Signs Of Impaired Circulation Research Articles

Morphological Changes and Characteristics of the Expression of Serine Racemase in the Rat Hippocampus after Repeated Exposure to Negative Gravitational Overload

Objectives: To study the morphometric parameters and levels of expression of serine racemase in the rat hippocampus after repeated gravitational overloading in the caudocranial direction (–9 Gz). Materials and methods. Rats aged 12 months were subjected to a force of 9 G for 5 min twice a day with 12-h intervals for 28 days (group 2; gravity; n = 10). Rats not exposed to hypergravitation constituted group 1 (controls, n = 10). The morphometric mean areas of the nuclei and perikarya of pyramidal neurons were determined, along with the specific number of neurons with signs of damage and the relative areas of the perikarya of pyramidal neurons and the neuropil. Immunohistochemical studies addressed the level of expression of serine racemase in all zones of the hippocampus. Results. Signs of impaired circulation in the microcirculatory compartment were seen in the form of spongiosis, thickening of capillary walls, and diapedesis of erythrocytes. All zones of the hippocampus in experimental rats showed sharp increases in the numbers of pyramidal neurons with signs of damage. Atrophic changes were identified, consisting of reductions in the mean and relative perikaryon areas of neurons. Immunohistochemical studies demonstrated increased expression of serine racemase in field CA1, along with translocation of reactive material into the processes of pyramidal neurons. Fields CA3 and CA4 showed a tendency to decreases in serine racemase contents. Conclusions. Prolonged gravitation in the caudocranial direction produced signs of marked damage in all hippocampal fields in rats, combined with enhanced expression and accumulation of serine racemase in the dendrites of field CA1 pyramidal neurons, which may be evidence for the involvement of excitotoxicity in the mechanisms of secondary damage in these zones.

Immediate fluid management of children with severe febrile illness and signs of impaired circulation in low-income settings: a contextualised systematic review

ObjectiveTo evaluate the effects of intravenous fluid bolus compared to maintenance intravenous fluids alone as part of immediate emergency care in children with severe febrile illness and signs of impaired...

Post-thrombotic syndrome, recurrence, and death 10 years after the first episode of venous thromboembolism treated with warfarin for 6 weeks or 6 months.

The influence of the duration of anticoagulant therapy after venous thromboembolism (VTE) on the long-term morbidity and mortality is unclear. To investigate the long-term sequelae of VTE in patients randomized to different duration of secondary prophylaxis. In a multicenter trial comparing secondary prophylaxis with vitamin K antagonists for 6 weeks or 6 months, we extended the originally planned 2 years follow-up to 10 years. The patients had annual visits and at the last visit clinical assessment of the post-thrombotic syndrome (PTS) was performed. Recurrent thromboembolism was adjudicated by a radiologist, blinded to treatment allocation. Causes of death were obtained from the Swedish Death Registry. Of the 897 patients randomized, 545 could be evaluated at the 10 years follow-up. The probability of developing severe PTS was 6% and any sign of PTS was seen in 56.3% of the evaluated patients. In multivariate analysis, old age and signs of impaired circulation at discharge from the hospital were independent risk factors at baseline for development of PTS after 10 years. Recurrent thromboembolism occurred in 29.1% of the patients with a higher rate among males, older patients, those with permanent triggering risk factor - especially with venous insufficiency at baseline - signs of impaired venous circulation at discharge, proximal deep vein thrombosis, or pulmonary embolism. Death occurred in 28.5%, which was a higher mortality than expected with a standardized incidence ratio (SIR) of 1.43 (95% CI 1.28-1.58), mainly because of a higher mortality than expected from cancer (SIR 1.83; 95% CI 1.44-2.23) or from myocardial infarction or stroke (SIR 1.28; 95% CI 1.00-1.56). The duration of anticoagulation did not have a statistically significant effect on any of the long-term outcomes. The morbidity and mortality during 10 years after the first episode of VTE is high and not reduced by extension of secondary prophylaxis from 6 weeks to 6 months. A strategy to reduce recurrence of VTE as well as mortality from arterial disease is needed.

The Infragluteal Skin Flap: A New Option for Reconstruction in the Perineogenital Area

Use of a local flap is often needed for closure of a defect in the perineogenital area. For this we have applied a pedicled skin flap raised in the infragluteal fold, the technical details and surgical results of which are presented in this paper. From 1985 until 1995, this infragluteal flap has been used to widen the vaginal introitus in 6 patients, to reconstruct the labia majora in 5, to close a rectovaginal fistula in 4, and to reconstruct the perineal body in 1. In all 16 patients the flap survived without signs of impaired circulation. The donor scar is inconspicuously located in the natural infragluteal plica, not violating any anatomic unit. The infragluteal skin flap adds to the surgical armamentarium for perineal and genital repair.

Intussusception Complicated by Bowel Perforation During Hydrostatic Reduction

Most perforations of the bowel during attempt at hydrostatic reduction of intussusception occur in an area of localised infarction in the normal transverse or left colon. An animal model of intussusception was used to find indications for the cause of this phenomenon. We submitted the intussuscipiens of 10 strangulated intussusceptions in 6 dogs to a histological examination. In 6 of 10 intussusceptions we found ischaemic changes in the mucosa of the intussuscipiens. In 3 cases these lesions were multiple. All lesions were found in locations where there was a close contact between the intussusceptum and the intussuscipiens. We did not find signs of impaired circulation of the whole intussuscipiens. We conclude that our findings give an indication that perforation of the intussuscipiens during attempt at hydrostatic reduction occurs through areas of localised ischaemic infarction on the basis of direct pressure by the intussusceptum.

Mönckeberg's arteriosclerosis.

MONCKEBERG'S arteriosclerosis is a clinically benign form of calcification of the blood vessels. Needless anxiety results from failure to differentiate this condition from intimal arteriosclerosis. Intimal arteriosclerosis often goes on to progressive occlusion of the blood vessels and carries an unfavorable prognosis. In Monckeberg's arteriosclerosis, thrombosis of the blood vessels in the extremities does not occur, and in patients who have been observed for many years there has been no tendency to develop impaired circulation. The clinical characteristics that distinguish Monckeberg's arteriosclerosis from other forms are extreme calcification of the arteries of the lower extremities in young and middle-aged persons who have no symptoms or signs of impaired circulation. Calcification of the blood vessels is usually discovered by accident when a roentgenogram is made for arthritis, fracture, or some other bone or joint condition. There are no complaints of coldness or pain in the legs or difficulty in walking. All

MONCKEBERG'S ARTERIOSCLEROSIS

Monckeberg's arteriosclerosis is a clinically benign form of calcification of the blood vessels. Needless anxiety results from failure to differentiate this condition from intimal arteriosclerosis. Intimal arteriosclerosis often goes on to progressive occlusion of the blood vessels and carries an unfavorable prognosis. In Monckeberg's arteriosclerosis, thrombosis of the blood vessels in the extremities does not occur, and in patients who have been observed for many years there has been no tendency to develop impaired circulation. The favorable prognosis in Monckeberg's arteriosclerosis has been pointed out by Moschcowitz.1The clinical characteristics that distinguish Monckeberg's arteriosclerosis from other forms are extreme calcification of the arteries of the lower extremities in young and middle-aged persons who have no symptoms or signs of impaired circulation. Calcification of the blood vessels is usually discovered by accident when a roentgenogram is made for arthritis, fracture, or some other bone or joint condition. There are no