1/81. Hyperbaric oxygen in acute ischaemia due to allergic vasculitis.A case of a child with allergic vasculitis to penicillin is presented. The patient received successful treatment with hyperbaric oxygen (HBO) therapy. The pathophysiological mechanism of acute peripheral anoxia and the infleunce of HBO treatment on it is described.- - - - - - - - - - ranking = 1keywords = oxygen (Clic here for more details about this article) |
2/81. hyperbaric oxygenation treatment of acute paraplegia after resection of a thoracoabdominal aortic aneurysm.Acute spinal cord ischemic injury after resection of thoracoabdominal aneurysm remains a relatively common and potentially devastating complication. The complete resolution of postoperative paraplegia after resection of a type II thoracoabdominal aneurysm, after treatment with hyperbaric oxygenation, is reported.- - - - - - - - - - ranking = 1keywords = oxygen (Clic here for more details about this article) |
3/81. Acute fulminant lactic acidosis complicating metastatic cholangiocarcinoma.A patient with cholangiocarcinoma, metastatic to the liver and lungs, developed acute fulminant lactic acidosis in the absence of overt hepatic failure, sepsis, hypoxia, or circulatory failure. Despite extensive tumor replacement of hepatic parenchyma, no acid-base disorder was present during initial evaluation. The onset of acute lactic acidosis was temporally associated with the development of otherwise asymptomatic episodes of intermittent atrial arrhythmias. Once established, lactic acidosis was inexorably progressive, despite resolution of arrhythmias. Extensive areas of acute necrosis within the large hepatic metastases were demonstrated on postmortem examination, suggesting that local tissue ischemia, precipitated by cardiac arrhythmias, lead to excessive lactic acid production.- - - - - - - - - - ranking = 0.17610355113784keywords = hypoxia (Clic here for more details about this article) |
4/81. Core cooling after hypoxia and ischaemia.Two patients sustained severe circulatory inadequacy before and during thoracotomy for coronary surgery. Both patients were promptly cote cooled to between 20 degrees and 25 degrees C. After coronary surgery, each patient was rewarmed and the operation was terminated uneventfully in each case, No important cerebral deficit was apparent despite periods of circulatory insufficiency and arrest which were well beyond the usually accepted limits. It is suggested that prompt core cooling may exert a protective effect in this context.- - - - - - - - - - ranking = 0.70441420455138keywords = hypoxia (Clic here for more details about this article) |
5/81. Postoperative splanchnic perfusion following the reconstruction of thoracoabdominal aortic aneurysm involving abdominal visceral branches. Report of a case.A 58-year-old man with thoracoabdominal aortic aneurysm involving visceral arteries underwent graft replacement of the thoracoabdominal aorta and associated reconstruction of abdominal visceral branches. Femoro-femoral extracorporeal bypass, intermittent selective visceral arterial perfusion and a staging cross-clamping method of the aorta were utilized at surgery. The total cross-clamping time of the aorta was 165 minutes. The patient's postoperative course was uneventful with no incidence of hepatic and renal failure or paraplegia. Although postoperative systemic blood pressure and cardiac output recovered to normal values within 7 hrs after the release of aortic clamping, it took 18 hrs for hepatic venous hemoglobin oxygen saturation (ShvO2) to recover. Base excess in arterial blood, lactic acid in arterial and hepatic venous blood, and ketone body ratio in arterial blood (AKBR) and hepatic venous blood (HVKBR) recovered to within normal ranges after 18 hrs of the release of aortic clamping. ShvO2 monitoring is a simple and may be a useful parameter in evaluating postoperative splanchnic perfusion and predicting abdominal organ failure at the time of thoracoabdominal aortic reconstruction involving visceral arteries.- - - - - - - - - - ranking = 0.2keywords = oxygen (Clic here for more details about this article) |
6/81. Ischemic maculopathy in patients with acquired immunodeficiency syndrome.PURPOSE: To describe the characteristics of ischemic maculopathy in patients with human immunodeficiency virus (hiv) infection, as a means of understanding this uncommon disorder more fully. methods: This is a multicenter, retrospective review of clinical data available for five hiv-infected patients who were given the diagnosis of ischemic maculopathy. RESULTS: All cases had been diagnosed on the basis of fluorescein angiograms obtained after patients complained of vision loss. Four of the five patients had bilateral macular disease. visual acuity at presentation in the nine affected eyes ranged from 20/20 to count fingers. Vision loss was gradual in both eyes of one patient and was abrupt in onset in seven eyes. Each of the seven eyes with abrupt vision loss had opacification of the superficial retina and/or intraretinal hemorrhages near the fovea. fluorescein