bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation, by Noninvasive Methods, of the Effects of Acute Loss of Thyroid Hormones on the Heart
Authors: Fazio Serafino , Biondi Bernadette , Lupoli Giovanni , Cittadini Antonio , Santomauro Maurizio , Tommaselli Antonio P. , Lombardi Gaetano , Sacca Luigi
Published: November 2007

To evaluate the effects of the acute loss of thyroid hormones on the heart the authors studied 11 women with acute hypothyroidism. The cardiac study was performed by means of electrocardiography (ECG), radionuclide ventriculog raphy (RNV) at rest and under effort, and monodimensional echocardiography (MD-echo) and was repeated with ECG and MD-echo after six months of thyrox ine suppressive therapy. The ECG showed a significant prolongation of QT in terval and flattening and inversion of T wave with normal heart rate. The MD-echo revealed left ventricular function in the normal range and normal left ventricular dimensions. RNV showed the ejection fraction in the lower normal range at rest, which increased to a smaller extent under effort in comparison with a control group. The ECG performed during suppressive therapy with L- thyroxine yielded normal findings with an increase of heart rate and of R wave amplitude, and the MD-echo showed no significant variations of cardiac func tion due to the increase of heart rate.
Beneficial Effects of Methionine on Myocardial Hemodynamic and Cellular Functions in Hemorrhagic Shock
Authors: Kapoor Rakesh , Kalra Jawahar , Prasad Kailash
Published: November 2007

Hypochlorous acid (HOCI), produced by activated polymorphonuclear (PMN) leukocytes, has been reported to depress cardiac function and contractility. Var ious mechanisms exist for activation of PMN leukocytes during hemorrhagic shock and reperfusion. In order to determine the role of HOCI in hemorrhagic shock and reinfusion, the authors studied the effects of shock and reinfusion on the cardiac function, contractility, blood lactate, blood gases, and creatine kinase (CK) and MB fraction of CK (MBCK) with and without methionine (quencher of HOCI) in anesthetized dogs. Dogs were divided into two groups: Group I, hemorrhagic shock (two hours) and reinfusion (two hours): Group II, hemorrhagic shock and reinfusion with methionine treatment. Cardiac index, mean arterial pressure, and index of cardiac contractility were similar in the two groups during shock. Postinfusion recovery of cardiac function and con tractility was better in group II. Increases in blood lactate were similar in the two groups during shock. The rate of return of blood lactate to preshock values after reinfusion was greater in group II. The increases in serum CK and MBCK of the two groups during shock were similar but not significant. Following rein fusion the levels of these enzymes increased significantly, but the increases in group II were less.

These results suggest that HOCI produced by activated PMN leukocytes may play a role in cardiac damage during hemorrhagic shock and reinfusion. Methio nine may have beneficial effects in the hemodynamic and metabolic recovery and may reduce cellular damage during hemorrhage shock and reinfusion.
Nailfold Videomicroscopy and Local Cold Test in Type I Diabetics
Authors: Gasser P. , Berger W.
Published: November 2007

Twenty-five type I diabetics (9 men, 16 women) with a mean disease duration of 19.9 years and 25 sex- and age-matched healthy control subjects were stud ied.

Digital capillary blood flow measurements in combination with a local cool ing test were assessed by nailfold videocapillaroscopy using the technique of flying spot and compared with nailfold capillary microscopy in four subgroups divided according to (A) disease duration, (B) retinopathy, (C) fasting blood glucose level, and (D) HbA 1c values. Differences in morphologic capillary diame ters and capillary density were found between the diabetics and the healthy control subjects. These were attributable to the patients with retinopathy.

The hemodynamic findings at rest and after local cooling were unable to differentiate either between type I diabetics and healthy controls or within the different subgroups.
Cardiovascular Disease in Male Patients with Carotid Transient Ischemic Attacks or Minor Strokes
Authors: Falke P. , Stavenow L. , Hansen F. , Lilja B. , Lindgärde F.
Published: November 2007

The authors tested the hypothesis that coronary heart disease and lower extremity atherosclerosis occur more frequently in patients with transient ische mic attacks (TIA) than in patients with minor stroke. Thirty-three consecutive male patients with TIA and 36 with minor stroke from the carotid artery terri tory were examined with ultrasonography of the cardiac, iliac, and femoral arteries; echocardiography (UCG); electrocardiogram (ECG); thallium scinti graphy (TS) of the myocardium; and assessment of the ankle/arm index (A/AI). TS showed myocardial infarctions to be more common among TIA patients than among minor stroke patients, 54% vs 19%, p=0.019. UCG showed the frequency of left ventricular and atrial dilatation to be higher in the TIA group than in the minor stroke group, 64% vs 27%, p=0.0084. Significant artery stenosis (≥ 50%) was not, however, more frequent in the TIA group than in the minor stroke group, nor was there any significant difference between the groups in A/AI. The frequency of TS-verified myocardial infarction (MI) was higher in the subgroup with ≥ 50% carotid artery stenosis than in that with < 50% stenosis, 61% vs 25%, p=0.022, and also higher in the pathological UCG subgroup than in the normal UCG subgroup, 50% vs 15%, p=0.025.

