bluuebunny/crossref_metadata_2025 huggingface dataset:
Intimal Thickening of Jugular and Femoral Veins vs Arteries in the Rabbit Following Investment
Authors: Funaki Chiaki , Naito Michitaka , Hayashi Toshio , Kuzuya Masafumi , Asai Kanichi , Kuzuya Fumio
Published: November 2007

The authors induced intimal thickening in the jugular and femoral veins and in the common carotid and femoral arteries of rabbits by placement of a poly ethylene tube cuff. The comparative effects on the intima were studied by light and electron microscopy.

Even in the veins, thickening resulted from the migration of medial smooth muscle cells into the intima with subsequent proliferation. Thickening in the arteries consisted of tightly packed smooth muscle cells and a few elastic fibers, whereas that in the veins was characterized by an abundance of collagen fibers, layers of smooth muscle cells, and a few elastic fibers.

Capillaries were often observed in the thickened intima of the veins but not of the arteries.
Do Thallium Myocardial Perfusion Scan Abnormalities Predict Survival in Sarcoid Patients without Cardiac Symptoms?
Authors: Kinney Evlin L. , Caldwell John W.
Published: November 2007

Whereas the total mortality rate for sarcoidosis is 0.2 per 100,000, the prognosis, when the heart is involved, is very much worse. The authors used the difference in mortality rate to infer whether thallium 201 myocardial perfusion scan abnormalities correspond to myocardial sarcoid by making the simplifying assumption that if they do, then patients with abnormal scans will be found to have a death rate similar to patients with sarcoid heart disease. The authors therefore analyzed complete survival data on 52 sarcoid patients without cardiac symptoms an average of eighty-nine months after they had been scanned as part of a protocol. By use of survival analysis (the Cox proportional hazards model), the only variable that was significantly associated with survival was age. The patients' scan pattern, treatment status, gender, and race were not significantly related to survival. The authors conclude that thallium myocardial perfusion scans cannot reliably be used to diagnose sarcoid heart disease in sarcoid patients without cardiac symptoms.
Magnesium Treatment Of Torsade de Pointes—A Case Report
Authors: Gould Lawrence A. , Betzu Robert , Vacek Thomas , Muller Reid T. , Pradeep Vettiazhath , Scafa Anthony
Published: November 2007

An eighty-one-year-old woman received quinidine in order to convert atrial fibrillation to a sinus rhythm. The patient developed a prolonged QT interval on the EKG, as well as episodes of torsade de pointes. With the administration of intravenous magnesium sulfate, the abnormal rhythm was suppressed within minutes. Thus, magnesium should be the first drug used in patients with torsade de pointes and prolonged QT interval on the electrocardiogram.
Effects of Prostaglandin I2 and a Selective Thromboxane Synthetase Inhibitor on the Arteriolar Constriction Caused by Norepinephrine
Authors: Kato Tadashi , Goto Yukio , Yoneda Shunki , Yamamoto Kikuko , Aochi Osamu
Published: November 2007

Effects of prostaglandin (PG) I2 and thromboxane (Tx) A2 on the systemic blood pressure, the internal diameter of arterioles with a diameter of 20 to 30 μm, and the change caused by the topical administration of norepinephrine (NE) were studied in the rat mesentery. The change in diameter was measured by an image-shearing eyepiece and television microscopy. The rats were divided into three groups. Group I (9 rats) served as the non-treated, control group. In group II (6 rats), PGI2 was given at the rate of 0.6 μg/kg/min for ten minutes. In group III (6 rats), (E)-3-[4-(1-imidazolylmethyl)phenyl]-2-propenoic acid hydrochloride monohydrate (OKY 046), which is a highly selective TxA 2 synthetase inhibitor, was administered at the rate of 0.5 mg/kg/min for ten minutes. The hypotension caused by PGI2 administration was accompanied by arteriolar constriction, although it disappeared with the increase in the systemic blood pressure five minutes after administration of PGI2 was stopped. The systemic blood pressure and the internal diameter of arterioles showed no change in the OKY 046 and in the control group. The vasoconstrictive response to NE was inhibited by PGI2 and OKY 046 for thirty to forty-five minutes and the inhibitory effects were similar in both cases. These results show that PGI2 and a selective Tx synthetase inhibitor, OKY 046, attenuate the vascular response to NE.
Gender Differences in Coronary Angiographic Findings from 1972 Through 1981 in Los Angeles, California
Authors: Leaf David A. , Sanmarco Miguel E. , Bahl Rana A.
Published: November 2007

