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At least 1,243 records · Page 69Linked to original sources

Hypercoagulability in patients with peripheral vascular disease.

Twenty-seven patients with peripheral vascular disease had studies of thrombin generation, antithrombin III -alues, factor VIII values, platelet adhesitivity, and activated partial thromboplastin time. Of the studies performed, the thrombin generation index, antithrombin III values, and, to a lesser extent, activated partial thromboplastin time were reliable in confirming clinically suspected hypercoagulability. When patients were placed into groups with and without operative complications, it was noted that the group with operative complications had higher average values of thrombin generation index and lower average values of antithrombin III and activated partial thromboplastin time than did the group without operative complications. It is thought that these tests may be useful in selecting those patients with a high risk of thrombotic complications from vascular surgery and who may benefit from anticoagulant management while undergoing necessary vascular reconstructive procedures.

Adult↗

[Methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism in ischemic vascular disease].

AIM: Genetic and metabolism of C677T methylenetetrahydrofolate reductase (MTHFR) mutation and its relationship with ischemic vascular disease are revised. DEVELOPMENT: Homocygotes for C677T MTHFR mutation, 10-15% of general population, develop a thermolabil variant of the MTHFR enzyme which has a reduced functional activity. Because of this lower activity, is more likely for these patients to have mild hyperhomocysteinemia, a potential vascular risk factor, through their lives. A correct intake of folates and group B vitamins can help to compensate this genetic trend caused by the mutation. CONCLUSION: Molecular finding of C677T MTHFR mutation allow us to identify a part of population with a potential risk factor for ischemic vascular disease, with the advantage that is an easily revertible factor by modulation of the diet.

Brain Ischemia↗

[Radiologic spectrum of specific vascular diseases].

The diagnosis of vascularitis should be proposed when a concentric and regular thickening of the wall of the aorta or one of its branches is observed or when there is late enhancement of the arterial wall, on sites which are usually free from atheromatous lesions and in a young patient. The radiologist must be aware of the associated clinical signs: oral and genital ulcerative lesions in the Behçet syndrome; finger necrosis in a young male smoker in Buerger disease; hip and shoulder arthropathy and headache in a 70 Year old female and Horton disease; pulseless upper limbs and inflammatory syndrome in a young adult for the Takayasu arteritis. The diagnosis of popliteal entrapment or adventitial cyst should be proposed in young patients without atheromatous lesions.

Adult↗

Regulation of antioxidant and oxidant enzymes in vascular cells and implications for vascular disease.

Data from numerous studies demonstrate that oxidative stress plays an important role in the pathogenesis of vascular disease. Oxidative stress leads to many pathologic events, such as inactivation of nitric oxide, lipid oxidation, enhanced mitogenicity and apoptosis of vascular cells, and increased expression and activation of redox-sensitive genes, which contribute to atherogenesis at all stages of the disease. Multiple enzymes are expressed in vascular cells that are involved in the elimination and production of reactive oxygen species, including the superoxide dismutases, catalase, thioredoxin reductase, glutathione peroxidase, NAD(P)H oxidase, xanthine oxidase, myeloperoxidase, and endothelial nitric oxide synthase. Several agonists and pathologic conditions that predispose to vascular disease induce changes in the expression and activity levels of these antioxidant and oxidant enzyme systems, leading to modulation of vascular oxygen radical load. Identification of key enzymes and mechanisms of vascular oxidative stress is important for the development of novel, specific pharmacologic interventions.

Animals↗

Differing distributions of CXCR3- and CCR4-positive cells among types of interstitial pneumonia associated with collagen vascular diseases.

Interstitial pneumonia (IP) is an important complication in collagen vascular diseases (CVDs). We examined the distribution of helper T cell subsets in lung biopsies of cases of IP associated with CVD (CVD-IP). The tissues from 27 CVD-IP patients with rheumatoid arthritis (RA), 8 with polymyositis or dermatomyositis (PM/DM), and 8 with systemic sclerosis (SSc) were compared with those from 10 patients with idiopathic pulmonary fibrosis (IPF) in our previous study. The expressions of CXCR3 and CCR4 (chemokine receptors associated in vitro with Th1 and Th2 cells, respectively) in the mononuclear infiltrate were analyzed immunohistochemically. The positive cells were semiquantified in fibrosing areas of the CVD-IP and IPF cases. The number of CXCR3-positive cells was significantly greater in RA-IP than in PM/DM-IP, SSc-IP, or IPF, whereas there were fewer CCR4-positive cells in RA-IP, PM/DM-IP, and SSc-IP than in IPF. The CXCR3-/CCR4-positive cells ratio was significantly higher in RA-IP and PM/DM-IP (but not in SSc-IP) than in IPF. These results support previous reports of the dominance of Th2 cells in some SSc-IP and IPF cases. However, Th1-type immune responses may predominate in RA-IP and PM/DM-IP. Our findings suggest that the pathogenesis of CVD-IPs differs with the helper T cell subset.