Thus, there was a greater incidence both of TS-verified MI and of UCG verified cardiac dilatation in the TIA group than in the minor stroke group but no difference between the groups in the degree of atherosclerosis either in the carotid or lower extremity regions. The findings constitute further support for a previous hypothesis of ours, that carotid TIA and minor stroke often differ in vascular pathophysiology.
Hypernatremic Dehydration Complicated by Peripheral Gangrene in Elderly—Case Reports
Authors: Schwartz J. , Leibovitz A. , Habot B.
Published: November 2007

The authors describe the association of hypernatremic dehydration and pe ripheral gangrene in elderly patients. This association is known in infancy but hitherto has not been described in the elderly.
Arteriovenous Malformation of the Vein of Galen in a Newborn Diagnosed with Color Doppler Examination—
Authors: Eltohami Eltohami A. , Robida Andrej
Published: November 2007

A fourteen-day-old newborn infant presented with severe heart failure due to arteriovenous malformation of the vein of Galen. It was diagnosed by two- dimensional, pulsed-wave and color Doppler echocardiographic imaging. The latter method showed the afferent vessel to be the anterior cerebral artery en tering an aneurysm of the vein of Galen at its posterior aspect. Information for surgical anatomic definition appears to be adequately provided by color Dop pler examination, which permits avoidance of preoperative angiography.
Cardiosynchronous Limb Compression: Effects on Noninvasive Vascular Tests and Clinical Course of the Ischemic Limb
Authors: Steinberg Joel
Published: November 2007

Some patients with chronic arterial obstruction of the limbs may still suffer the consequences of advanced tissue ischemia, including ulceration and rest pain, and face threatened limb loss in spite of available surgical, pharmaco logic, and other treatments. Additional therapeutic modalities were thus sought to accomplish limb salvage. A literature review indicated that most reports on R-wave-triggered circumferential limb compression (cardiosynchronous limb compression [CSC]) demonstrate its ability to augment limb arterial blood flow and improve ischemic limbs. To determine the device's efficacy and safety, and possibly confirm earlier positive reports, a systematic study was undertaken, using older, as well as newer, more electronically reliable CSC devices.

The present study was designed to determine the following:

1. objectively, by noninvasive vascular tests, changes in limb blood flow, if any, by CSC

2. clinical effects of CSC, if any, on the ischemic limb

3. duration of CSC-induced limb improvements, if any

4. side effects or safety of CSC

The study demonstrated that CSC treatments:

1. caused increased limb blood flow as determined by increased ankle/arm indices and hallux photoplethysmograph waveform amplitudes during treatments

2. led, in most cases, to improvement in or resolution of the presenting is chemic problem (eg, ulcer, cellulitis, rest pain)

3. induced limb improvements that persist for up to seven years

4. caused no adverse side effects
First-Pass Radionuclide Cineangiography: A Reevaluation of Its Sensitivity and Limitations in the Detection of Significant Coronary Artery Disease
Authors: Sacher Howard L. , Sacher Michael L. , Landau Stuart W. , Dietrich Kathleen A. , Chien Allen , Dooley Frances
Published: November 2007

The sensitivity of first-pass cineangiography in the detection of significant coronary artery disease (CAD) was recently assessed in 33 patients. No normal controls were studied. Overall sensitivity was 86% with a predictive value of 83% and a 36% false-positive rate. Attainment of an adequate exercise end point increased sensitivity to 92%; failure to achieve this end point diminished sensitivity to 71%. Correlation between first-pass and contrast angiography ejection fractions was high (r = 0.88, p < .005) with a moderate correlation in wall motion analysis (r=0.58, p < .005). The development or the intensification of a wall motion abnormality (WMA) was the single most sensitive indicator of CAD (84%). Presence of WMA plus failure of the ejection fraction to increase by 6% over baseline increased testing sensitivity to 89%. The mean WMA score for patients with CAD was 2.0±1.5 compared with 0.6±1.3 for those with nor mal study results (p < .01). The first-pass method identified 4 subjects who sub sequently had normal findings from catheterization. Data confirm testing sensitivity of the first-pass technique and underscore the apparent limitations of this modality in differentiation of patients with normal vasculture.
Anomalous Septal Perforator Artery: A Source for Supportive Circulation in Severe Coronary Artery Disease—Case Reports
Authors: Topaz On , Mackall Judith A. , Nair Ravi , Thames Marc D. , Hodgson John McB.
Published: November 2007

Anomalous origin of a septal perforator artery is an infrequent angiographic finding. However, its recognition is important in patients with coronary artery disease in order to avoid misdiagnosis and consequent management mistake. In 2 patients, coronary arteriography demonstrated an anomalous septal perfora tor artery supplying significant blood flow to a myocardial region previously perfused by a severely obstructed major coronary vessel. It appears that an anomalous septal artery can serve as an important source for supportive circu lation in severe coronary artery disease.
Efficacy of Antihypertensive Medication in Orthotopic Heart Transplant Recipients and its Effect on Renal Function
Authors: Schechter David , Ziady Galal M. , Lee Ann , Armitage John M. , Kormos Robert L. , Griffith Bartley P. , Hardesty Robert L.
Published: November 2007

The authors looked at 77 patients following orthotopic heart transplant who received a triple immunosuppressive regimen including cyclosporine to see the effect of various antihypertensive medications on mean arterial blood pressure and renal function. There were 62 men and 15 women retrospectively classified into three groups according to the antihypertensive medications they received. Group 1 included 26 patients followed up for 10.7 ± 2.7 months who received hydralazine therapy. Group 2 included 32 patients followed up for 9.0 ± 3.4 months who received angiotensin-converting enzyme inhibition therapy. Group 3 included 19 patients followed up for 10.1 ± 3.3 months who received beta- adrenergic blocking agents. Mean arterial pressure (MAP), serum blood urea nitrogen (BUN), and serum creatinine (CR) were determined for each group at the start and end of the follow-up period. The MAP at the start of the study was 107 ± 14 in group 1,110 ± 13 in group 2, and 100 ± 11 in group 3. It was not statistically significantly different in any of the groups.