angiography revealed enlargement of the foveal avascular zone and mild staining of the juxtafoveal vessels in affected eyes. Six eyes had active or clinically inactive cytomegalovirus retinitis at presentation, and a seventh eye developed cytomegalovirus retinitis 2 weeks later. All patients were receiving anticytomegalovirus drugs when they developed visual symptoms. visual acuity remained stable in five eyes, became worse in two eyes, and improved in two eyes; final visual acuity ranged from 20/25 to count fingers. CONCLUSIONS: Ischemic maculopathy may cause profound and permanent vision loss in hiv-infected individuals. fluorescein angiography should be considered in all hiv-infected patients with unexplained loss of vision. The pathogenesis of ischemic maculopathy remains unknown.- - - - - - - - - - ranking = 0.051211747721428keywords = deficiency (Clic here for more details about this article) |
7/81. Catastrophic antiphospholipid antibody syndrome manifesting as an orbital ischemic syndrome.Painful bilateral ophthalmoparesis, marked proptosis, increased intraocular pressure, and blindness developed in a 29-year-old woman with protein c deficiency and catastrophic antiphospholipid syndrome. magnetic resonance imaging of the orbits showed bilateral proptosis, globe tenting, and tethering of the optic nerves consistent with an orbital ischemic syndrome. Despite aggressive therapy for antiphospholipid syndrome, the patient died. The autopsy showed necrosis of orbital tissues. This is the first report of orbital ischemic syndrome from protein c deficiency and antiphospholipid syndrome.- - - - - - - - - - ranking = 0.020484699088571keywords = deficiency (Clic here for more details about this article) |
8/81. Regional extra-corporeal circulation to protect transplanted kidney and pancreas from ischemia during vascular reconstruction.The development of severe aorto-ilio-femoral atherosclerotic disease in a patient with a previous double transplantation, kidney and pancreas, is a major surgical challenge. The transplanted organs have to be protected from extensive ischemia during the vascular reconstructive procedure and achieve optimal revascularization. The surgical management of a complex case where regional extra-corporeal circulation was used to protect transplanted pancreas and kidney during aorto-bifemoral vascular grafting in a 39 yr old diabetic patient is described.Regional femoro-femoral extra-corporeal circulation with an oxygenator is a safe technique that allows time for the proximal revascularization, minimizes the warm organ ischemia time and results in preservation of organ function.- - - - - - - - - - ranking = 0.2keywords = oxygen (Clic here for more details about this article) |
9/81. Retinal oxygen saturation levels in patients with central retinal vein occlusion.PURPOSE: To validate the efficacy of Fourier transform-based spectral retinal imaging (SRI) in quantifying retinal ischemia. DESIGN: Prospective, observational case series. patients AND methods: Eleven eyes of 10 patients with central retinal vein occlusion (CRVO) and 4 fellow unaffected eyes of selected patients were examined by both fluorescein angiography and SRI. The fluorescein angiograms were correlated with oxygen saturation maps that were calculated from the SRI. RESULTS: Oxygen saturation levels in the fundus were shown as color grading in 35 degrees fundus images processed by SRI. This grading correlated well with the severity of CRVO, as estimated by fluorescein angiography. CONCLUSIONS: The severity of circulatory disturbances in CRVO may be graded by applying SRI.- - - - - - - - - - ranking = 1keywords = oxygen (Clic here for more details about this article) |
10/81. Mesenteric ischemia affects young adults with predisposition.An 8-year retrospective review of indiana University hospital records consisting of any patient age 18 to 40 years old who presented with arterial mesenteric ischemia was performed. Three patients were identified that met our criteria. The first patient was discovered to have a protein c deficiency. The second patient was afflicted with afibrinoginemia, a protein C and an antithrombin iii deficiency. The third patient had been previously diagnosed with Takayasu's arteritis and had an elevated ESR. Each patient had a protracted course of symptoms before mesenteric disease was considered, confirmed by angiography, and treated by arterial bypass with/without bowel resection. All patients survived and are currently asymptomatic at an average of 2 years postoperatively. Mesenteric ischemia in patients under the age of 40, especially in the absence of cocaine use, is rare and often causes a delay in diagnosis and appropriate treatment. The high incidence of hypercoagulable states in our study cases suggests the need for a search for such disorders and the possible need for long-term anticoagulation therapy as a deterrent to recurrence.- - - - - - - - - - ranking = 0.020484699088571keywords = deficiency (Clic here for more details about this article) |
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