The angiographic findings of 930 men and 257 women who were referred to a Los Angeles County hospital from 1972 through 1981 are compared. Chi square test results indicated triple-vessel disease was more common in men (37.1%) compared with women (18.7%). The prevalence of normal angiographic findings was higher in women (23.3%) than in men (8.1%). However, for men and women with evidence of coronary artery disease, virtually identical percentages of subjects had left main, single-, double-, and triple-vessel disease. Although the incidence of coronary artery disease decreased during this time for the Los Angeles population as a whole, no differences in patterns of coronary vessel lesions were evidenced.
The Effect of Local Temperature Versus Sympathetic Tone on Digital Perfusion in Raynaud's Phenomenon
Authors: Engelhart Merete , Seibold James R.
Published: November 2007

Matched groups of 7 to 8 patients with primary Raynaud's phenomenon, systemic sclerosis, and undifferentiated connective tissue disease and cold-tolerant normal control subjects were studied by simultaneous digital strain gauge plethysmography and laser Doppler capillary velocimetry during two controlled cycles of hand warming and cooling with and without addition of central cooling and during clinical maneuvers to evoke sympathetic tone. Transient vasoconstrictor responses of comparable degree could be evoked in all patient groups and in both the arterial and microvascular beds. While the addition of central cooling had little influence on arterial flow, patients with systemic sclerosis manifested a failure to maintain nutritive perfusion at finger temperatures associated with Raynaud's phenomenon. Linear regression and multivariate analysis suggested that finger temperature was the principal determinant of arterial flow in systemic sclerosis and that arterial flow was the principal determinant of microvascular perfusion. The inability of patients with systemic sclerosis to maintain nutritive flow in the face of either reflex or cold-induced proximal arterial constriction is consistent with their clinical propensity to ischemic tissue injury and separates these patients physiologically from other forms of Raynaud's phenomenon.
Successful Direct PTCA on LAD after First Episode of Acute Myocardial Infarction: Does It Improve Cardiac Function?
Authors: Asonuma Hirohiko , Tanji Yasuhiro , Nakatoh Hiroshi , Nakajima Takanobu , Akita Hirotoshi , Sasaki Akira , Shoji Kohjiro
Published: November 2007

Patients who received direct percutaneous transluminal coronary angioplasty (PTCA) after acute mycardial infarction and maintained potency but with unim proved cardiac function were studied. In 15 patients, the first episode of acute myocardial infarction was caused by a left anterior descending branch lesion; 11 had an ejection fraction of 50 % or more in the left ventriculogram in the follow-up period (improved group), and 4 patients had ejection fraction of less than 50% (unimproved group). There was so significant difference between the groups in the mean time between the onset of infarction and revascularization (improved group, 259.3 ± 76.9 min; unimproved group, 168.0 ± 101.6 min) or in the ΣQ. which was the sum of the Q wave depth of V 2, V3, and V4 at the time of admission (improved group, 12.1 ± 15.6 mm; unimproved group 29.8 ± 13.4 mm). The maximum creatine kinase concentration was significantly higher in the unim proved group (improved group 2670 ± 893 IU/L; unimproved group, 7243 ± 1928 IU/L, p < 0.05), and the time taken from the onset to reach its peak was significantly shorter in the unimproved group (improved group, 13.0 ± 5.1 hr; unimproved group, 6.8 ± 1.3 hr, p<0.05.) These results suggest the probability of sudden deterioration of myocardium, and factors other than microcirculatory thromboembolism should be considered as the cause of unimproved cardiac function after successful direct PTCA.
Transient Reversal of Inverted U Waves During Valsalva's Test—A Case Report
Authors: Kanemoto N. , Fukushi H.
Published: November 2007

The authors demonstrate for the first time that resting U wave inversion can become upright transiently during Valsalva's test.
Experimental and Clinical Percutaneous Angioscopy Experience with Dynamic Angioplasty
Authors: Gehani A.A. , Ball S.G. , Latif A.B. , Davies G.A. , Rees M.R.
Published: November 2007

