. Endovascular treatment of vascular disease involving the descending thoracic aorta can be performed safely. It is an alternative option to open repair, less invasive, and carries a relatively low risk. Due to the low morbidity and mortality of endovascular repair, this option has become attractive to many surgeons lately. Stent grafting has become the first-line approach to traumatic thoracic aortic transections in some trauma centers. However, the challenges of accurate placement within an angulated arch, size of the delivery system, and uncertainty regarding long-term durability have been cited as reasons for caution. Major challenges are the technical aspects of the procedure and the learning curve to handle the delivery system and the variability in the anatomy of the aorta. The goal of this article is to review endovascular repair of the thoracic aorta in the current literature outlining some recent patents.
 ...
PMID:Endovascular repair of thoracic aortic aneurysms. 1960 21

Spinal dural arteriovenous fistulas (DAVFs) are the most common type of spinal arteriovenous malformation and are an important, underdiagnosed cause of progressive myelopathy and morbidity in patients with spine disorders. Successful microsurgical management of these lesions is dependent on the surgeon's ability to identify vessels of the fistula and to confirm its successful obliteration postintervention. Indocyanine green (ICG) fluorescent angiography is an emerging tool for delineating intraoperative vascular anatomy, and it has significant potential utility in the treatment of vascular disease in the spine. The authors present the case of a 76-year-old man with progressive and debilitating bilateral lower-extremity weakness and numbness on exertion, in whom a left T-8 spinal DAVF was diagnosed based on results of conventional spinal angiography. Unfavorable anatomy based on angiographic findings precluded endovascular embolization of the fistula, and the patient subsequently underwent T7-9 bilateral laminectomies for microsurgical clip occlusion. Intraoperative ICG fluorescent angiography was used before clip placement to identify the arterialized veins of the fistula, and after clip placement to confirm obliteration of the fistulous connection and restoration of normal blood flow. Intraoperative ICG angiography serves an important role in the microsurgical treatment of DAVF. It can be used to map the anatomy of the fistula in real time during surgery and to verify fistula obliteration rapidly after clip placement. This report adds to the growing body of literature demonstrating the importance of ICG angiography in vascular neurosurgery of the spine.
 ...
PMID:Intraoperative indocyanine green angiography for obliteration of a spinal dural arteriovenous fistula. 1995 Oct 23

Pulmonary involvement is second in frequency only to esophageal involvement as a visceral complication of systemic sclerosis (SSc) and has surpassed renal involvement as the most common cause of death. Interstitial lung disease and pulmonary vascular disease, particularly pulmonary arterial hypertension, are the most commonly encountered types of lung involvement. Chronic aspiration, airway disease, neuromuscular weakness, extrinsic pulmonary restrictive pathology, pleural effusions, pneumothorax, and lung cancer cause clinically significant disease and occur commonly enough to be routinely considered in the assessment of the SSc patient with respiratory symptoms. Affected patients have a significantly worse prognosis than patients with SSc who are free of pulmonary involvement.
 ...
PMID:Scleroderma lung disease. 2006 8

The idiopathic inflammatory myopathies (IIM) encompass a heterogeneous group of rare disorders that present with acute, subacute, or chronic muscle weakness. Besides overlapping clinical manifestations, polymyositis, dermatomyositis and autoimmune necrotizing myopathy may be associated with cancer or collagen vascular disease, and respond generally well to immunosuppressive therapy. However, these 3 IIM are divergent from the histopathological and pathogenetic standpoints. On the other hand, inclusion body myositis (IBM), the most common IIM in the elderly, is clinically, histopathologically and pathogenetically distinct. IBM is also refractory to all currently available therapies. In this manuscript, we depict advances in our knowledge of the IIM, with emphasis on clinical presentation, associated conditions, laboratory features, electrophysiology, muscle histopathology, pathogenesis, and therapy.
 ...
PMID:Idiopathic inflammatory myopathies. 2109 64


<< Previous 1 2 3 4 5 6 7 Next >>