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

A series of autopsy studies is presented of 13 cases of obliterative vascular disease of the vasa nervorum in a wide range of conditions, including polyarteritis nodosa, Wegener's granulomatosis, lymphomatoid granulomatosis, polymyositis and rheumatoid arthritis. In most cases, including 1 of rheumatoid neuropathy, the lesions were of the necrotising type. This supports the concept of polyarteritis nodosa as a pattern of reaction common to several diseases rather than that of a specific nosological entity. The remaining 4 cases of rheumatoid neuropathy, were associated with a bland endarteritis known as Bywater's arteritis. A comparison of these autopsy findings with clinical data and observations on sural nerve biopsies leads to the conclusion that all severe and most of the mild cases of rheumatoid neuropathy are due to occlusive vascular disease. Segmental demyelination independent of vascular lesions may be responsible for some of the mild cases and is frequently found in patients without clinical neurological manifestations.
Clin Exp Neurol 1977
PMID:Observations on vascular neuropathies. 2 90

1. The results of the Veterans Administration Co-operative Study have been extended by the subsequent clinical trials, which included patients of both sexes and with less vascular disease. The later studies confirm the effectiveness of treatment in preventing most complications except myocardial infarction and sudden death. Furthermore, the lower diastolic blood pressure in which treatment has been shown to have a significant beneficial effect has been lowered from 105 mmHg as indicated by the Veterans Study to 100 mmHg as shown by the much larger Australian trial. The possibility of reducing the incidence of sudden death and fatal myocardial infarction has been suggested by other recent control trials using beta-adrenoreceptor-blocking drugs, an approach that needs further exploration. 2. A number of interesting and useful new drugs have appeared which include tienilic acid, minoxidil, saralasin and captopril, and in addition recent controlled trials have re-emphasized the effectiveness of the old drug, reserpine, when combined with a diuretic. The art of treatment of hypertension therefore appears to be in a healthy state and we should expect more advances in the future.
Clin Sci (Lond) 1979 Dec
PMID:Treatment of hypertension: state of the art in 1979. 4 33

1. Males, born between 1900 and 1925, with mild hypertension have been treated for periods varying from 300 to 2000 days. 2. The life and death status of all patients (except two) was known on 1st November 1978. 3. A group of patients with mild hypertension receiving treatment based on a thiazide diuretic had a greater mortality than the other drug-treated group. 4. The increased mortality was caused by an increased number of myocardial infarcts. 5. Elderly male patients with mild hypertension probably have preexisting vascular disease and therapy should not automatically be started. If therapy is started, beta-adrenoreceptor-blocking drugs may be a preferred therapy.
Clin Sci (Lond) 1979 Dec
PMID:Treatment of mild hypertension in elderly males. 4 34

Vagatomy or atropinization protects rats from lethal anaphylaxis and histamine shock. These procedures do not significantly affect production of anaphylactic antibodies or release of histamine following induction of anaphylaxis. The response of the intestinal microvasculature during anaphylaxis is observed to consist of an early brief increase permeability followed by prolonged and irreversible damage. Cholinergic blockade abolishes the latter and markedly reduces deposition of colloidal carbon and immune complexes in the vessel. The possible relevance of these observations to development of chronic immunological vascular disease is discussed.
Clin Exp Immunol 1976 Apr
PMID:Effect of vagotomy on anaphylaxis in the rat. 5 51

Cysteine-homocysteine mixed disulphide, formed in the degradation of methionine, is detected routinely in the plasma of fasting patients homozygous for homocystinuria and in some obligate heteroxygotes. It has not hitherto been identified in the plasma of normal fasting man. Using a highly cross-linked resin with lithium citrate buffers on a JEOL. Amino Acid Analyser, we have detected the mixed disulphide in every one of the plasma samples from twenty normal fasting subjects. The mean concentration was 3.25 mumol/l (SD 0.85, N = 20), with a range of from 1.68 to 4.85 mumol/l. The other neutral and acidic amino acids were within the accepted normal range. The study shows that circulating homocysteine is normally not immediately transformed to cystathionine or remethylated to methionine; some combines with cysteine to form measurable amounts of mixed disulphide. Since homocysteine may produce endothelial damage, the present findings could be relevant to an understanding of the pathogenesis of vascular disease.
Eur J Clin Invest 1978 Aug
PMID:The detection of cysteine-homocysteine mixed disulphide in plasma of normal fasting man. 10 Mar 23

We measured plasma sulphur amino acids in twenty-two patients with chronic renal failure and compared the findings with those obtained in twenty-two normal subjects. In fasting blood (08.00 hours) cysteine-homocysteine mixed disulphide was significantly increased in the renal patients, mean values (+/- SD) being 8.2 +/- 3.4 and 3.1 +/- 1.0 mumol/l respectively (P less than 0.001). The increase was positively correlated with reduced renal function, as assessed by serum creatinine (r = 0.62; P less than 0.01). Homocystine was detected in nineteen patients, the mean concentration (+/- SD) being 1.7 +/- 0.6 mumol/l; it was not found in any normal subject. Methionine levels were not different but there were significant increases in cystine (P less than 0.001) and taurine (P less than 0.05) in the patients. Similar values for these amino acids were found in a second blood sample drawn at 16.00 hours. Changes in the other neutral and acidic amino acids measured were in agreement with those reported in chronic azotaemia. We concluded that plasma levels of all the principal sulphur amino acids except methionine are elevated in chronic renal failure emphasizing the importance of the kidney in sulphur excretion. Prolonged accumulation of homocysteine and cysteine-homocysteine mixed disulphide may be relevant to the development of accelerated vascular disease in patients with chronic renal failure by producing endothelial damage.
Eur J Clin Invest 1979 Aug
PMID:Sulphr containing amino acids in chronic renal failure with particular reference to homocystine and cysteine-homocysteine mixed disulphide. 11 20