The authors have used ultrathin angioscopes with high optical resolu tion to assess the effects of dynamic angioplasty in vitro and in vivo. Ex perimentally, angioscopy was used to study the effects of the 5F "Kensey" catheter in "normal" porcine coro nary arteries (NPCA) and postmor tem human coronary arteries (PMHCA). In NPCA, the catheter keeps a coaxial position. Intimal flaps (IFs) were seen in 21/23 NPCAs. They occurred with all cam rotation speeds and were usually single and small (less than 25% of lumen). Perfora tions in patent arteries were rare (1/23). However, when the catheter was forced against the wall by passing through a narrowing of 5F diameter (made by a band ligature), perfora tions were more common at higher cam speeds. The epicardium re mained intact in two thirds of perfo rations. Angioscopy visualized perforations in only 10% of cases (1/10),the common sign being that of large and multiple intimal flaps, which were often obstructive (5/10). In PMHCAs, angioscopy was more sensitive than angiography in detect ing atheromatous lesions. The au thors were able to give a better assessment of the effect of dynamic angioplasty on treated lesions, includ ing the demonstration of intimal flaps that were not visible on angiography. In vivo, they have performed percuta neous angioscopy before and after dy namic angioplasty using 8 French Kensey catheters. Angioscopy re vealed features that were not shown angiographically.
Comparison of Standard One-Minute Treadmill Exercise and Strandness Test (Absolute Walking Distance) in Relation to Site of Lesion, Walking Distance, and Diastolic Blood Flow Velocity (Doppler Curves)
Authors: Fabry Regine , Dubost Jean-Jacques , Pochon Philippe , Duchene-Marullaz Pierre
Published: November 2007

In 215 outpatients suffering from occlusive arterial disease of the lower limbs the authors compared the decrease in the ratio of ankle systolic pressure to brachial systolic pressure according to whether the treadmill exercise was limited to one minute or extended until pain forced the patient to stop. After a one-minute walk the pressure index always decreased significantly, especially when walking was restricted. The decrease in the pressure index was generally greater when the exercise was continued until the absolute walking distance, and the recovery time was usually twice as long. The fall in the pressure index was significantly greater for patients with single and multiple iliac stenoses than for those with stenoses at lower levels. In patients having a diastolic blood flow velocity on Doppler curves at rest, not modified by walking, a maximum drop in peripheral pressure was recorded after walking for one minute. In this instance there was no intensification of the decrease in peripheral pressure, unlike in patients without a diastolic blood flow velocity at rest.

This one-minute test is not a maximal hemodynamic response, but it is suf ficient for the appreciation of ischemia during exercise, according to the differ ent parameters measured.
Doppler Diagnostics, Indications, and Control of Surgical Treatment in Patients with Carotid Pathology
Authors: Grosdinsky L. , Rankov S.T. , Petrov V. , Drenovsky V.
Published: November 2007

Major stroke is a relatively common cause of death or disabling invalidism in patients with atherosclerosis. In a large percentage of cases it is caused by stenotic/thrombotic processes in carotid arteries and this emphasizes the impor tance of the problem of early diagnosis and treatment of carotid pathology. Recently Doppler sonography has become a leading non-invasive method of early screening of stenotic processes in carotid arteries.

The aim of the present study was to ascertain the diiagnostic abilities of Doppler sonography for screening of carotid pathology, assessment of extra-cra nial and intracranial hemodynamics, defining of indications, and control of vascular reconstructions of carotids.
A Pitfall in Azygos Vein Cannulation in Cirrhotic Patients: Mistaken Cannulation of the Mammary Vein
Authors: Lee Samuel S. , Hadengue Antoine , Braillon Alain , Lebrec Didier
Published: November 2007

Azygos venous flow can be measured by a thermodilution catheter in patients with cirrhosis. This is a useful technique since azygos flow is thought to reflect the superior portosystemic collateral flow in these patients. The authors report 3 cases in which mistaken internal mammary vein cannulation mimicked azygos vein cannulation in the supine fluoroscopic view. A lateral fluroroscopic view con firmed internal mammary cannulation. They suggest that if the azygos arch is unpronounced or flow measurements are unexpectedly low in patients with portal hypertension due to cirrhosis, a lateral view be performed to rule out internal mammary vein cannulation.
Bronchiolar Morphology After Systemic Arterial Interruption
Authors: Closset Jean , Vanderhoeft Patrick J. , Delcour Christian
Published: November 2007

