Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0162871 (abdominal aortic aneurysm)
 8,664 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Abdominal aortic reconstruction surgery in patients with arteriosclerosis obliterans usually has been carried out under standard intratracheal anaesthesia and only a some few centres have included continuous suprameningeal anaesthesia. On the basis of that scanty data it seems that combined intratracheal and suprameningeal anaesthesia might have some advantages over the standard anaesthesia owing to reducing general symptoms of perioperative stress. The aim of this study was to investigate the operative stress during abdominal aortic reconstruction in patients with arteriosclerosis obliterans as dependent on a type of anaesthesia: standard intratracheal and combined-intratracheal supported by suprameningeal doses of anaesthetics. The evaluation of a magnitude of perioperative stress was based on determinations standard markers of stress response in serum: cortisol, adrenaline, noradrenaline, somatotropic hormone and glucose as well. The assessment of the stress condition during abdominal aortic reconstruction in patients with arteriosclerosis obliterans might be of a great importance as most of the patients suffer from ischaemic heart disease. Thus, the choice of an optimal perioperative treatment might improve recovery process. Elective abdominal aortic reconstruction with prosthesis implantation were performed in the year 1995 in 42 patients--8 with abdominal aortic aneurysm (AAA) and 34 with aorto-iliac occlusion (AIO) divided at random in 2 comparable groups according to a type of anaesthesia: I--standard, general anaesthesia supported by myorelaxants and by analgetic drugs given intravenously in a postoperative period, II--combined anaesthesia with a standard general anaesthesia fortified by subarachnoid anaesthesia (0.5% bupivacaine with morphine) reaching the T4-T5 dermatome. The case protocol included: duration of surgery, duration of aorta clamping, type of prosthesis, blood loss, fluid balance, serum level of cortisol, adrenaline, noradrenaline, human growth hormone, glucose, blood morphology, and total creatine kinase activity. Analysing of mean levels of stress markers has shown that they have been lower in combined anaesthesia. It seems that combined anaesthesia is better than the standard anaesthesia owing to reducing general symptoms of perioperative stress.
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PMID:[Operative stress during aorto-bifemoral reconstruction as dependent on a type of anesthesia]. 1107 Jul 62

Aortocaval fistula is a rare complication of ruptured abdominal aortic aneurysm (AAA), and patients with an aortocaval fistula show multiple symptoms. We report an 87-year-old man who was diagnosed as having an AAA with aortocaval fistula and who developed refractory hypotension after induction of anesthesia. Following a phenylephrine injection for slight hypotension induced by anesthetic induction, he developed severe hypotension and bradycardia, and his skin became cyanotic. Vasopressor agents had no immediate effect on the hypotension, but blood pressure gradually increased in about 30 min with continuous infusion of dopamine and noradrenaline. Transesophageal echocardiography (TEE) showed right ventricle (RV) hypokinesis and massive tricuspid regurgitation (TR). Central venous pressure (CVP) showed a remarkably high value. After the repair of the aortocaval fistula, the hemodynamics became stable, RV motion was improved, TR was reduced, and CVP became normal. Anesthetic management of the repair of an aortocaval fistula is very difficult. The hemodynamics changed dramatically throughout anesthesia in our patient with this disorder, even though low-dose anesthetics were used. For the successful treatment of this disorder, preparation for the operation is required before the induction of anesthesia, and urgent closure of the fistula is necessary after the induction of anesthesia. TEE is a useful tool for monitoring hemodynamics in such patients.
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PMID:Anesthetic management of a patient with aortocaval fistula. 1923 33

We investigated the effect of valproate (ip, 500 mg/kg), which is regarded as a potent plasma protein tryptophan (TRP) displacer, on the central nervous system (hippocampal) and peripheral (plasma) levels of the aromatic amino acids (AAAs; e.g. TRP, tyrosine and phenylalanine) and branched-chain amino acids (BCAAs; e.g. valine, isoleucine and leucine) as well as the other amino acids (glutamate, GABA, alanine, glutamine, glycine, aspartate and taurine) involved in the regulation of neurotransmission. Furthermore, we investigated whether the changes in the BCAA/AAA ratio affected the hippocampal concentration of monoamines [serotonin (5-HT), dopamine (DA) and noradrenaline (NA)]. Valproic acid (VPA) administration potently modified the balance between the BCAA and AAA. In the brain, the significantly increased AAA and decreased BCAA concentrations were followed by a decrease in the BCAA/AAA ratio. In the plasma, VPA significantly decreased the BCAA and AAA levels. The changes in the BCAA and AAA levels were accompanied by an increase in the NA, DA and 5-HT levels as well as hippocampal 5-HT metabolism. This novel finding indicates that VPA, through the displacement of TRP from its protein-binding sites, could disturb the BCAA/AAA ratio, with central nervous system consequences, including the possible contribution to VPAs effects in affective disorders.
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PMID:Valproate disturbs the balance between branched and aromatic amino acids in rats. 2424 29

Renewal in extinction learning describes the recovery of an extinguished response if the extinction context differs from the context present during acquisition and recall. Attention may have a role in contextual modulation of behavior and contribute to the renewal effect, while noradrenaline (NA) is involved in attentional processing. In this functional magnetic resonance imaging (fMRI) study we investigated the role of the noradrenergic system for behavioral and brain activation correlates of contextual extinction and renewal, with a particular focus upon hippocampus and ventromedial prefrontal cortex (PFC), which have crucial roles in processing of renewal. Healthy human volunteers received a single dose of the NA reuptake inhibitor atomoxetine prior to extinction learning. During extinction of previously acquired cue-outcome associations, cues were presented in a novel context (ABA) or in the acquisition context (AAA). In recall, all cues were again presented in the acquisition context. Atomoxetine participants (ATO) showed significantly faster extinction compared to placebo (PLAC). However, atomoxetine did not affect renewal. Hippocampal activation was higher in ATO during extinction and recall, as was ventromedial PFC activation, except for ABA recall. Moreover, ATO showed stronger recruitment of insula, anterior cingulate, and dorsolateral/orbitofrontal PFC. Across groups, cingulate, hippocampus and vmPFC activity during ABA extinction correlated with recall performance, suggesting high relevance of these regions for processing the renewal effect. In summary, the noradrenergic system appears to be involved in the modification of established associations during extinction learning and thus has a role in behavioral flexibility. The assignment of an association to a context and the subsequent decision on an adequate response, however, presumably operate largely independently of noradrenergic mechanisms.
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PMID:Noradrenergic stimulation modulates activation of extinction-related brain regions and enhances contextual extinction learning without affecting renewal. 2574 89