Adult↗

Intravenous digital subtraction angiography and its role in ocular vascular disease.

One hundred patients with ocular occlusive vascular disease were studied by intravenous digital subtraction angiography (IV DSA). In 17 patients with transient monocular blindness, 65% showed ipsilateral carotid atheroma. The degree of carotid stenosis was greater than 70% in eight of the 17 patients. Severe unilateral or bilateral stenosis was demonstrated in 70% of ten patients with chronic retinal artery obstruction, ie, venous stasis retinopathy or orbital hypoxia. An ipsilateral carotid artery source of emboli or substantial degree of stenosis was documented in 50% of 48 patients with acute retinal artery obstruction. Little or no carotid disease was found in 72% of 25 patients with retinal vein obstruction. The greatest value of IV DSA is in the management of patients with transient monocular blindness.

Aged↗

Arterio-venous shunting complicating occlusive atherosclerotic peripheral vascular disease.

Three cases of severe occlusive peripheral vascular disease are described in which spontaneous arterio-venous fistulae at the site of atheromatous occlusion have been demonstrated by angiography during the arterial phase. Although none of these patients exhibited specific clinical signs of an arterio-venous fistula, this phenomenon is considered to have been a clinically significant factor in the patients' peripheral ischaemia. In one case both the superficial femoral artery stenosis and the spontaneous shunts were effectively treated by percutaneous angioplasty.

Aged↗

Renal vascular disease and renovascular hypertension in children.

Renal vascular disease is the second most common cause of secondary pediatric hypertension, usually occurring as intimal or atypical medial-perimedial stenoses. Developmental lesions account for 40 per cent of these stenoses. Assessments of renin activity and arteriography are useful in identifying functionally important lesions. Urography in this age group has little diagnostic utility. Renal revascularization offers a 95 per cent beneficial outcome to properly selected patients.

Age Factors↗

Immunization of the elderly and patients with collagen vascular diseases with live varicella vaccine and use of varicella skin antigen.

Elderly subjects and patients with collagen vascular diseases were immunized with a live varicella vaccine to assess the vaccine's potential for preventing herpes zoster. An improved varicella-zoster virus (VZV) skin test antigen was then used to assess cell-mediated immunity to VZV. The antigen was prepared from culture fluid of VZV-infected cells and had far less protein content than crude antigen prepared by sonication of infected cells. In 11 of 12 patients with ophthalmic zoster and 17 of 21 with dermal zoster, the skin reaction was negative at the beginning of the disease but became positive later. After two doses of VZV vaccine, 8 of 12 elderly subjects (greater than 60 years old) and 4 of 6 patients with collagen vascular diseases, who were VZV-skin test negative but purified protein derivative tuberculin test-positive, became VZV skin test-positive.

Adolescent↗

Differentiation between idiopathic pulmonary fibrosis and interstitial pneumonia associated with collagen vascular diseases by comparison of the ratio of OKT4+ cells and OKT8+ cells in BALF T lymphocytes.

Idiopathic pulmonary fibrosis (IPF) and interstitial pneumonia associated with collagen vascular disease have been shown to be difficult to differentiate by clinical, roentgenological, pathological and immunological findings. We have applied the analysis of BALF T cell phenotypes to these two groups by enumerating the cell populations of OKT4+ and OKT8+ cells in BALF and, as a result, have been able to discern a clear and meaningful differentiating point between the two groups. In all 9 patients with IPF were examined in whom OKT4+ cells outnumbered OKT8+ cells in BALF T cell subsets, while 13 patients with collagen vascular disease were tested (3 SLE, 6 RA, 2 Sjögren's syndrom and 2 MCTD) in whom OKT8+ cells were more numerous than OKT4+ cells. No difference was observed in blood T lymphocytes between these two groups. These results provide us with a means of differentiation between these groups, especially in clinically borderline cases.

Adrenal Cortex Hormones↗