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PubMed1994

[The effect of noise and vibration on the cardiovascular system in exposed workers and possibilities of preventing their harmful effects].

We examined the state of blood pressure, peripheral arterial circulation and changes of polycardiogram before and after three hour work of 160 workers professionally exposed to noise and vibrations. They were divided into two sub-groups regarding physical recreational activity (walking, swimming or running), with the average load level from 60% to 80% of maximal oxygen consumption. 85 workers made up the control group. They were not exposed to noise and vibrations at work. The gathered results show that the prevalence of the arterial hypertension and obliterating endarteritis is statistically significantly higher in the group of workers exposed to noise and vibrations and that these professional damages cause important hemodynamic changes of cardiovascular system, but also that permanent physical recreational activity (swimming, running or walking) can prevent such effects.

Cardiovascular Diseases↗
PubMed1994

[Use of vazaprostan in the treatment of multifocal peripheral obliterating lesions of arteries of the lower limbs].

Vazaprostan was prescribed to 13 patients with the lower limbs obliterating atherosclerosis and the coronary arteries atherosclerotic lesion (first group) and in 17--with obliterating atherosclerosis and endarteritis of the lower limbs vessels (second group). The treatment was found to be effective one in all of the patients of the first group and in 13--of the second. The authors consider vazaprostan application to be expedient in patients with the lower limbs obliterating lesions as a supplement to operative intervention and also in coincidence of this pathology with the ischemic heart disease.

Aged↗
PubMed1995

[The involvement of the cardiovascular system in syphilis].

Three lethal cases of visceral (cardiovascular) syphilis are reported. A pathogenetic role of specific vasculitis in organic lesions, of myocarditis in a decline of inotropic cardiac function and endarteritis of renal vessels in development of organic parenchymatous insufficiency are discussed.

Adult↗
PubMed1994

[Secondary sclerosing cholangitis and chemo-embolization with lipiodol].

Two cases of sclerosing cholangitis after oily arterial chemoembolization are reported. In one patient angiocholitis with liver abscesses, in the other patient gradual cholestasis were the main clinical features. In both cases, endoscopic retrograde cholangiogram showed a stricture of the common hepatic bile duct and, in one case, irregularities of intrahepatic biliary tree. Histologic examination of the liver in the two patients pointed out the involvement of small bile ducts and arteriolar endarteritis obliterans. Ischaemia is likely to be the main mechanism of these two cases of sclerosing cholangitis as well as in those described after FUDR intra-arterial chemotherapy. The prevalence of sclerosing cholangitis after arterial oily chemoembolization is probably underestimated because of a non specific clinical presentation and need to be precise by further study.

Carcinoma, Hepatocellular↗
PubMed1996

IgA nephropathy in patients over 50 years of age: a multicentre, prospective study.

BACKGROUND: IgA nephropathy (IgAN) is considered as a disease of young men under 30 years of age. Findings on clinical and histological presentation and outcome in older patients have rarely been published. METHODS: In a prospective cohort of IgAN patients, recruited over 3 years, 33 patients over age 50 were compared to 96 patients under age 50, according to clinical and histological findings. Actuarial renal survival rate was studied after a mean post-biopsy follow-up of 41 months. RESULTS: Both groups of patients were comparable at baseline for frequency of proteinuria, microscopic haematuria and gross haematuria, but older patients had a significantly higher incidence of hypertension (65 vs 24%, P<0.01). Time between onset and diagnosis of IgAN was similar in both groups. Proteinuria/day, systolic blood pressure, and serum IgA levels were significantly higher, and Ccr was significantly lower in older patients at the time renal biopsy was performed, but serum creatinine and albumin were not. No difference was observed between the two groups for the presence of glomerular or tubulointerstitial lesions. Only endarteritis was significantly more common in older patients (75 vs 34%, P<0.01). End-stage renal failure (ESRF) was confirmed in five patients over 50 and 17 under 50. Renal actuarial survival curves did not show any significant difference between the two groups, even though the six patients who died were classified as ESRF. CONCLUSIONS: When the histological diagnosis of IgAN was established, factors that carry a poor prognosis, i.e. proteinuria, high blood pressure, and decreased Ccr were more commonly present in patients over 50 than under 50. However, after the completion of a relatively short follow-up period, renal survival was identical in the two study groups. Prolonged follow-up is necessary to confirm this trend.

Adolescent↗
PubMed1977

[Sepsis after catheterization of the femoral artery].

