WordNet

bring disorder to (同)disarray
a physical condition in which there is a disturbance of normal functioning; "the doctor prescribed some medicine for the disorder"; "everyone gets stomach upsets from time to time" (同)upset
a disturbance of the peace or of public order
of or relating to or having vessels that conduct and circulate fluids; "vascular constriction"; "a vascular bundle"
not arranged in order (同)unordered

PrepTutorEJDIC

〈U〉『無秩序』,混乱,乱雑(confusion) / 《しばしば複数形で》(社会的・政治的な)粉争,騒動 / 〈C〉(肉体的・精神的な)不調,異常,障害 / …‘の'秩序を乱す / 〈心身〉‘に'異常を起こさせる
(血液・樹液などを運ぶ)管の,導管の,血管の

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/06/17 19:03:25」(JST)

wiki en

Vascular disease is a form of cardiovascular disease primarily affecting the blood vessels.

Some conditions, such as angina and myocardial ischemia, can be considered both vascular diseases and heart diseases.^[1]

Cigarette smoking is the major risk factor.^[2]

Background

Vascular disease is a pathological state of large and medium sized muscular arteries and is triggered by endothelial cell dysfunction. Because of factors like pathogens, oxidized LDL particles and other inflammatory stimuli endothelial cells become activated. This leads to change in their characteristics: endothelial cells start to excrete cytokines and chemokines and express adhesion molecules on their surface. This in turn results in recruitment of white blood cells (monocytes and lymphocytes), which can infiltrate the blood vessel wall. Stimulation of smooth muscle cell layer with cytokines produced by endothelial cells and recruited white blood cells causes smooth muscle cells to proliferate and migrate towards the blood vessel lumen. The process causes thickening of the vessel wall, forming a plaque consisting of proliferating smooth muscle cells, macrophages and various types of lymphocytes. This plaque result in obstructed blood flow leading to diminished amounts of oxygen and nutrients, that reach the target organ. In the final stages, the plaque may also rupture causing the formation of clots, and as a result strokes.

Diagnosis

It can be very difficult to make a vascular disease diagnosis as there are a wide variety of symptoms that a person can carry.^[3] Vascular diagnosis is primarily made upon the symptoms, family history and after a physical examination performed by a specialist.

The physical exam may be slightly different depending on the type of vascular disease that is suspected. In the case of a peripheral vascular disease the physical exam consists in checking the blood flow in the legs or flow or the blood pressure. During the physical examination of a cerebrovascular disease the doctor listens with the help of a stethoscope to detect abnormal sounds of blood flow (called bruit) on the neck.^{[citation needed]}

Tests and exams

In order to confirm a cerebrovascular disease, few additional tests may be required whenever there are doubts in what the diagnosis concerns. These may include tests such as the cerebral angiography (carotid angiogram). This test is made by inserting a catheter into the patient's artery in the leg with the help of a needle through the vessels in the abdomen and chest, until it reaches the arteries of the neck. The coronary angiogram is basically the same procedure which is however utilized for detecting cardiovascular conditions.

The carotid duplex (carotid ultrasound) is another type of noninvasive test which uses ultrasound waves in order to detect plaque, blood clots or any other type of blood flow abnormalities in the carotid arteries. The specialists may detect hemorrhagic strokes with the help of a X-ray computed tomography. They are easily visualized due to the differences in density between the blood, bone and brain tissue. The CT scans are also useful in finding out abnormalities in the heart and in diagnosing cardiovascular conditions.^[4]

The Doppler ultrasound is a test used to diagnose both cerebrovascular disease and peripheral vascular disease. It utilizes high frequency sound waves that are being directed to the vein or artery which presents abnormalities and are then detected on the Doppler.

Electroencephalography may be required in order to detect electrical impulses in the brain by placing small metal discs called electrodes on the scalp of the patient.