At the end of the follow-up period, MAP was 112 ± 10, 111 ± 10, and 106 ± 12 for the three groups respectively, and it was not significantly different in any group. The serum BUN in group 3 was 25 ± 8 mg/dL at the start of the study, and it was not significantly lower than that in group 1, 28 ± 6, but it was significantly different from that in group 2, 34 ± 9, P < 0.05. At the end of the follow-up period, the difference was still maintained. Moreover, it was signifi cantly different also from the BUN of group 1. The serum CR was 1.16 ± 0.25 at the start in group 3, and it was not significantly lower than that of either group 1 (1.27 ± 0.25) or group 2 (1.38 ± 0.37). There was a significant rise of serum CR levels in all groups over the duration of the follow-up (P < 0.05) re gardless of the antihypertensive therapy they received, however, CR of group 3 was significantly lower than that of groups 1 and 2 at the end of the follow-up.

The authors conclude that hypertension that develops after heart transplant is not easily controlled by medications. The deterioration in renal function over time is not related to the height of arterial blood pressure or to the antihyperten sive medications used.
Clinical and Angiographic Features of Patients from the Indian Subcontinent Treated with Intravenous Streptokinase for Acute Myocardial Infarction: Experience in Qatar
Authors: Chouhan Lalit K. , Hajar Hajar A. , George Thomas , Pomposiello Juan Carlos
Published: November 2007

The authors reviewed their experience with 245 patients who were treated with intravenous streptokinase for acute myocardial infarction at an average time of less than three hours from the onset of chest pain. Of these, 148 patients were from the Indian subcontinent (Group 1) and the remaining (Group 2) were predominantly from an Arabic background. Group 1 patients were younger and had lower serum cholesterol and fibrinogen levels than the Group 2 patients. Group 1 patients had a lower incidence of previous myocardial infarction (p = 0.0006) and antecedent angina pectoris (p = 0.017). A patency rate of 77.5 % was seen in all patients studied at 5.37±2.96 days after admission and was similar in both the groups. Group 1 patients had a lesser extent of coronary artery disease (p = 0.01) manifested as a higher incidence of single-vessel disease (p = 0.06) and a lower incidence (p = 0.06) of three-vessel obstruction. The overall mortality for the initial hospitalization was 2.18% and showed no difference between the two groups. Patients from the Indian subcontinent presenting with acute myocardial infarction appear to be a unique population in that they are younger, have a somewhat lower cardiac risk profile, and have less extensive coronary artery disease than their Arabic counterparts.
Cerebral Microcirculatory Changes After Cerebral Embolization Induced by Glass Bead Injection in Rabbits
Authors: Nagano Hiroshi , Suzuki Tsunemasa , Hayashi Motohide , Asano Makishige
Published: November 2007

The authors investigated microcirculatory changes in cerebral embolization induced by an injection of glass beads (mesh size 20/400, 15 mg/body) using intravital microscopy and reflectance spectrophotometry in normal rabbits. Cerebral embolization with the glass bead injection reduced the inner diameter of cerebral arterioles, the index of cerebral hemoglobin concentration (IHb), and the index of oxygen saturation (ISO2). Moreover, platelet aggregation rates and plasma levels of thromboxane B2 (TXB2) and 6-keto-prostaglandin F1α (6-keto-PGF1α) appreciably increased. During observation of the pial vasculature, "white bodies" became visible at the entrance of arteriolar branchings two to three minutes after the glass bead injection. After indomethacin administration (3 mg/kg, IV), they could not observe white bodies, and platelet aggregation rates were significantly reduced. The plasma levels of TXB2 and 6-keto-PGF1α were also significantly reduced. These findings suggest that glass beads do injury to the microvascular endothelial cells leading to development of white bodies, ie, "flying thrombi." Therefore, the cerebral microvascular embolization induced by the glass bead injection appears to be an experimental model for evaluating efficacy of remedies for the cerebral microcirculatory disorders.
Holt-Oram Syndrome in an Elderly Patient— A Case History
Authors: Schwartz J. , Leibovitz A. , Berti B. , Baumel Y. , Habot B.
Published: November 2007

The authors present a typical case of Holt-Oram syndrome in an eighty-year-old woman. The patient had atrial-septal defect and phocomelia but was independent in the activities of daily living.
Effects of Intravenous Streptokinase and CLS 2210 (Calcium Dobesilate) on the Biochemical Markers of Early Acute Myocardial Infarction: A Historic Comparison with Both Studies
Authors: Szlavy Laszlo , Repa Imre , Lengye Imre , Lamboy Laszlo
Published: November 2007

In a previous double-blind, randomized study, CLS 2210 (a new formula tion of calcium dobesilate) or placebo was administered by intravenous infusion to 41 patients having their first acute myocardial infarction. In the present study 19 comparable patients were treated intravenously with streptokinase under iden tical contidions and the results compared with those from the previous study. In all patients administration was begun within three hours of onset of symptoms and continued over seventy-two hours. Blood samples were taken for the meas urement of serum activity of creatine kinase and its isoenzyme MB, and the se rum and urinary concentrations of myoglobin and glycosaminoglycans were also measured.

