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[Indications and contraindications for surgical treatment of abdominal-aortic aneurysm].

An analysis of 176 patients with aneurysms of the abdominal aorta is presented, 125 of these patients having been operated on (the average age was 60 years). The presence of an aneurysm of the abdominal aorta, irrespective of its dimentions and nature of clinical manifestations, serves as an indication for surgery, provided the following contraindications are absent: severe state of the patient, fresh myocardial infarction, cardiac lesions with circulatory insufficiency of stage II B or III, fresh haemorrhage to the brain, hepatic and renal lesions with azotemia, atherosclerotic occlusion of vessels in the lower extremities with a complete block of all major vessels.

Adolescent↗

[Systemic amyloidosis as a cause of so-called atherosclerotic hemorrhagic complications].

BACKGROUND: A survey of the pathogenesis, diagnostics and treatment of amyloidosis is presented, illustrated by long-term clinical experience with the treatment of 28 patients with primary amyloidosis, 4 patients with familial and 7 patients with secondary amyloidosis. METHODS AND RESULTS: To all patients combined treatment of glucocorticosteroids and cytostatics was administered. For primary amyloidosis methylprednisolone, vincristine (oncovine), cyclosphosphamide, alkeran, chlorethylnitrosourea (MOCCA), and in secondary amyloidosis cyclophosphamide, vincristine, prednisone (CVP). In all patients, this treatment was combined with dimethylsulphoxide treatment (DMSO) administered in intravenous infusion (5 g/100 ml saline) for 3-5 days before the start of cytostatic therapy. In primary amyloidosis the median of survival was 48 months, in secondary amyloidosis the median survival was 72 months. CONCLUSIONS: The authors emphasise the need of an early diagnosis and start of comprehensive therapy completed in recent years successfully with immunomodulatory therapy using hydrolytic enzymes (WOBE MUGOS).

Adult↗

[Magnetic resonance angiography].

INTRODUCTION: MR angiography (MRA) is a group of MRI techniques capable of producing projectional images of arteries and veins without the use of ionising radiation or catheters. MATERIAL AND METHODS: This review describes two of the main techniques, time-of-flight (TOF) MRA and phase contrast MRA, that provide high signal-intensity vessels due to flow phenomena, and a third main technique, contrast-enhanced MRA, which relies on intravenous injection of contrast media. Contrary to the iodine-containing x-ray contrast media, the contrast media for MRA are not nephrotoxic, making contrast-enhanced MRA a good alternative for patients with reduced renal function. MRA is indicated in several vascular areas, especially head and neck arteries and veins, the large thoracic and abdominal arteries and veins, and the lower extremity arteries. INTERPRETATION: For several indications, the sensitivity and specificity of MRA is approaching those of the gold standard, x-ray angiography. There are reasons to believe that most diagnostic angiographic procedures will soon be performed as MRA.

Aortography↗

[Magnetic resonance angiography].

INTRODUCTION: MR angiography (MRA) is a group of MRI techniques capable of producing projectional images of arteries and veins without the use of ionising radiation or catheters. MATERIAL AND METHODS: This review describes two of the main techniques, time-of-flight (TOF) MRA and phase contrast MRA, that provide high signal-intensity vessels due to flow phenomena, and a third main technique, contrast-enhanced MRA, which relies on intravenous injection of contrast media. Contrary to the iodine-containing x-ray contrast media, the contrast media for MRA are not nephrotoxic, making contrast-enhanced MRA a good alternative for patients with reduced renal function. MRA is indicated in several vascular areas, especially head and neck arteries and veins, the large thoracic and abdominal arteries and veins, and the lower extremity arteries. INTERPRETATION: For several indications, the sensitivity and specificity of MRA is approaching those of the gold standard, x-ray angiography. There are reasons to believe that most diagnostic angiographic procedures will soon be performed as MRA.

Aortography↗

[Effect of xuefu zhuyu pill on blood stasis syndrome and risk factor of atherosclerosis].

OBJECTIVE: To observe the effect of Xuefuzhuyu Pill (XFZYP) on blood stasis syndrome and risk factor of atherosclerosis. METHODS: Fifty-seven patients of atherosclerosis were randomly divided into XFZYP group (30 cases) and aspirin group (27 cases) treated with XFZYP (6 g, three times daily) and aspirin (40 mg per day) oral taken respectively for one month. RESULTS: XFZYP could improve blood stasis syndrome of patients (P < 0.01) and reduced the level of risk factor of atherosclerosis, including high blood cholesterol (P < 0.01), oxidation of low density lipoprotein (P < 0.05) and plasma granule membrane protein alpha (P < 0.01). CONCLUSION: XFZYP is beneficial to retard the progress of atherosclerosis.

Aged↗

Isolated stenosis of a persistent hypoglossal artery visualized at 3D CT angiography.

The persistent hypoglossal artery is a rare perseverance of an embryonic vessel connecting the anterior and posterior circulations and is generally considered to be an incidental finding. This is a case of a patient with an atherosclerotic narrowing at the origin of the persistent hypoglossal artery seen at 3D CT angiography. The pertinent findings and clinical implications of this anomalous vessel are discussed.

Aged↗

[Multicenter survey on clinical features and regional variations in acute brain infarction].

To assess the clinical features and regional variations in clinical profile of and managements for acute ischemic stroke patients, 14,864 patients with 3 major clinical categories of brain infarction (lacunar, atherothrombotic and cardioembolic stroke), among the acute ischemic stroke patients registered by 156 representative hospitals all over Japan (Japan Multicenter Stroke Investigators' Collaboration: J-MUSIC) during a period of one year from May 1999 to April 2000, were subjected to the study. Data were analyzed in each 7 geographic district (Hokkaido, Tohoku, Kanto, Chubu, Kinki, Chugoku/Shikoku and Kyushu). As for overall proportions of 3 major categories, lacunar stroke was the most common type (41.3%), followed by atherothrombotic (35.4%) and cardioembolic stroke (23.3%). In Kanto, Kinki and Chugoku/Shikoku Districts, however, proportion of atherothrombotic stroke was larger than that of lacunar stroke, which seemed to correspond to the higher frequency of patients with diabetes mellitus and hyperlipidemia in these 3 districts. Drug treatments, care and hospital facilities varied among districts considerably. Nation-wide consensus for ideal treatments by each stroke category is therefore needed.

Aged↗

Diagonal earlobe creases and atheromatous disease: a postmortem study.

The association between the grade of earlobe creases and degree of atheromatous disease was investigated in 376 postmortem examinations. Each earlobe crease was individually graded from 0 to 3. The risk of atherosclerosis as a cause of death was nearly doubled in men with grade 3 creases in both earlobes, and more than trebled in women with bilateral high-grade creases. The risk of death from myocardial infarction was 2.50 in men with high-grade creases and 3.70 in women. The earlobe crease is an important sign of atheromatous disease and it may be useful to include it in the clinical examination of patients.

Aged↗