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Query: UMLS:C0042384 (vasculitis)
 20,525 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Finger systolic blood pressure (FSP) was measured by cuff technique before and after local cooling in three groups of patients (Raynaud's disease (7), subclavian stenoses, (5), thrombo-angiitis obliterans (15)), and in 15 normals. The response to finger cooling registered as a decrease in FSP indicates an increase of digital arterial tone. In all three groups, digital arterial tone increased more than in normals during finger cooling. Patients with Raynaud's disease showed a pathological increase in arterial tone at 23.5 degrees C with closure of the digital arteries at a mean temperature of 18.5 degrees C. The temperature eliciting these phenomena in patients with thrombo-angiitis obliterans was about 7 degrees C lower (16.5 and 11.0 degrees C, respectively). Accordingly, cold sensitivity and Raynaud's phenomena in the two groups may have a different pathophysiological mechanism, namely a pathological arterial tone in Raynaud's disease vs. a normal arterial tone in obliterative diseases acting on a narrow vessel.
Scand J Thorac Cardiovasc Surg 1978
PMID:Raynaud's phenomenon in arterial obstructive disease of the hand demonstrated by locally provoked cooling. 71 93

Giant cell arteritis is a rare, poorly understood, and often misdiagnosed entity. A case is reported of giant cell arteritis in a 30-year-old white male who developed severe bilateral peripheral claudication affecting both legs. The erythrocyte sedimentation rate (ESR) was markedly elevated. The diagnosis of vasculitis was established by histology postoperatively following exploration of both superficial femoral arteries and the placement of a reversed saphenous vein bypass graft to the right leg. Biopsy of the temporal artery revealed no pathology. The patient has been completely asymptomatic postoperatively and has resumed all previous normal activities. This condition has persisted in spite of a failed graft determined by an arteriogram performed 3 months after surgery. He has been treated with steroids continuously since the procedure.
J Cardiovasc Surg (Torino)
PMID:Bilateral superficial femoral giant cell arteritis. 219 69

This investigation tested the effect of anti-inflammatory agents acting at different levels of the arachidonic acid cascade on leukocyte migration into the vessel wall. An animal model of vasculitis was used in which leukocytes stimulate migration of smooth muscle cells from the media into the intima resulting in formation of intimal lesions. In this model, an endotoxin-soaked thread is implanted in the adventitia along the ventral side of the rat femoral artery. At 2 days, subendothelial and medial leukocyte accumulation occurs exclusively in the ventral half of the vessel. At 14 days, intimal lesions composed primarily of smooth muscle cells are localized to the ventral half of the vessel. Treatment with neither the lipoxygenase inhibitor L-651,392 nor the dual cyclooxygenase and lipoxygenase inhibitor BW755C affected leukocyte migration into the vessel wall or subsequent lesion formation. Treatment with the cyclooxygenase inhibitor diclofenac sodium greatly reduced both leukocyte accumulation and lesion formation, whereas leukocyte migration and lesion formation were nearly totally inhibited by treatment with dexamethasone. Thus, it has been demonstrated that although leukocyte accumulation in the vessel wall stimulates intimal lesion formation, pharmacologic inhibition of leukocyte accumulation prevents lesion formation.
J Cardiovasc Pharmacol 1989
PMID:Leukocyte stimulation of intimal lesion formation is inhibited by treatment with diclofenac sodium and dexamethasone. 247 29