The purpose of this study was to determine the effects of CLS 2210, place bo, and streptokinase on these biochemical markers of acute myocardial infarc tion, thereby assessing their actions in limiting myocardial necrosis.

In the CLS 2210-treated patients, the levels of serum creatine kinase and se rum and urinary myoglobin were significantly lower than in the placebo patients throughout the seventy-two hours (p = 0.01, 0.005, 0.004 respectively). The levels of creatine kinase MB and serum glycosaminoglycan in the CLS 2210 patients were initially higher than in the placebo patients but fell below placebo levels between the fortieth and fifty-fifth hours, respectively (p = 0.89, 0.02). Only the glycosaminoglycan urinary concentrations were higher in the CLS 2210 group than in the placebo group throughout (p = 0.0005). The values for the six variables investigated showed no statistically significant difference between placebo and streptokinase. These findings suggest that CLS 2210 reduces myocardial infarct size in human subjects, probably by the same mechanisms of action (principally, improved cardiac lymphatic drainage) that have been observed in previous animal studies. Combination therapy with thrombolytic agents may, therefore, be advocated, since they exert their protective effect by other mechanisms.
Skin Blood Flow and Current Perception in Pentoxifylline-Treated Diabetic Neuropathy
Authors: Rendell Marc , Bamisedun Ola
Published: November 2007

There are several anecdotal reports of improvement in diabetic sensory neu ropathy following a course of pentoxifylline therapy. Pentoxifylline theoretically could improve skin blood flow, thus reducing ischemia at axonal endings. The authors used laser Doppler techniques to measure skin blood flow and mea sured sine wave current perception thresholds (CPTs) in pentoxifylline-treated diabetic patients with sensory neuropathy. Twenty-four patients completed a six-month course of treatment. These patients had a predominantly "stocking" neuropathy; all the major abnormalities on clinical, laser Doppler, and current perception testing were found on the lower extremity. Seventeen of the 24 pa tients reported symptomatic improvement. A careful, graded neurologic exami nation confirmed that improvement, with a decrease in symptom score on the lower extremity (SSDW) from a baseline of 5.0±0.7 to 3.5±0.7 (p < 0.01) and of physical score (PSDW) from baseline 22.0±2.0 to 16.0±1.9 (p < 0.01) after six months. On the lower extremity, there was an increase in laser Doppler measured flow score (FS) both at 35 ° and at 44°C. FSDW (35°) increased from 10±2 to 14±3 at six months (p < 0.05). FSDW (44°) increased from 58±5 to 77 ±7 at six months (p < 0.01). There was an improvement in sine wave current perception measured by current perception threshold score (TS). TSDW dropped from 150±32 to 84±28 at six months (p < 0.03). In patients with dia betic sensory neuropathy, pentoxifylline appears to improve skin blood flow. Current perception thresholds improve in tandem, corroborating improvement in clinical neurologic findings. A double-blind, placebo-controlled study would be appropriate to establish the efficacy of pentoxifylline as therapy of diabetic sensory neuropathy.
Aortitis Syndrome with Fatal Acute Aortic Regurgitation Due to Aortic Dilatation and Aortic Valve Perforation — A Case Report
Authors: Satoh Toru , Chino Masao , Takahashi Masaki , Suzuki Keiji
Published: November 2007

This is a case report of a fifteen-year-old female with aortitis syndrome com plicated by acute fatal aortic regurgitation due to the aortic valve perforation, as well as to aortic dilatation, which was confirmed by the autopsy. Aortic valve perforation was first recognized as the important cause of acute aortic regurgi tation in the aortitis syndrome in this report.
Determinants of Failure in Superficial Femoral Artery Angioplasty
Authors: El-Bayar H. , Roberts A. , Hye R. , Davis G. , Freischlag J.
Published: November 2007

Although results of iliac artery balloon angioplasty have been shown to be good, there are much less data regarding initial success and durability of superficial femoral artery (SFA) dilation. The authors retrospectively reviewed the results of 22 patients treated for 27 SFA lesions between 1981 and 1986. Mean age was 64.5 years (fifty-five to seventy-six). Results were analyzed with respect to initial, early (< twelve months), and late (> twelve months) angiographic and clinical success. Indications were claudication (22), nonhealing ulcer (3), and rest pain (2). Mean follow-up was 30.9 months; 100% at one year and 92% at two years. Initial failure occurred in 9 (33%) lesions. There were 2 early and 2 late failures for a cumulative patency rate of 90.3% and 78% at one and two years, respectively. Predictors of clinical failure were: (1) initial—age, SFA occlusion, and angioplasty rating; (2) early—age, SFA occlusion, degree of atherosclerosis, and angioplasty rating; (3) late—angioplasty rating. There were 3 complications (11%).

The authors conclude that: (1) 33% of attempted SFA angioplasties were initially unsuccessful and that the cumulative patency rate was 78% at two years. (2) Age is predictive of initial and early failure; SFA occlusion, of initial and early failure; degree of atherosclerosis, of early failure; and angioplasty appearance, of initial, early, and late failures. (3) Complications did not result in limb loss or require surgery.
Lymphoscintigraphy of Head-and-Neck Cancer
Authors: Terui Shoji , Terauchi Takashi , Ebihara Satoshi , Yoshizumi Takashi , Mashima Kazuhiko , Saikawa Masahisa , Nakatsuka Takashi , Nishino Hiroshi , Ota Yojiro , Hirano Kohichi , Hayashi Ryuichi
Published: November 2007