The catheterization of the femoral artery in a case of necrotic stage of obliterating endarteritis resulted in the development of sepsis. Catheterization of main arteries and intraaterial medication in patients, suffering from obliterating diseases of the arteries of the lower extremities, holds the risk of bringing the infection into the arterial bed, and, hence, such medication should be performed only under especially strict aseptic conditions.

Catheterization↗
PubMed1989

Lacunar syndrome due to neurocysticercosis.

Seven patients with neurocysticercosis presented with a lacunar syndrome. Four patients had sensorimotor stroke, two had pure motor hemiparesis, and one had ataxic hemiparesis. In every patient, computed tomography or magnetic resonance imaging or both showed a lacunar infarct that was secondary to the occlusion of a terminal vessel affected by endarteritis and was most commonly associated with cysticerci in the suprasellar cistern. Diagnosis of neurocysticercosis was difficult on clinical grounds, but proper integration of data from computed tomography and cerebrospinal fluid analysis provided an accurate diagnosis in every case. Neurocysticercosis should be considered in the differential diagnosis of young adults with a lacunar syndrome who come from areas of the world where this disease is endemic.

Adolescent↗
PubMed1979

Hyperbaric oxygen. A new adjunct in the management of radiation necrosis.

Radiation necrosis is a significant complication of surgery for previously irradiated head and neck malignant neoplasms. We used hyperbaric oxygen therapy (HBO) as adjunctive therapy in 52 cases of radiation necrosis. Thirty-nine cases involved the head and neck. Nineteen of 23 cases of osteoradionecrosis of the mandible remain arrested after as much as two years of follow-up. Fifteen of the 16 cases of soft-tissue radionecrosis of the head and neck were successfully managed with HBO therapy as an adjunct to surgery and antibiotics. Fibroblastic proliferation, collagen formation, and capillary budding require at least 20 to 30 mm Hg of wound Po2. This effect can be achieved in wounds that are rendered hypoxic by radiation endarteritis and ischemia with high-dose or hyperbaric oxygenation.

Adult↗
PubMed1976

Rheumatoid arthritis with rheumatoid heart disease and granulomatous aortitis.

Aortic insufficiency and aortitis are frequent complications of ankylosing spondylitis but are considered rare in rheumatoid arthritis. A 49-year-old woman with severe rheumatoid arthritis had the cardiovascular changes common to both diseases. At autopsy, the heart and aorta showed granulomatous ane fibrinous pericarditis and epicarditis, "core" granulomas in the aortic valve cusps and mitral valve leaflets, and coronary arteritis. These are considered to be classical changes of rheumatoid carditis. In addition, there were mesoaortitis with obliterative endarteritis of the vasa vasorum and fibrosis of the aortic cusps with separation of the commissures. These are considered to be changes of ankylosing spondylitis. This case, therefore, represents a mixed form of cardiovascular involvement within the spectrum of the rheumatoid diseases.

Aorta↗
PubMed2000

Malignant hypertension - the role of the paracrine renin-angiotensin system.

Malignant hypertension remains one of the life-threatening complications of blood pressure elevation. It is a clinico-pathological syndrome of severe blood pressure elevation combined with malignant vascular injury. This is a characteristic form of vascular damage, with two elements: fibrinoid necrosis and endarteritis proliferans. Although the morphology of these has been well described, the molecular events are not fully understood. This review summarizes the evidence from transgenic animals for a role for the activation of a local paracrine renin-angiotensin system in the pathogenesis of malignant vascular injury. These animal models provide pathological, pharmacological, and genetic evidence supporting the hypothesis that intra-renal generation of angiotensin 2 and exposure of the microcirculation to elevated blood pressure co-operate in causing tissue damage in malignant hypertension.

Angiotensin II↗
PubMed1994

Breast reconstruction. Surgical options and patient selection.

Breast reconstruction has undergone a steady evolution since the introduction of the silicone gel prosthesis in the early 1960s. Current restrictions of the use of breast implants have increased the reliance on autologous tissue reconstruction. The improvement in the quality of breast reconstruction can be attributed in part to a refinement in mastectomy technique. There is an increasing emphasis on skin preservation, which makes it easier to match the remaining breast. In this paper, various methods, including tissue expansion, the latissimus dorsi flap, the transverse rectus abdominis musculocutaneous flap, and free flaps, are described. The indications as well as potential complications for each methods also are discussed. Local recurrence after breast conservation generally necessitates a total mastectomy. Radiation fibrosis and endarteritis interfere with skin blood supply and impair wound healing. Reconstruction in this setting has a potential for increased operative morbidity. Treatment options, including techniques to reduce potential complications, are presented.