To assess ischemic lesions as a fac tor in obliterative bronchiolitis after lung transplantation, the authors sev ered the left bronchial arteries of 15 dogs, together with the left stem bronchus, the latter being immedi ately reanostomosed. They examined the bronchioles at weekly intervals up to three and a half months. On the week chosen each dog was anesthe tized, totally heparinized, and exsan guino-perfused with saline. Just after heart arrest, the thoracic aorta was injected with a barium solution until this white medium appeared in the bronchial arteries. The heart-lung blocs were excised en bloc, submitted to soft-tissue x ray, fixed, and then sliced to 1 cm. Corresponding right and left 5-mm-thick samples of these slices were prepared for contact mi croradiography followed by histo logic 5-to-20-micron-thick, stained, correlated specimens. For two weeks the left bronchial arteries remained empty, but there was no necrosis or edema. Between two and four weeks barium solution appeared in the bronchial arteries, and the bronchio lar epithelium had become multi- stratified. Later the left bronchian giogram became similar to the right, but there were more folds of the mu cosa and a little submucosal fibrosis. These studies provide proof that no significant ischemic lesions occurred during repermeation of the bronchio lar vascular bed. Ischemia, if exist ent, is not a significant factor in obliterative bronchiolitis.
Platelet Aggregation Is Not Necessary for Occurrence of Raynaud's Phenomenon: A Clinical History and Laboratory Results
Authors: Bellucci S. , Kedra A. , Bray P. , Caen J.P.
Published: November 2007

"Raynaud's phenomenon (R.P.) is characterized by a spastic vasoconstric tion of hand and/or feet extremities leading to painful ischemic attacks. In the pathogeny of this syndrome the role of a platelet hyperactivation was evidenced. Nevertheless, the responsibility of platelet aggregation remains controversial. We report here the case of a patient presenting with a Glanzmann thrombasthenia defined by the complete lack of platelet aggregation, and show ing a typical RP which was confirmed by the measurement of hand temperature and the decrease of digital and hand blood flow. Thus, the description of this case shows that platelet aggregation by itself is not necessary for the occurrence of RP, and encourages for therapeutic purposes the development of vasodilatators rather than platelet antiaggregants agents."
Quantitation of Anbornal 67GA Uptake in Pulmonary Interstitial Vascular Disease—A New Test to Detect Diffuse Lung Disease
Authors: Demeter Stephen L. , Cordasco Edward M. , MacIntyre William , O'Donnell James , Golish Joseph A. , Feiglin D.H.I. , Saha G.B. , Stepanitis Joseph
Published: November 2007

Gallium 67 has been used as a modality to diagnose and follow the clinical course of diseases such as tumors, infections, inflammatory disorders, and inter stitial lung disease. It has been appreciated, however, that mild to moderate changes in scan activity, when these disorders are followed over time, are less than optimal. SPECT (single-photon emission computed tomography) scanning is a new technique designed to obviate this problem. SPECT scanning utilizes com puter acquisition to provide three-dimensional scanning and the additional ben efit of colorization to aid in discerning differences of uptake. SPECT scanning was performed on 22 patients with interstitial lung disease of various etiologies. Additionally, 7 patients had follow-up SPECT scanning to determine their re sponse to treatment. Two patients are presented as examples.
Active Drainage of Cardiac Lymph in Relation to Reduction in Size of Myocardial Infarction: - An Experimental Study
Authors: Taira Akira , Uehara Kagemitsu , Fukuda Shigeru , Takenaka Koji , Koga Masaaki
Published: November 2007

Active drainage of cardiac lymph using hyaluronidase was attempted in dogs. The results were satisfactory and the ischemic myocardium was salvaged. The infract risk area (I/R) ratio decreased after drainage.