To achieve the visualization of regional lymph nodes by lymphoscintigraphy, 21 patients with head-and-neck cancer were studied with the aid of 99mTc-labeled rhenium sulfur colloid (99mTc Re). Four injection sites were selected; the injections were given into the subcutaneous tissue of the parietal area of 11 patients, into the submucosa of the retromolar area of 6 patients, into the subcutaneous tissue of the postauricular area of 2 patients, and into the thyroid glands of 2 patients. Lymphoscintigraphy was done three hours after the injection. The cervical regions were visible in 85.7% of the patients on the affected side and in 90.5% on the healthy side. The visualization comprised the following regions: submental, submandibular, deep cervical, accessory, and supraclavicular regions. In total, 102 nodes were visualized on the affected side (average 4.8 per patient) and 110 nodes in the healthy side (average 5.5). Histologically, 15 of 21 patients had lymph nodes metastases and 6 did not. Of these 21 patients, 66.7% (14/21) had confirmed lymph node metastases in the visualized regions. This technique appears to be a relatively easy and efficient method of imaging the regional lymph nodes in head-and-neck cancer both before treatment and after neck surgery.
Long-Term Clinical and Duplex Follow-up After Proximal Vertebral Artery Reconstruction
Authors: Van Schil Paul E. Y. , Ackerstaff Robert G. A. , Vermeulen Freddy E. E. , Eikelboom Bert C. , Schepens Marc A. A.
Published: November 2007

From 1977 to 1989, 28 patients, 18 men and 10 women, underwent 29 proxi mal vertebral artery reconstructions. Indications were vertebrobasilar insuffi ciency in 17 patients and TIA or stroke in 6. Five were asymptomatic. Procedures performed were endarterectomy in 20, reimplantation in 5, venous bypass in 3, and decompression in 1 case. Concomitant procedures were coro nary artery bypass grafting (6) and carotid, subclavian, or innominate artery revascularization (14).

There was no operative mortality. There were 3 early reoperations for occlu sion, bleeding, and lymph fistula, respectively.

Except for 1 foreign patient recent clinical follow-up was complete. Mean follow-up was 85.6 months (range 17-146). During follow-up 10 patients died. Causes were mainly cardiac (3), carcinoma (3), and stroke (2). Seventeen pa tients were alive, 13 had no cerebrovascular symptoms, 2 sustained a hemi spherical stroke, 1 was only slightly improved, and 1 had a drop attack 131 months after operation. Five and ten-year actuarial survival rates were 85% and 51 % respectively.

Follow-up with duplex scan was available in 26 patients and was complete in 24. Mean duplex follow-up was 78.6 months (range 3-146). Significant abnor malities were noted in 6 but with symptoms in only 1 patient. Mean time to restenosis was 77.3 months. Late angiographic control in 10 patients correlated well with duplex findings.

Proximal vertebral artery reconstruction yields good clinical long-term results, and duplex scan is a useful tool in the follow-up of these patients.
Failure of Thrombin-Antithrombin III Complexes in the Diagnosis of Deep Vein Thrombosis
Authors: Cogo Alberto , Lensing Anthonie , Prandoni Paolo , Canova Giuseppe , De Toni Renzo , Cuppini Stefano , Ruol Arturo
Published: November 2007

Plasma thrombin-antithrombin III (T-AT) complexes are reputed to be an indirect manifestation of thrombin generation, and a role for their determina tion in the diagnosis of deep vein thrombosis (DVT) has been advocated. In order to evaluate the accuracy of T-AT complexes assay for DVT diagnosis, in 166 consecutive outpatients with clinical suspicion of the disease, plasma con centration of T-AT complexes was measured immediately before venography by means of an enzyme-linked immunosorbent assay kit. The result of the T-AT complexes assay was elevated in 29 of the 48 patients with DVT (sensitivity, 60%). The T-AT complexes levels were within the normal range in 104 of the 118 patients with normal venograms (specificity, 88%). The positive and the nega tive predictive value were 67% and 85%, respectively. The authors conclude that the T-AT complexes assay is of little value for the diagnosis of DVT in outpatients.
Diet-Induced Atherosclerosis in Cynomolgus Monkey Aorta and Regression by the Sixth-Month Observation
Authors: Yamada Tsutomu , Yoshikuni Yoshiaki , Taira Masafumi , Yoshida-Suzuka Hirotsugu , Kimura Kiyoshi , Sakurai Isamu , Takenaka Osamu
Published: November 2007

Pathomorphologic analysis was employed to evaluate diet-induced athero sclerosis in cynomolgus monkey aorta and regression by administration of a hypolipidemic agent for six months after the atherogenic ration. Twenty-seven male cynomolgus monkeys were divided into three groups. Group A was fed individually with a high-fat diet containing 0.3% cholesterol under identical conditions for six months. Group B was fed with normal monkey chow for six months after the same atherogenic ration. Group C was fed with normal mon key chow and administered a hypolipidemic agent 1% of 4-[2-(4-isopropylben zamido)ethoxy] benzonic acid for six months after the same atherogenic ration. Each thoracic and abdominal aorta of animal models was separately analyzed. Lipid composition analysis and esterified cholesterol (CE) in aortic wall, ratio of free cholesterol to phospholipid, surface involvement, and atherosclerotic index after Sudan IV staining were studied for evaluation of progression and regres sion. The configurations of atherosclerotic involvement were histologically eval uated among each group. These observed lesions, features specific to cynomol gus lesions, mainly consisted of lipid-rich foam cells, lipid debris, and prolifer ated extracellular matrix. No different lesion composition was noted between the thoracic and abdominal aorta. This may suggest that some local factors play an important role for development of atherosclerosis after the initial event. Group C had remarkable reduction of foam cells and of CE accumulation in both the thoracic and abdominal aortic wall. Accelerated regression in group C as compared with group B was demonstrated both biochemically and pathohis tologically. These results suggest that substantial regression of atherosclerosis in both the thoracic and abdominal aorta can be expected. This hypolipidemic agent exerts notable antiatherosclerotic activity, along with a lowering effect on plasma total cholesterol levels.
Improvements in Immunization Compliance Using a Computerized Tracking System for Inner City Clinics
Authors: Tung Ying , Duffy Linda C. , Gyamfi Joyce O. , Wojtaszczyk Frances , Dozier Askia , Tempfer Tammy , Clark Anne , Putnam Theodore , Bonafede Ronald
Published: November 2007