Breast Neoplasms↗
PubMedDate not supplied

Nodular regenerative hyperplasia of the liver associated with the toxic oil syndrome: report of five cases.

Nodular regenerative hyperplasia of the liver developed in five patients who had the toxic oil syndrome caused by ingestion of adulterated cooking oil. This hepatic complication was detected from 19 to 37 months (mean-2.5 years) after the onset of the toxic oil syndrome. Nodular regenerative hyperplasia was asymptomatic, although all patients had persistently abnormal liver function. Hepatomegaly was present in four cases, mild jaundice in three and signs of portal hypertension in two. Pathogenesis of nodular regenerative hyperplasia in toxic oil syndrome is unknown, but probably microcirculatory disturbances within the liver might have played a role. Fibrosis in Zone 3, sinusoidal dilatation and occasionally intralobular hemorrhage were seen in three cases; in one of them, characteristic lesions of veno-occlusive disease were also present. In another case, endarteritis changes of hepatic arterioles were evident.

Adolescent↗
PubMed1976

Pulmonary arterial thrombo-embolism and pulmonary arterial mycotic aneurysms in cattle with vena caval thrombosis: a condition resembling the Hughes-Stovin syndrome.

Sixteen cattle affected by thrombosis of the posterior vena cava were examined post mortem and the various lesions are described. The thrombus was in the hepatic portion in 12 animals and in the intrathoracic part in four. Thrombi had formed as a result of phlebitis in 13 cases in which hepatic or post-diaphragamatic abscesses were present but the aetiology of the other three was not discovered. Embolism from the vena cava thrombus resulted in pulmonary lesions in every case: these included pulmonary arterial thrombo-embolism, pulmonary arteritis, pulmonary endarteritis, chronic suppurative pneumonia and the formation of multiple pulmonary abscesses. The pulmonary arterial lesions had given rise to mycotic aneurysms of that vessel and rupture of these was followed by massive haemoptysis or intrapulmonaary haemorrhage. Pulmonary arterial aneurysms are not common in man and are very rare in animals, except in association with vena cava thrombosis of cattle. However, the "Hughes-Stovin" syndrome of man has some features in common with the condition described in cattle and these are discussed. The different sequelae of posterior vena cava thrombosis and infective endocarditis of the right heart in cattle are also considered.

Aneurysm, Infected↗
PubMed1996

Relationship of pelvic radiation to intestinal blood flow.

Pelvic radiation remains the mainstay in the treatment of many malignancies. Chronic radiation injury represents an obliterative endarteritis. The purpose of our experiment was to investigate the chronic changes in blood flow that occurred in a model of pelvic radiation. Also, we investigated the potential benefits of an elemental diet, sodium meclofenamate, and vitamin A within the radiated large and small bowel. Female Sprague-Dawley rats, 200-250 g, were anesthetized and received 900 rads once a week for 5 weeks for a total of 4500 rads. Group B received sodium meclofenamate, group C elemental diet, and group D vitamin A. Group A received radiation only where control animals (group E) received anesthesia but no radiation. All animals were given treatments during the course of radiation therapy only. Blood flow was determined within the terminal ileum, proximal jejunum, and distal colon 1 week, 5 weeks, 6 months, and 1 year postradiation therapy. Blood flow was determined by strontium-labeled 15-microns microspheres. Results showed that radiation resulted in an increase in blood flow within the terminal ileum at 1 week postradiation of approximately 175% when compared to controls. Blood flow then decreased (59%) when compared to controls at 5 weeks and increased (141%) again at 6 months when compared to controls. No change in blood flow was noted at 1 year postradiation therapy. An elemental diet and sodium meclofenamate prevented these changes in blood flow at each of these times points. No change in blood flow was seen at any of the time points measured within the jejunum or colon.

Animals↗
PubMed1985

Human cardiac transplants. Diagnosis of rejection by endomyocardial biopsy. Causes of death (about 30 autopsies).

1,000 endomyocardial biopsies performed in 110 patients treated by cardiac graft were reviewed. These biopsies permitted early detection of acute rejection after cyclosporin treatment and a good appreciation of its intensity. By this method, almost all rejection episodes were resolved after adequate treatment. Chronic rejection was diagnosed by arteriography used in vivo or in cardiac transplants removed by surgery or necropsy. Rejection provoked an obliterative fibrous endarteritis often complicated by atherosclerosis and its ischaemic consequences. 34 autopsies were performed in patients dead at a variable time after cardiac or cardio-pulmonary transplantation. In early death (14 cases), graft failure and systemic disorders were observed. Acute and chronic rejection was noted less frequently (9 cases). Systemic infections (10 cases) occurred either early (post-surgical complications) or late (bacterial, fungal and parasitic lesions). In one case, death was due to a contemporaneous bladder carcinoma. The complications of cyclosporin treatment are briefly discussed.