Regional myocardial ischemia and infarction were provided by means of ligature of the left coronary artery for 120 and 240 minutes respectively. Cardiac lymph was collected by conventional procedures. Enzymes released from the myocardium increased significantly in the cardiac lymph. The volume of cardiac lymph gradually increased after ligature of the coronary artery. Administration of hyaluronidase further increased the cardiac lymph flow and significantly decreased the I/R ratio as determined by triphenyl tetrazolium chloride (TTC) and methylene blue staining. Drainage of the cardiac lymph salvaged the ischemic myocardium. Reduction of interstitial edema and augmentation of cardiac lymph flow with the hyaluronidase prevented the development of the infarction. This is the first documentation of the effect of active drainage of cardiac iymph on the development of infarction through observation of the I/R ratio.
Hemophilic Pseudotumor Treated with Transcatheter Arterial Embolization: Case Report
Authors: Pisco João M. , Garcia Vasco L. , Martins José M. , Mascarenhas António M.
Published: November 2007

A case of pseudotumor in the wing of the iliac bone of a fifty-one-year-old man with hemophilia A successfully treated with transcatheter arterial embolization is reported.
Heparin-Induced Thrombocytopenia: A Case Report
Authors: Van Damme H. , Damas P. , David J.L. , Limet R.
Published: November 2007

The authors report a case of heparin-induced thrombocytopenia, in whom massive pulmonary embolism occurred in spite of heparin anticoagulation. Suc cessful pulmonary thrombectomy was carried out under cardiopulmonary by pass, with limitation of platelet clumping during bypass by aggregation inhibitors. This report is a comprehensive contribution to a better understanding of this rare immunoallergic complication of heparin administration, with a high incidence of serious thromboembolic events. The optimal management for cases of unavoid able reexposure to heparin is discussed.
Right-to-Left Shunting Through a Patent Foramen Ovale Caused by Pulmonary Hypertension Associated with Rheumatoid Arthritis and Sjögren's Syndrome: A Case Report
Authors: Inoue Teruo , Yamaguchi Hirokazu , Hayashi Terumi , Morooka Shigenori , Takabatake Yutaka
Published: November 2007

This case report presents a fifty-four-year-old woman with right-to-left shunt in the atrium. It seemed clinically at first that the shunt was due to atrial septal defect. However, she also had pulmonary disease associated with rheumatoid arthritis and Sjögren's syndrome. At autopsy atrial septal defect was not evident, but a patent foramen ovale and pulmonary artery disease were observed. This case suggests that pulmonary hypertension secondary to rheumatoid arthritis and Sjögren's syndrome could lead to right-to-left shunting through a patent foramen ovale.
ST Segment Alternans During Percutaneous Transluminal Coronary Angioplasty—A Case Report
Authors: Okamoto Shinya , Inden Masaaki , Konishi Tokuji , Nakano Takeshi
Published: November 2007

The occurrence of electrical alternans of the ST segement has been reported in patients with variant angina. The authors encountered a patient with typical electrical alternans of the ST segment in leads V4 through V6, which developed during percutaneous transluminal coronary angioplasty (PTCA) of the proximal left anterior descending artery. Hemodynamic pulsus alternans of the aortic pressure tracing was not observed during electrical alternans, and a Ca2+ blocker could not prevent this phenomenon during PTCA.
Giant Left Atrium—A Case Report
Authors: Gould Lawrence A. , Betzu Robert , Yang David Chang-Sing , Patel Devayani
Published: November 2007

A seventy-seven-year old woman, with mitral stenosis, presented with car diomegaly evident on her chest roentgenogram. The cardiac enlargement was due to a giant left atrium that distorted the cardiac structures. An echocardio gram and a first-pass nuclear angiogram were able to delineate the huge left atrum.
Sudden Appearance of Coronary Thrombus Observed by Angiography—A Case Report
Authors: Moriuchi Masahito , Saito Satoshi , Tamura Yasuo , Honye Junko , Kamata Tomohiko , Kaseda Naoto , Tsuji Masazumi , Hibiya Kazuhira , Ozawa Yukio , Hatano Michinobu
Published: November 2007

A sudden coronary thrombus formation was documented by chance during cardiac catheterization in a patient with postinfarction angina. The thrombus was successfully treated with intravenous urokinase and heparin infusions, and there after, coronary angioplasty was performed without any complication.
Unilateral Diffuse Pulmonary Artery Involvement in Takayasu's Arteritis Associated With Coronary-Pulmonary Artery Fistula and Bronchial-Pulmonary Artery Fistula: A Case Report
Authors: Horimoto Masashi , Igarashi Keiichi , Aoi Kenichirou , Okamoto Kiyotaka , Takenaka Takashi
Published: November 2007

Diffuse involvement of the right pulmonary artery associated with fistulas between the pulmonary artery and systemic artery is reported in a woman with Takayasu's arteritis. The most proximal portion of the abdominal aorta was pronouncedly narrowed and the aortic wall was markedly calcified. Both the celiac artery and the superior mesenteric artery were totally occluded and drained by the meandering artery arising from the inferior mesenteric artery. The proximal right pulmonary artery was focally narrowed and the middle lobe artery was occluded. All other branches of the right pulmonary artery were diffusely narrowed with sparse distributions of their distal branches.