Vaccination compliance rates were calculated for 1995 to 2001 for enrolled patients, based on the Centers for Disease Control and Prevention guidelines and age-appropriate vaccine schedules. The results reported here indicate computerized tracking with the Doctor's Pediatric Immunization Program (Dr. PIP) maintained vaccine compliance rates (>90%) in healthy and immunocompromised children at 2 months and 12 months of age. Instituting the computerized system has yielded nearly optimal results in both indigenous inner-city clinics. Despite the efficient progress made by automated tracking, the results for specific vaccine strategies (Varicella) and target groups (human immunodeficiency virus, high-risk indigent populations) may require ongoing and intensive educational efforts to achieve optimization levels. Clin Pediatr. 2003;42:603-611
Hypoglycemia Complicating Dehydration due to Acute Gastroenteritis
Authors: Reid Samuel , McQuillan Susan , Losek Joseph
Published: November 2007

To identify clinical variables predictive of hypoglycemia in dehydrated children with acute gastroenteritis (AGE), clinical variables were recorded for dehydrated children younger than 5 years old with AGE before measuring serum glucose. One hundred and eighty-four children were enrolled; 62 with, and 122 without, hypoglycemia. Multivariate analysis identified variables associated with hypoglycemia. Female gender, neurologic symptoms of hypoglycemia, and a greater amount of vomiting vs. diarrhea were significantly associated with hypoglycemia. Clinical variables do not have adequate sensitivity and specificity to accurately predict which children with AGE have hypoglycemia. Glucose determination should be considered for these patients. Clin Pediatr. 2003;42:641-646
Practical Aspects of Infant Feeding
Authors: Sly R. Michael
Published: November 2007

New parents find themselves devoting a large share of their time to preparation of milk mixtures and feeding of their infant. This subject has probably received more attention in the medical literature than any other aspect of infant care, especially in years gone by. Most of the studies have dealt with determin ing the most appropriate formula for the health and growth of the infant. One evi dent conclusion is that normal, healthy, full term infants thrive on a wide variety of mix tures. Nevertheless practical considerations are still of major importance in the selection of the proper milk mixture.

While recommendations regarding the me chanics of formula preparation have hereto fore been generally uniform, recent research has suggested that practicality may also be pertinent in this area.
Moniliasis, Steatorrhea, Diabetes Mellitus, Cirrhosis, Gallstones, and Hypoparathyroidism in a 10-Year-Old Boy
Authors: Stickler Gunnar B. , Peyla Thomas L. , Dower John C. , Logan George B.
Published: November 2007

What disease states are occasionally associ ated with hypogarathyraidisna?

Is there any explanation for the association of moniliasis or steatorrhea in the syndrome re ported ?

Is there a familial incidence of the syndrome of hypoparathyroidism, Addison's disease and moniliasis?
Combined Private Practice of Pediatrics and Adolescent Medicine
Authors: Shen Jerome T.Y.
Published: November 2007

In the last ten years there has been a general tendency for pediatricians, intern ists, and general practitioners to include adolescents in their medical practices. The reasons for this tendency are threefold: (I) the general awareness that ado lescents do have problems, physical and emotional, that need medical attention different from that of adults or children: (2) starting with the establishment, in 1951, of the Adolescents' Unit by Dr. J. R. Gallagher at the Children's Hospital Medical Center, Boston, the importance and the feasibility of giving better medi cal care to adolescents are being appreciated both by the public and the medical profession; (3) the rapid advances in the biological and behavioral sciences are making many physicians dissatisfied with practice or research which has an age limit. Pediatricians like to know what happens to their patients after adolescence is reached, and internists like to know the how and the why behind their adult patients' physical and mental conditions.
Clinical Review : Fructosemia
Authors: Levin B. , Snodgrass G.J.A.I.
Published: November 2007

A relatively new syndrome, one of whose principal manifestations may be failure to thrive, has recently been elu cidated. This is fructosemia or hereditary fructose intolerance, an inborn error of fructose metabolism.
A Project for Unwed Pregnant Adolescents in Chicago
Authors: Visotsky Harold M.
Published: November 2007

Here is an illuminating exploration of the attitudes to sexual behavior and early pregnancy by unmarried ad olescent girls and their par ents within a socio-econom ically deprived segment of a metropolitan population.
Acute Glomerulonephritis with Minimal Urinary Findings
Authors: Kahn Lawrence
Published: November 2007

A case of acute glomerulonephritis with no microscopic hematuria and mild pro teinuria. The illness was apparently post- streptococcal in origin. This case is re ported to provide additional evidence that acute glomerulonephritis may occur with slight or minimal urinary findings, and to indicate the diagnostic value of per cutaneous renal biopsy.
Injuries of the Castro-intestinal Tract in Children Notes on Recognition and Management
Authors: Haller J. Alex
Published: November 2007