Concurrent hypertension in pregnancy alters the diagnosis and prognosis of both the vascular disease and the gestation. Insight into the physiologic and pathophysiologic changes is essential to assessing the patient's status and to determining what antenatal care may yield the best outcome of the pregnancy. In this monograph we have presented (1) a classification, which correlates well with those currently in use, of the types of hypertension and their causes; (2) a brief review of current fact and theory regarding the effect of hypertension on maternal and perinatal morbidity and mortality; (3) a detailed approach to monitoring the physical and laboratory parameters of the parturient; (4) a rational approach to monitoring the fetoplacental unit; and (5) an analysis of currently available therapeutic regimens that may alter the course of hypertension in pregnancy sufficiently to increase fetal salvage and decrease maternal complications. Certainly more research into the mechanisms of CHP will be forthcoming as will newer and more precise diagnostic aids. Pharmacologic agents with varied hypotensive actions are constantly being developed, and combinations of these may yield more beneficial results.
Clin Obstet Gynecol 1978 Sep
PMID:Concurrent hypertension and pregnancy. 15 13

Previous studies have shown that the concentrations of 3', 5' cyclic adenosine monophosphate (cAMP) and 3', 5' cyclic guanosine monophosphate (cGMP) in cerebrospinal fluid (CSF), brain, or both, are increased by melanotropic peptides and catechol amines, and by cholinergic agents. The present study measured the concentrations of cAMP, cGMP, and melanotropic activity in the CSF of normal patients and in 136 subjects with various neurologic diseases. In normal lumbar CSF, concentrations (ave +/- SD) were: cAMP, 21 +/- 8 mM; cGMP, 2.4 +/- 0.5 mM; melanotropic activity, 17 +/- 6 units/100 ml. Concentrations of cAMP, cGMP, and melanotropic activity did not differ significantly (P is less than .05) from normal in the following categories of adult and pediatric patients: back pain due to vertigo of unknown cause; cerebral atrophy; cerebral vascular disease; and brain tumor subdural hematoma not causing increased ventricular pressure. Nine children with retarded psychomotor development caused by diffuse brain disease (infection, trauma, hemorrhage, degenerative process, long-standing hydrocephalus with thinning of the cerebral mantle) had subnormal levels of cAMP and melanotropic activity. These two variables were significantly correlated in the entire series of CSF samples (r=+0.55, P is less than .005). cGMP was elevated in the ventricular fluid of adult and pediatric patients when the ventricular pressure was abnormally elevated. The nucleotide's level rose as high as 50 X normal when ventricular pressure exceeded 300 mm H2O. The concentration of ventricular cGMP was proportional to that of ventricular pressure (r=+0.76, P is less than .005). The correlation was similar regardless of the type of hydrocephalus (congenital or acquired, communicating or obstructive), the age of the patient, or the nature of the underlying disease.
J Clin Endocrinol Metab 1976 Jun
PMID:Observations on the cyclic nucleotide concentrations in human cerebrospinal fluid. 18 45

1. The intravenous fat-tolerance test and serum lipid and lipoprotein measurements were carried out in ninety-three normal subjects, fifty-one patients with ischaemic heart disease and thirty patients with peripheral vascular disease. 2. The fractional turnover rate of exogenous triglyceride was significantly slower in patients with ischaemic heart disease and in patients with peripheral vascular disease than in normal men. The rate was also slower in normal men than normal women. 3. Serum triglyceride and cholesterol concentrations were higher in both vascular disease groups than in control subjects. 4. The proportion of both groups of patients who had a subnormal fractional turnover rate of exogenous triglyceride was 35%, and 32% of patients had hypertriglyceridaemia in the fasting state; 27% of patients were hypercholesterolaemic. 5. Although the intravenous fat-tolerance test did not provide significantly better discrimination between cardiovascular patients and control subjects than did measurement of serum triglyceride, the results suggest that hypertriglyceridaemia in such patients may be separable into a group in which impaired triglyceride clearance may be partly responsible, and a group in which overproduction of serum triglyceride may be the major mechanism of the hyperlipidaemia.
Clin Sci Mol Med 1976 Oct
PMID:Intravenous fat-tolerance test in ischaemic heart disease and peripheral vascular disease. 18 30

Lipids and lipoproteins were analysed in forty-one survivors of stroke, aged less than 65 years, and the same number of age and sex matched controls without vascular disease. The stroke subjects had no evidence of coronary artery or peripheral vascular disease. High density lipoprotein cholesterol was significantly lower (1.19 +/- 0.06 mmol/l) in the stroke subjects than the controls (1.47 +/- 0.07 mmol/l). Triglyceride was also elevated in the stroke subjects, but this was confined to those who were taking antihypertensive treatment which included beta-blockers and/or thiazides. The low levels of high density lipoprotein in stroke were independent of hypertension or its treatment. Thus low levels of high density lipoprotein appear to be associated with cerebrovascular disease, while elevated triglyceride is a complication of anti-hypertensive therapy.
Eur J Clin Invest 1979 Jun
PMID:Reduced high density lipoprotein in stroke: relationship with elevated triglyceride and hypertension. 22 76


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