Fistulas were identified between the right coronary artery and the right pul monary artery and between the right bronchial artery and the right pulmonary artery. This is the first English report of Takayasu's arteritis presenting with a coronary-pulmonary artery fistula that is secondary to a diffuse unilateral in volvement of the pulmonary artery.
Total Occlusion of the Left Main Coronary Artery in a Young Woman with Survival: A Case Report
Authors: Papadopoulos George P.
Published: November 2007

The total occlusion of the left main coronary artery (LMCA) is rare, and the survival depends on the existence of collateral circulation. The author presents a case of total occlusion of the left main coronary artery with survival in a young woman because he thinks this is a very rare case, owing to the sex and age of the patient.
Cardiac Arrest Due to Spontaneous Coronary Artery Dissection in a Patient with Coronary Ectasia—A Case Report
Authors: Huikuri Heikki V. , Mallon Steven M. , Myerburg Robert J.
Published: November 2007

Spontaneous coronary artery dissection is a rare event and only in a few patients has the diagnosis been angiographically confirmed during life. A spon taneous dissection of the right coronary artery was detected as a cause of out-of- hospital cardiac arrest in a patient with coronary artery ectasia.
Transcranial Doppler in Reversible Migrainous Vasospasm Causing Cerebellar Infarction: Report of a Case
Authors: Gomez Camilo R. , Gomez Sandra M. , Puricelli Mark S. , Malik Maheen M.
Published: November 2007

A young woman with a history of classic migraine suffered a large cerebellar infarction . Comprehensive evaluation did not disclose any potential causes for the stroke and she had no other risk factors. Transcranial Doppler (TCD) was useful in identifying vasospasm of the vertebral arteries. Following treatment with propranolol, angiography and repeat TCD revealed resolution of the vasospastic disorder.

TCD is a useful noninvasive tool in detecting vasospasm associated with ischemic lesions in certain patients with migraine.
Alterations in Erythrocyte Rheology in Patients with Severe Peripheral Vascular Disease: 1. Cell Volume Dependence of Erythrocyte Rigidity
Authors: Hung Ting-Cheng , Pham Si , Steed David L. , Webster Marshall W. , Butter Desiree B.
Published: November 2007

The erythrocyte rigidity of patients suffering from severe peripheral vascular disease (PVD) was measured by a filtration method using 3 μm pore size filters. Filtration pressures for both PVD patients and normal subjects showed a cell volume dependency, and patient filtration pressures were normalized to cell volume to evaluate intrinsic, ie, nonvolume dependent, abnormalities in erythro cyte deformability. A signifcant (p < 0.001) increase in cell rigidity was found in 44 of 54 PVD patients in comparison with volume-matched normal controls. No significant difference was found between patient mean corpusculer hemoglobin (MCH) and normal MCH at any given mean corpuscular volume (MCV), indi cating that observed increases in erythrocyte rigidity are not attributable to changes in patient MCH. Therefore, the mechanism of increase in erythrocyte rigidity for PVD patients still needs further investigation into such parameters as levels of adenosine triphosphate,2,3-DPG, and membrane fluidity (calcium and/or protein-binding membrane, cholesterol and phospholipid content of mem brane, etc), as well as other aspects of erythrocyte physiology.
Investigations on the Biochemical Characteristics of Chronically Underperfused Muscle
Authors: Schweiger Hans
Published: November 2007

During operation, biopsies from the gastrocnemius muscle and, in some cases, from the sartorius muscle were taken from 32 patients with peripheral arterial occlusive disease and from 5 subjects with normal peripheral circulation.

In patients with inadequate circulation only during exercise, when compared with the control group, increased activities of enzymes involved in oxidative metabolism (malate dehydrogenase, nicotinamide adenine dinucleotide phos phate-dependent isocitrate dehydrogenase, cytochrome C oxidase, creatine ki nase), in amino acid metabolism (asparate aminotransferase, alanine aminotransferase), and in anaerobic glycoysis (lactate dehydrogenase) were found.