Cardiovascular manifestations develop in the majority of SLE patients at some time during the course of their illness, the most common being acute fibrinous pericarditis and pericardial effusion. Echocardiography has demonstrated an increased incidence of pericardial effusion, even in those who have minimal symptoms. Chronic adhesive pericarditis, pericardial tamponade, and constrictive pericarditis occur rarely. While myocarditis is commonly noted at autopsy, it is often silent clinically. Diagnosis during life can be confirmed only by endomyocardial biopsy. Electrocardiographic changes are often nonspecific. Endocarditis with superimposed nonbacterial verrucous vegetations (Libman-Sacks) is noted in more than 40% of hearts at autopsy, but is rarely diagnosed during life. Valve dysfunctions, such as aortic stenosis, aortic insufficiency, mitral stenosis, and mitral insufficiency, occasionally manifest during life and rarely may necessitate surgery. Atrial and ventricular arrhythmias, first degree AV block, and acquired CHB occur in association with pericarditis, myocarditis, vasculitis, and myocardial fibrosis, respectively. CCHB developing in newborns of mothers with SLE, particularly those who have an antibody to soluble tissue ribonuclear protein RO(SS-A), is increasingly being appreciated by both pediatric cardiologists and rheumatologists. Recently, severe coronary atherosclerosis resulting in angina pectoris and/or myocardial infarction in young adults has been noted, particularly in those who had developed risk factors such as hypertension and hyperlipidemia while receiving prolonged corticosteroid therapy. Rarely, coronary arteritis may produce similar symptoms. Congestive heart failure of either single or multiple etiologies carries an ominous prognosis. It remains a cause of high morbidity and mortality unless recognized early and treated properly. Extracardiac vascular manifestations of SLE include telangiectasia, vasculitis, livedo reticularis, Raynaud's phenomena, and thrombophlebitis, all of which may occur either alone or in different combinations. Evidence is now slowly accumulating that substantiates that immune complex deposition, complement activation and subsequent inflammatory reaction is responsible for the majority of the cardiovascular manifestations of SLE, for example, pericarditis, myocarditis, endocarditis, coronary arteritis, coronary atherosclerosis, and systemic and pulmonary vasculitis.(ABSTRACT TRUNCATED AT 400 WORDS)
Prog Cardiovasc Dis
PMID:Cardiovascular manifestations of systemic lupus erythematosus: current perspective. 286 Jun 99

Two patients needed mitral valve replacement for severe mitral regurgitation after surgical relief of subaortic stenosis. A third, much older patient (who died) also had mitral regurgitation after surgery to relieve subaortic stenosis and to close a ventricular septal defect. All the mitral valves showed both macroscopic and microscopic abnormalities, the latter being characterized by myocytolysis, vasculitis, and fibrosis. The severity of these abnormalities was inversely proportional to the age of the patient. The findings were compared with those (surgical and necropsy specimens) of five patients with congenital "left-sided" anomalies (group 1) and five with "right-sided" lesions (group 2). Coagulation necrosis and ischemic changes were observed in both of the control groups, but none demonstrated the combination of features observed in the patients with subaortic stenosis. The observation of myocytolysis, vasculitis, and fibrosis suggests that there may be a pathologic substrate for mitral valve malfunction in patients, especially very young ones, with subaortic stenosis.
Am J Cardiovasc Pathol 1988
PMID:The pathology of mitral papillary muscles in mitral regurgitation associated with discrete subaortic stenosis. 320 92

Forty-two patients underwent resection of primary cardiac neoplasms at Stanford University Medical Center and the Palo Alto Veterans Administration Medical Center between 1961 and 1986. A total of 27 atrial myxomas, seven benign nonmyxomatous tumors, and eight malignant tumors were resected. The mean age was 47 years (range 8 to 79) in 27 female and 15 male patients. The clinical presentations included congestive heart failure in 24 patients, palpitations in nine, neurologic symptoms in six, recurrent cardiac tamponade in three, vasculitis in two, and chest pain in two. Thirty-one of 34 benign lesions were completely resected, although one patient required cardiac transplantation to resect completely an "inoperable" benign tumor. All gross tumor was resected in four of eight patients with malignant lesions. All patients survived operation, but three with malignant disease died within 30 days. Late outcome was known for 41 of 42 (98%) patients. Total follow-up for the series was 200.1 patient-years, for an average of 4.7 years (range 1 month to 18 years). Excellent early and late results were obtained in patients with benign lesions, as there was no known tumor recurrence even if resection was incomplete. Effective palliation and local control of disease is possible with extensive resection of malignant primary tumors, but more effective adjuvant therapy will be necessary to improve long-term prognosis.
J Thorac Cardiovasc Surg 1987 Apr
PMID:Primary cardiac neoplasms. Early and late results of surgical treatment in 42 patients. 356 Sep 97

