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Query: UMLS:C0162871 (abdominal aortic aneurysm)
 8,664 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To assess the early morbidity and mortality from coronary artery disease (CAD), we reviewed the charts of 49 patients who had elective resection of infrarenal abdominal aortic aneurysms between September 1978 and February 1986 at the VA and LSU medical centers in Shreveport. On the basis of history, physical examination, and resting electrocardiogram, patients were divided into two groups--those with clinical evidence of coronary artery disease (group 1, n = 21) and those without clinical evidence of coronary artery disease (group 2, n = 28). End points measured were perioperative (30-day) myocardial infarction (MI) rate and death. A definite MI was diagnosed when an abnormally elevated CPK-MB was accompanied by a new electrocardiographic abnormality or a reversal of the normal LDH isoenzyme pattern. A possible MI was diagnosed when an elevated CPK-MB was the only abnormality. In group 1, one definite (4.5%) and two possible (9.5%) MIs occurred. In group 2, there were no definite or possible MIs. All cardiac events were discovered by measurements of cardiac enzymes, since none of the patients had cardiac symptoms. This retrospective study reveals a low incidence of clinically significant cardiac events after resection of abdominal aortic aneurysms, even in patients with clinical evidence of coronary artery disease. Prophylactic coronary artery bypass surgery does not appear to be necessary for most patients needing repair of an abdominal aortic aneurysm.
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PMID:Cardiac complications of aneurysm repair. 270 72

The changes of serum enzyme and metabolism were studied by comparing the serial change among three groups. The first group consisted of twenty seven patients treated by surgery under extracorporeal circulation. The second group of ten patients of thoracic aortic aneurysm treated under temporary bypass and the third group of nineteen patients of abdominal aortic aneurysm under aortic cross clamp. The following results were obtained: The enzyme of serum GOT, LDH and CPK increased postoperatively in the all groups, the changes after surgery being greater in the group 1 than the other groups. The metabolism of lactic acid and glycolipid was depressed in the group 1 higher than the other groups. The tissue injury of total body after surgery with extracorporeal circulation was greater than the other groups without extracorporeal circulation. And these results suggest the necessary of improvement of circuit and perfusion technique of extracorporeal circulation.
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PMID:[Clinical study of serum enzyme and metabolic changes after extracorporeal circulation--comparison with the surgery of aortic aneurysm]. 372 94

In this study, we tested a new artificial liver device using liver pieces in 8-h hemoperfusion of comatous porcine blood and compared two alternative tissue preparations. Acute hepatic coma in the pigs was induced by complete devascularization of the liver. The animals were killed in stage IV coma (15-25 h after the operation), and 1 l blood was perfused over 200 g fresh or DMSO-preserved liver cubes. After the devascularization GOT, GPT, GLDH, AP, LDH, SDH, bilirubin, free fatty acid, and bile acid levels in serum increased progressively. Ammonia concentrations underwent a rapid increase in the first 9 h of coma development from 126.0 +/- 9.9 to 321.9 +/- 62.2 mumol/l. Most of the amino acids in serum were elevated and molar ratio of BCAA/AAA declined from 3.87 +/- 0.79 to 0.92 +/- 0.24. In the course of hemoperfusion ammonia was removed from the perfusate to 71% of the initial values using fresh and to 39% using preserved tissue. Correspondingly, there was an increase in urea concentrations. Amino acid metabolism was ameliorated during the perfusion; Fischer's quotient increased from 0.91 +/- 0.15 to 1.38 +/- 0.14 (fresh liver) and from 0.89 +/- 0.14 to 2.11 +/- 0.44 (preserved liver); neuroexcitatory amino acids Asp and Glu were markedly elevated. Energy charge of the liver cells increased and reached levels exceeding 0.5 in both experimental groups, a balanced energy metabolism was maintained and suggests active metabolization by the liver pieces. In comparison with fresh tissue, preserved liver cubes proved effective. We consider our artificial liver device capable of temporary hepatic support in acute necrosis of the liver and suppose that its efficiency can be potentiated by combining this system with other procedures.
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PMID:Successful treatment of hepatic coma by a new artificial liver device in the pig. 408 14

Intestinal ischemia after abdominal aortic surgery is a highly lethal complication. In order to evaluate the pathogenesis, the diagnostic modalities and the best management, in a retrospective review, 12 patients undergoing postoperative small bowel or colonic ischemic lesions were identified between 1983 and 1995. Preoperative occlusion of IMA was present in nine patients, while a selective angiography of SMA demonstrated occlusive disease of peripheral branches in two asymptomatic diabetic patients. No patent IMA was ligated. When possible, hypogastric circulation was preserved by distal anastomosis into iliac bifurcation (4 cases). Postoperative leukocytosis or elevated LDH values were present. Colonscopy showed a suspected ischemic colitis in two patients and necrotic lesions in three cases. One patient died and diagnosis was made at autopsy. Nine patients were submitted to reoperation and a bowel resection with a proximal stoma was performed in seven of them. In two patients, the aorta or iliac artery below the proximal anastomosis and hypogastric artery suffered acute thrombosis, while prosthetic grafts were patent. A coagulation disorder caused thrombosis of intramural arterioles of the small bowel while peripheral branches of SMA were pulsatile. Eight of the patients submitted to relaparotomy died; non-operative management resulted in a left colon late stricture, while the remaining patient survived without sequelae. Overall mortality rate was 66.6%. Symptoms of this complication are not specific and diagnosis is delayed; consequently surgical repair is often unsuccessful. One patient with small bowel necrosis after elective AAA resection survived, which is extremely rare.
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PMID:Intestinal ischemia after aortic surgery. 891 93

Heterointerface engineering can be used to develop excellent catalysts through electronic coupling effects between different components or phases. As one kind of promising Pt-free electrocatalysts for hydrogen evolution reaction (HER), pure-phased metal phosphide exhibits the unfavorable factor of strong or weak H*-adsorption performance. Here, 6 nm wall-thick Ni2 P-NiP2 hollow nanoparticle polymorphs combining metallic Ni2 P and metalloid NiP2 with observable heterointerfaces are synthesized. It shows excellent catalytic performance toward the HER, requiring an overpotential of 59.7 mV to achieve 10 mA cm-2 with a Tafel slope of 58.8 mV dec-1 . Density functional theory calculations verify electrons' transfer from P to Ni at the heterointerfaces, which decreases the absolute value of H* adsorption energy and simultaneously enhance electronic conductivity. That is, the heterojunctions balance the metallic Ni2 P and the metalloid NiP2 to form an optimized phosphide polymorph catalyst for the HER. Furthermore, this polymorph combination is used with NiFe-LDH nanosheets to form an alkaline electrolyzer. It shows highly desirable electrochemical properties, which can reach 10 mA cm-2 in 1 m KOH at 1.48 V and be driven by an AAA battery with a nominal voltage of 1.5 V. The work about interfacial charge transfer might provide an insight into designing excellent polymorph catalysts.
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PMID:Interfacial Electron Transfer of Ni2 P-NiP2 Polymorphs Inducing Enhanced Electrochemical Properties. 3028 80