In patients with circulatory disturbances that manifested themselves already at rest, enzyme activities were, with the exception of LDH, lower than those of patients with exclusively exercise-related insufficiency. By means of in traindividual comparisons with the corresponding enzyme activities in the sarto rius muscle, the author was able to show that the changes found were not simply the result of differences in training conditions. The diminished concentrations of energy-rich phosphate are an expression of the anaerobic metabolic state in patients with inadequate circulation at rest.

It is concluded that chronic ischemia of muscle leads to changes in the energy metabolism of the cell. In the presence of more nearly adequate circulation at rest, the portion of oxidative potential of the total energy metabolism increases. In contrast, if there is an inadequate circulation at rest, the mainly anaerobic glycolysis becomes quantitatively predominant.
Mycotic (Aspergillus) Arteritis Resulting in Fatal Subarachnoid Hemorrhage: A Case Report
Authors: Lau Alan H.C. , Takeshita Moiriyuki , Ishii Nobuyoshi
Published: November 2007

A seventy-one year-old Japanese man suffering from carcinoma of the com mon bile duct died from subarachnoid hemorrhage secondary in intracranial mycotic arteritis (MA). Repeated cultures of the discharge from the draining tubes, the tip of intravenous hyperalimentation catheters, blood, sputum, and urine failed to grow any fungus. Autopsy disclosed MA due to Aspergillus at the terminal portion of the right internal carotid artery close to the posterior commu nicating artery.
Validity of Cerebrovascular Mortality Rates
Authors: Stehbens William E.
Published: November 2007

Cerebrovascular disease (CVD) mortality rates are being increasingly used to establish a relationship with coronary heart disease risk factors. Cerebrovascular mortality rates suffer from the same general defects as coronary heart disease mortality rates but with greater diagnostic error in regard to subdivisions of CVD or stroke. These vital statistics, whether national or regional, are too inaccurate for scientific use and cannot be regarded as representing true mortality rates for any country. Moreover, clinical CVD is an inappropriate surrogate for severity of atherosclerosis, providing inexact data and allowing indeterminate overlap in epidemiologic studies.
Double-Blind Placebo-Controlled Trial of Buflomedil in the Treatment of Raynaud's Phenomenon: Six-Month Follow-up
Authors: Le Quentrec Ph. , Lefebvre M.L.
Published: November 2007

The efficacy of buflomedil in reducing the mean daily frequency and severity of winter ischemic attacks has been shown in a randomized, double-blind, pla cebo-controlled trial including 31 patients (16 in the buflomedil group, 15 in the placebo group) suffering from idiopathic Raynaud's phenomenon and followed up for six months.

The efficacy was confirmed by nail fold capillaroscopy, which showed a significant alleviation of hemodymanic disturbances and background pallor in comparison with the placebo.

Results in terms of clinical and laboratory safety parameters assessed over a six-month period were satisfactory, thus demonstrating the possibility of a long- term treatment.
Assessment of Coronary Artery Disease by Thallium Scan in Type-1 Diabetic Uremic Patients Awaiting Combined Pancreas and Renal Transplantation
Authors: Trochu Jean-Noel , Cantarovich Diego , Renaudeau Jocelyne , Patra Odile , du Roscoat Philippe , Helias Jacques
Published: November 2007

Twenty-five type-1 diabetic uremic patients (14 men, 11 women, mean age forty ± eleven years, range, nineteen to sixty) were prospectively analyzed for coronary artery disease (CAD) by thallium scan (TLS) before syn chronus pancreas and kidney trans plantation. Duration of diabetes ranged from ten to thirty-two years (mean twenty-two ± five). Fifteen pa tients (60%) were in dialysis from two to sixty months (mean twenty ± eigh teen). Advanced diabetic degenerative complications were present in all pa tients. Twenty exercise and five phar macologic thallium scans were performed.