Injuries of the gastro-intestinal tract occur in approximately 10 per cent of children with either blunt or penetrating trauma to the abdomen. These injuries require prompt surgical intervention, and in general are curable with an excellent prognosis if one is alert to the possibility of their occurrence and is familiar with the approaches to prompt and accurate diagnosis.
Using X-Rays to Establish the Correct Age of Children
Authors: Bloch Aaron
Published: November 2007

Each year hundreds of immigrants' children appeal to Israeli Health Offices for correction of incorrectly recorded ages. Presented with this problem, Dr. Bloch found that through the proper use of careful histories, physical examina tions, and adequate radiographic bone age determinations he could, with a fair degree of assurance, determine the ac tual age of children—even those in the very difficult 14 to 17-year age period. This article, spiced with controversy, carries also a taste of life in the bold, new nation.
Plagues on Our Children
Authors: Nopar Robert E.
Published: November 2007

Twenty-five years ago, at the beginning of World War II, chemical and biological weapons began to be developed in this country. At that time, President Franklin Delano Roosevelt stated: "Use of such weapons has been outlawed by the general opinion of civilized mankind ... we shall under no circumstances resort to the use of such weapons unless they are first used by our enemies."

A few years later the United States became the first country to use nuclear weapons. More recently, we have been employing non-lethal gases (tear and nausea gases) against the Viet Cong in South Vietnam. The world's press has been terming the use of these gases a form of chemical warfare.

As for biological warfare activities, the current published position of the United States on this matter is stated in Army Field Manual FM 27-10: "The United States is not a party to any treaty, now in force, that prohibits or restricts the use in warfare of toxic or nontoxic gases, of smoke or incendiary materials, or of bacteriological warfare."

Many military leaders believe that if non-lethal chemicals and diseases were employed as weapons there would be less killing and less destruction of homes and factories. It is not our purpose here to discuss whether these weapons are truly less humane than flame-throwers, napalm, and nuclear bombs. But once we have accepted the use of chemical and biological weapons, there is no guarantee that only non-lethal ones will be used.

As Sidel and Goldwyn * pointed out recently, there has been little public discussion by the medical profession on the ethics or advisability of developing and using chemical and biological weapons. Yet we must remember that it is our medical and other scientists, both in civilian and in military positions, who are helping to perfect these weapons and also the defenses against them.

To collaborate in or even simply to condone the imposition of disease on a population of civilians is certainly a contravention of Hippocrates' oath: "... I will use treatment to help the sick according to my ability and judgment, but never with a view to injury and wrong-doing. Neither will I administer a poison to anybody when asked to do so, nor will I suggest such a course...."

This issue is complex and uncomfortable, but each physician must evaluate his rights and duties—both as a citizen and as a doctor.

The dilemma has perhaps been best expressed by Albert Einstein when he said: Science has brought forth this danger, but the real problem is in the minds and hearts of men. —ROBERT E. NOPAR, M.D.
Tonsillectomy and Adenoidectomy
Authors: Evans Hugh E.
Published: November 2007

"There is no compelling evidence of any long term benefit from a T and A. Thus, the most conservative approach still seems appropriate. Consistent with the doctrine of primum non nocere (above all do no harm), the burden of proof of the efficacy for surgery should be on those who urge operation.".
Screening for Hemolytic Disease of the Newborn by Cord Blood Coombs Testing—
Authors: Clifford John H. , Mathews Pat , Reiquam C.W. , Palmer H.D.
Published: November 2007

An accepted diagnostic feature of hemo lytic disease of the newborn due to isoimmu nization by any of the Rh factors is a posi tive direct antiglobulin reaction (Coombs test) with umbilical cord blood.

Not so well documented is the usefulness of the direct antiglobulin test for the recog nition of hemolytic disease associated with ABO grouping differences. Some believe the test to be generally negative or weakly posi tive in infants who clinically and hemato logically have hemolytic disease related to ABO incompatibility, whereas others claim to find the direct test positive in 90 per cent of such infants. The latter contention is supported by the findings in the study here described.

The direct Coombs test on cord blood is suggested as a useful screening test particu larly when Rh or ABO grouping of the parents is either not known, or so related to each other that a potential isoimmunization problem may ensue in the infant.
Acute Pancreatitis and Hypoglycemia
Authors: Laraya-Cuasay L.R. , Wolfe Richard , Hughes Walter T.
Published: November 2007

Although hyperglycemia is a better rec ognized feature of acute pancreatitis, hypo glycemia may and does occur at times. Cli nicians should be aware of this possibility.

These authors add three cases to the lit erature. Two patients died with acute hem orrhagic pancreatitis; the third is alive after an attack associated with mumps.
Multiple Sclerosis in Early Childhood
Authors: Schneider Robert D. , Ong Beale H. , Moran Martin J. , Greenhouse Arnold H.
Published: November 2007

This report describes multiple sclerosis beginning in a four-year-old girl. Her clinical course illustrates not only the diagnostic problems presented by the demyelinating disorders in pediatric practice but emphasizes also the possible relations between these conditions. A literature survey indicates that multiple sclerosis though unusual may begin at an early age.
Fussing and Crying in Young Infants
Authors: Harley Louis M.
Published: November 2007

Crying in newborn infants usually assumes a definite pattern early, beginning and ending at approximately the same time every day. When not controlled, such fussing sometimes spreads to other hours as well, becoming a habit which can easily upset the entire household. Careful history usually uncovers some flaw in the baby's care. With proper guidance, early management and full cooperation by the parents, crying can usually be eliminated and a protracted course avoided.
Immunologic Deficiency States
Authors: Fulginiti Vincent A.
Published: November 2007

Immunologic deficiency states are variable, but several fairly distinct entities have been identified in recent years. This report summarizes current knowledge of immunologic development and presents several "new" diseases which illustrate nature's defects in development.