We compared the variation in plasma endothelin-1 (ET-1) levels by the sandwich-enzyme RIA method during each of the clinical stages of Kawasaki disease, a systemic vasculitis occurring in children (30 cases, ages 4-62 months) and examined whether ET-1 could be a clinical parameter for predicting coronary artery dilatation. The results revealed that the ET-1 level in the acute stage was higher than that in the recovery stage, the chronic stage, or in healthy controls (3.46 +/- 1.22 versus 2.20 +/- 0.56, 1.55 +/- 0.52, and 1.57 +/- 0.45 pg/ml, respectively; p < 0.01). Furthermore, in the acute stage the ET-1 level in the group with coronary artery dilatation (positive group, five cases) increased more than that in the negative group (25 cases) (5.13 +/- 1.64 versus 3.09 +/- 0.70 pg/ml, respectively; p < 0.01). When the ET-1 value was more than 4.5 pg/ml in the acute stage, our prediction for coronary artery dilatation demonstrated a high value in indices of both sensitivity (100%) and specificity (96.1%). Thus, plasma concentration of ET-1 was increased in the acute stage of Kawasaki disease and was very high in patients with coronary artery dilatation. The plasma ET-1 level was considered to be an important factor in predicting the dilatational lesions of the coronary artery in the acute stage of Kawasaki disease.
J Cardiovasc Pharmacol 1993
PMID:Increased plasma endothelin-1 concentration in Kawasaki disease. 750 88

Inflammation of the arteries is a difficult condition to diagnose and treat. Eighteen consecutive patients (16 men, two women) with arteritis treated in the vascular surgery department of King Fahad Hospital, Jeddah, Saudi Arabia, over a period of 3 years were reviewed to define the local pattern of the disease. The mean age of the group was 29.2 (range 18-50) years. Buerger's disease was diagnosed in 11 patients and considered to be the most common type of arteritis. Other types of arteritis identified were: non-specific (four patients), infective (one), irradiation (one) and vasculitis secondary to scleroderma (one). The most common finding was severe lower-limb ischaemia from infrapopliteal occlusion. Arteriography carried out in 16 patients showed either occlusion or stenosis of the affected artery. In one patient an associated renal aneurysm was detected. All patients were advised to stop smoking and unilateral or bilateral lumbar sympathectomy undertaken in those with Buerger's disease. By adopting this policy limb salvage was achieved in nine of the 11 patients with Buerger's disease. In addition to these measures, corticosteroids were prescribed for selected cases of arteritis.
Cardiovasc Surg 1993 Jun
PMID:Arteritis: experience in Jeddah, Saudi Arabia. 807 32

The prevalence of posttransplantation pulmonary infection and the importance of this complication with respect to morbidity in patients undergoing lung transplantation is significant. Over a 1-year period, case histories of all patients undergoing lung transplantation at Barnes Hospital, Washington University, were reviewed to examine the importance of organisms isolated in the donor lung in the development of subsequent invasive infection in transplant recipients. Twenty-eight of 29 bronchial washings (97%) taken from donors before retrieval grew at least one organism. The most common organisms identified were Staphylococcus and Enterobacter. In 12 of these cases (43%), similar organisms were isolated from the tracheobronchial tree of the recipients, and 6 of these recipients (21%) subsequently had invasive pulmonary infections as a result of the organism originally isolated in the donor. We recommend that antibiotic coverage in transplant recipients should be initiated on the basis of Gram stain results and modified on the basis of cultures obtained from the donor lungs. Pathologic analysis of donor lung tissue taken before transplantation was available in 12 cases. Four donors had histologic evidence of established pneumonia in the donor lung, and infections then developed in the recipients. One other patient who received a lung that had widespread bone marrow emboli and subsequent infarction later had a complete anastomotic dehiscence. An additional patient had profound early donor lung dysfunction without any evidence of rejection or infection. Pathologic findings from the donor in this case demonstrated preexistent acute vasculitis with emboli. We suggest that as preservation techniques improve, the opportunities for closer scrutiny of donor lung tissue before implantation will become increasing desirable and feasible.
J Thorac Cardiovasc Surg 1993 Oct
PMID:The donor lung: infectious and pathologic factors affecting outcome in lung transplantation. 777

A 31-year-old woman with Cogan syndrome (a rare form of systemic vasculitis) was evaluated for a cold, painful left foot with diminished pulses. Arteriography demonstrated thrombosis of the left popliteal artery with evidence of vasculitis. Thrombolytic therapy was begun with initial success but eventual rethrombosis. After reinitiating thrombolytic therapy combined with intraarterial vasodilator therapy, successful angioplasty was performed with sustained results at 6-month follow-up.
Cardiovasc Intervent Radiol
PMID:Popliteal artery thrombosis in a patient with Cogan syndrome: treatment with thrombolysis and percutaneous transluminal angioplasty. 899 26


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