The magnetic resonance imaging technique is able to obtain 3D images of the body structure. The images are very clear and they are produced by using magnetic fields and recent computer technology. Due to the clarity of the pictures, the MRI can detect any signs of prior strokes. The MRI may also be performed on the heart if a cardiovascular disease is suspected. A lumbar puncture may also be performed but this is an invasive test which consists in taking a sample of cerebrospinal fluid from the space surrounding the spinal cord. The purpose of this test is finding traces of blood which may be due to cerebral hemorrhage.^[5]

Upon suspicion of peripheral vascular disease, the first-line study is the ankle brachial pressure index (ABPI/ABI) which is a measure of the fall in blood pressure in the arteries supplying the legs. An ABPI value that exceeds 0.9 is the confirmation that a peripheral vascular disease is not present. If the value of the ABPI is lower than 0.8, the peripheral vascular disease exists but it is normally a mild case. On the other hand, a value below 0.5 is the proof of a serious vascular condition.

References

^ http://www.bhf.org.uk/heart-health/conditions/cardiovascular-disease.aspx
^ "What is Vascular Disease?".
^ Vascular Disease diagnosis 2010-02-12
^ University of Maryland medical center. "Vascular Disease Screening" 2010-02-12.
^ Lumbar Puncture and Stroke American Heart Association. Retrieved on 2010-02-12

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 脳卒中評価の概要 overview of the evaluation of stroke
2. 脳卒中の病因、分類、および疫学 etiology classification and epidemiology of stroke
3. 急性脳卒中の初期評価およびマネージメント initial assessment and management of acute stroke
4. 虚血性脳卒中の二次予防の概要 overview of secondary prevention of ischemic stroke
5. Extracranial carotid artery aneurysm

English Journal

Novel insights in localization and expression levels of C5aR and C5L2 under native and post-transplant conditions in the kidney.

van Werkhoven MB, Damman J, Daha MR, Krikke C, van Goor H, van Son WJ, Hillebrands JL, van Dijk MC, Seelen MA.SourceDepartment of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, Postbus 30001, 9700 RB Groningen, The Netherlands. Electronic address: m.b.van.werkhoven@umcg.nl.
Molecular immunology.Mol Immunol.2013 Mar;53(3):237-45. doi: 10.1016/j.molimm.2012.08.013. Epub 2012 Sep 6.
AIMS: The complement system, and especially C5a, plays an important role in the pathophysiology of renal diseases and post-transplant renal injury. The two receptors for C5a are C5a receptor (C5aR) and C5a-like-receptor-2 (C5L2). Only renal C5aR expression has been reported, although exact localizat
PMID 22960554

Japanese Journal

再メチル化障害により退行を示しベタイン食療法が効果を示した1例

島田姿野,舟塚真,中陣瑠美,平野嘉子,伊藤進,吉井啓介,石垣景子,大澤真木子
東京女子医科大学雑誌 83(E1), E307-E312, 2013-01-31
メチオニン、ホモシステインはDNAメチル化において重要な働きを担い、メチル基転移反応の中心的な役割を担う。脳は遺伝子の厳密な調整を必要とする臓器でありDNAメチル化により遺伝子発現調節を行う。故にメチル基転移機構の異常はしばしば重篤な神経疾患を引き起こしうる。今回、アミノ酸代謝異常による再メチル化障害により急激な退行を来たし、ベタイン食事療法により神経症状の改善を認めた一例につき報告した。症例は9 …
NAID 110009559396

透析液カルシウム濃度3.0mEq/Lから2.75mEq/Lへの変更は血清PTH濃度に影響しない

松浦有希子,稲熊大城,板脇大輔 [他],隅智子,中川星明,岡田昭次,高木茂樹,新城響,冨永芳博,両角國男
日本透析医学会雑誌 = Journal of Japanese Society for Dialysis Therapy 45(9), 873-880, 2012-09-28
慢性腎臓病に伴う骨・ミネラル代謝異常が提唱されて以後，リン（P）ならびにカルシウム（Ca）の管理が，単に骨代謝だけではなく，血管石灰化と深く関連し生命予後にも影響を与えることが注目されている．薬物療法としては，ビタミンD受容体刺激剤（VDRA），Ca含有あるいは非含有P吸着剤に加え，二次性副甲状腺機能亢進症治療薬であるシナカルセト塩酸塩が登場し，臨床的に使用可能な薬剤が多くなってきている中で，透析 …
NAID 10031123034

Related Pictures

★リンクテーブル★

リンク元	「血管障害」「angiopathic」
拡張検索	「cerebrovascular disorder」「cardiovascular disorder」
関連記事	「disorder」「vascular」