Concepts have been simplified to make them understandable and recognizable in an individual patient. This well written, up-to-date work by a recognized authority on clinical immunology and infectious disease will be of great value to clinicians.
Antihistamine Toxicity in Children
Authors: Reyes-Jacang Amelia , Wenzl James E.
Published: November 2007

Five instances of antihistamine toxicity in children, one resulting in death, are reported here. Three cases were caused by accidental ingestions and two were caused by physician-prescribed overdoses. Initial symptoms and clinical course are far from constant. Control of toxic central-nervous-system symptoms by sedation or anticonvulsive drugs is a cardinal part of treatment. Stimulants or even mechanical respiratory devices may be needed later for management of postconvulsive depressive states.
Concerning A. G. Bell's Invention
Authors: Sturtz George S. , Brown Robert B.
Published: November 2007

"We believe that the practice of Pediatrics is a joyous and beautiful thing; it can be great fun, when performed easily and smoothly. We believe that much of the discontent about pediatric practice is a reflection of a lack of organizational skill on the part of the discontented ...." —From the letter accompanying the manuscript.
Erythrocyte Hypoplasia Due to Lead Poisoning
Authors: Moosa A. , Harris F.
Published: November 2007

A child with erythrocyte hypoplasia due to lead poisoning is successfully treated with Ca EDTA. This potentially lethal condition is discussed, and theories as to its etiology are summarized.
Scalp Defects in Trisomy 13
Authors: Abuelo Dianne , Feingold Murray
Published: November 2007

A chromosomal abnormality should be suspected in every patient with multiple congenital anomalies.

It is important to determine the specific type in order to provide the parents with a prognosis and proper genetic counseling.

In patients with multiple congenital anomalies who have scalp defects, the most likely diagnosis is Trisomy 13.
Psychologic Problems in the Management of Adolescents with Malignancy
Authors: Moore Dan C. , Holton Charlene P. , Marten George W.
Published: November 2007

Having a malignant disease and having to undergo long-term therapy is an additional stress to the normal physiologic and psychosocial stresses inherent in the adolescent's maturation. Such patients present complex problems in management. These problems are not the same as those encountered by the pediatrician when dealing with an infant or child who is too young to understand the meaning of malignancy or who has not yet developed a concept of self as it relates to death. Nor are these the same problems as those the internist meets when he treats adults who may have lived a full life or have developed effective ways of adjusting to the psychologic stress of having cancer. Though sufficiently mature to appreciate the implications of his diagnosis and prognosis, the adolescent has not yet completed the personality integration or fully evolved the adult defense mechanisms which might enable him to adjust successfully to the knowledge of his illness.
Safety Cap Closures on Drug Bottles
Authors: Harriss William E.
Published: November 2007

Placing medicines well out of reach of small children is always a satisfactory means for preventing their being reached by inquisitive youngsters. An additional method of protection is to dispense the medications in containers which cannot be opened readily by small children.
Syndromes of Infectious Mononucleosis
Authors: Lascari André D. , Bapat V.R.
Published: November 2007

Physicians are becoming more aware of the existence and diversity of the infec tious-mononucleosislike responses which patients may develop in certain circum stances. Differentiation and identification call for knowledgable familiarity with these various clinical-hematologic responses.
Isoproterenol Aerosols for Asthma
Authors: Falliers Constantine J. , Garces Fernando , Bates James W. , Molk Barry
Published: November 2007

In some circumstances bronchodilator therapy can be most helpful in the management of the child with asthma. In other circum stances—excessive sympathetic stimulation, progressive refractori ness, or threat of permanent dependence-their use is contraindicated.
Observations on Infection of the Urinary Tract and Childhood Nephrosis
Authors: Sonnenschein Harry , Joos Howard A.
Published: November 2007

"We would suspect a bacterial pyelonephritis in any nephrotic child who required an unusually large dose of steroids for improvement."
Diazepam as Adjuvant Therapy in Childhood Tetanus
Authors: Phatak Arun T. , Shah S.H.
Published: November 2007

Clinically and biochemically, Diazepam appears to be a safe anticonvulsant for routine use in the management of tetanus.
Do Parents Need to Know More About Innocent Murmurs?
Authors: Scanlon John W.
Published: November 2007

A fact sheet about innocent or functional heart murmurs can help relieve the anxiety which many parents would otherwise have. This also helps safeguard the child from being anxious about his heart.
Treating Adolescent Obesity
Authors: Hammar S.L. , Campbell V. , Woolley J.
Published: November 2007

In a follow-up study of 65 obese adolescents, 19 had achieved a non obese status while 46 remained obese. Twelve adolescents maintained the weight loss initiated during clinic attendance. Obese adolescents given dietary instruction and placed on a diet were more successful at losing and maintaining their lower weight than those treated with a nondietary approach. Although nine adolescents lost weight who had not received a diet, only two maintained this weight loss and none achieved a nonobese status. Group treatment did not ap pear to produce better long-term results than individual treatment.