Acute Disease↗
PubMed1990

Experimental complete ureteric occlusion in sheep: radionuclide renography and histopathologic findings.

Complete ureteric occlusion produces various pathophysiological changes that can be monitored externally by technetium 99m diethylenetriamine penta-acetic acid (99mTc-DTPA) diuretic renography (RDR). Being a dynamic imaging study, it reflects the function of the kidneys and the urodynamics of the urinary tract. The aim of this study was to correlate the changes in parameters of RDR with the histological changes before and after the release of complete ureteric occlusion. In 9 sheep, RDR studies were performed serially after various periods of complete ureteric occlusion (up to 7 weeks) and after release of the occlusion (up to 5 weeks). The histological changes were correlated with changes in RDR. The progressive decrease in renal flow seen on renal images and flow time-activity curves (TACs) was explained by the development of endarteritis and thrombosis of small renal arteries. The progressive decrease in the renal uptake as indicated by the percentage renal uptake and the extraction slope of TAC is related to the progressive damage to the renal parenchyma, initially affecting the collecting ducts and tubules, with increasing interstitial fibrosis in the later stages. Obstruction for 3 weeks or less was associated with moderate damage to the parenchyma from which recovery was possible. Obstruction for 7 weeks was associated with marked damage without chance of recovery. The RDR is a non-invasive technique that can be used to monitor kidney damage after various periods of complete ureteric occlusion and to predict the outcome of surgery before the release of occlusion.

Animals↗
PubMed1991

Arteriolosclerosis of the human renal allograft: morphology, origin, life history and relationship to cyclosporine therapy.

In the decade 1979-1988, 658 biopsies were collected from 568 cadaveric renal allografts. In 118 grafts a non-proliferative insudative vasculopathy (IVA) was found in afferent vessels. Immunosuppression was based on azathioprine (AZA) or on cyclosporin A (CsA), from 1983. The prevalence and extent of IVA has increased significantly since 1984. Light microscopy showed fibrinoid and hyaline masses of varying extent; transmural insudative "knobs", intimal oedema with metachromasia, and microthrombosis were also seen with CsA. The ultrastructure of the insudates was unremarkable but CsA grafts displayed early oedema and hypergranulation of endothelial cells with a disarray of smooth muscle cell (SMC) microfibrils, and pronounced degenerative changes of SMC. Rebiopsy showed stationary IVA in AZA grafts and progression in one-half of CsA-treated patients. Nephrectomy specimens revealed, however, a marked predominance of late rejection endarteritis; in only 3 cases was IVA and/or microthrombosis the possible cause of nephrectomy. The mean donor age was higher in severe IVA in CsA grafts and the mean post-transplantation interval at the time of diagnosis of IVA was significantly shorter in CsA-treated patients. No important differences in cumulative graft survival were seen between grafts with absent, moderate or severe IVA. Unused cadaveric donors' kidneys of comparable age exhibited normal arterioles or a slight focal insudative or hyaline lesion.

Arteries↗
PubMed1989

Is MCTD a distinct entity? Comparison of clinical and laboratory findings in MCTD, SLE, PSS, and RA patients.

Eighteen patients diagnosed as suffering from MCTD were reexamined during follow-up (mean duration 4.6 years). The clinical features of these patients were compared with those of 19 patients with systemic lupus erythematosus (SLE), 11 with progressive systemic sclerosis (PSS) and 22 with rheumatoid arthritis (RA). Considerable overlapping of abnormal features was found between MCTD and the other syndromes. At the end of the follow-up period, 70 per cent of the cases initially diagnosed as MCTD evolved to a more classical connective tissue disease, i.e., either PSS or SLE. Generally, however, the clinical evolution of the individual MCTD patient was not predictable. Abnormal aortic valve calcifications were found in the MCTD group. Four of the 18 MCTD patients were anti-RNP negative at reexamination. There was a tendency for HLA antigens B7 and B8 to be increased in the MCTD group, but this difference was not statistically significant. Three MCTD patients died before they could be reexamined (two of them from pulmonary hypertension with proliferative endarteritis of the lung vessels and one from septicaemia and multiple cerebral infarctions.

Adult↗