Forty-four percent of patients (6 men, 5 women, mean age forty-two ± eleven years, range, twenty-six to sixty) had a positive (reversible or per manent defects) TLS. In 2/11 cases, se vere CAD required further cardiac investigations for therapeutic manage ment decision. A statistical correlation with resting ECG nonspecific ST-seg ment and T-wave abnormalities was observed (p<0.05) despite the absence of angor in 8 of the 11 patients. On the contrary, no statistical correlations were found regarding high blood pres sure, smoking, hypercholesterolemia, duration of diabetes, and duration of dialysis.

In this particular diabetic popula tion (young age, male/female ratio = 1.2) with high incidence of silent isch emia, resting ECG repolarization ab normalities, though predictive, were not specific or prognostic of CAD severity; in these cases, exercise and pharmacologic TLS, a noninvasive and sensitive cardiovascular test, may be of great interest in diagnosis of CAD, allowing adequate cardiac man agement before, during, and after pancreas transplantation.
Suppression of Atherogenesis by n-3 Fatty Acids in the Cholesterol-Fed Rabbit
Authors: Demiroglu Cem'i , Özder Ayse , Altug Tuncay , Orbay Billur , Satar-Yíldírím Süheda , Bilir Ayhan , Deniz Günnur , Erbengi Türkan , Büyükdevrim Sevim
Published: November 2007

The effects of n-3 fatty-acid supplementation on serum lipids, platelet aggre gation, and the development of atherosclerotic lesions were studied in the choles terol-fed rabbit. Serum total cholesterol and LDL cholesterol values were significantly reduced in comparison with those of the nonsupplemented choles terol-fed group (p<0.005, p<0.0025, respectively), though still higher than those of the control group (p<0.0025, p<0.0125 respectively). Platelet aggregation was reduced below that of the cholesterol-fed and the control levels (p<0.0005, p<0.0025, respectively). The endothelial injury encountered in cholesterol-fed rabbits was inhibited in the supplemented group. It is concluded that n-3 fatty acids suppress atherogenesis in this animal model by interfering with platelet aggregation and lipid metabolism.
Severe Hypertension with Segmental Renal Infarction Following Surgical Removal of a Retroperitoneal Malignant Hemangiopericytoma: A Case Report
Authors: Matsumura Kiyoshi , Muratani Hiromi , Kinjou Kunihiko , Kimura Yorio , Eto Tanenao , Fukiyama Koshiro , Kusaba Akira
Published: November 2007

Severe hypertension developed in a fifty-five year-old woman after surgical removal of a retroperitoneal tumor, when the renal artery was injured. Renal arteriography after the surgery demonstrated a segmental infarction of the right kidney. A close relationship between activation of the renin-angiotensin system and the development of severe hypertension was observed. Satisfactory control of blood pressure concomitant with reduction of plasma renin activity was achieved by a combination of an angiotensin-converting anzyme inhibitor, β- blocking agent, and calcium-entry blocker. The mechanism of activation of the renin-angiotensin system in renal infarction is discussed.
Renal Artery Imaging: A Prospective Comparison of Intra-Arterial Digital Subtraction Angiography with Conventional Angiography
Authors: Kim Ducksoo , Porter David H. , Brown Robert , Crivello Madeline S. , Silva Patricio , Leeming Brian W.A.
Published: November 2007

This study describes a systematic comparison of intra-arterial digital subtraction angiography (DSA) of the main renal arteries with conventional angiography (CA), the currently accepted "gold standard" for the diagnosis of renal artery stenosis.

Twenty-five patients scheduled for abdominal aortography for various indications underwent first DSA then CA. The DSA and CA images were evaluated for number of renal arteries, presence and grade of renal artery stenosis, presence of post-stenotic dilation or fibromuscular changes, and diagnostic and pictorial adequacy of the images. DSA was found to be diagnostically adequate in 92 % of cases, compared with 96 % for CA.

In evaluating significant main renal artery stenosis, which the authors assumed to be any stenosis greater than 50%, there were 10 such stenoses seen by CA. DSA also detected 10 cases, but there was 1 false positive and 1 false negative, yielding a sensitivity of 90 % and a specificity of 98%. There was also close correlation of DSA and CA for the few cases of post-stenotic dilatation and fibromuscular dysplasia encountered. The authors conclude that DSA is an acceptable substitute for CA in the evaluation of patients for main renal artery stenosis.
Postphlebitic Syndrome and General Surgery: An Epidemiologic Investigation
Authors: Wille-Jørgensen Peer , Jørgensen Torben , Andersen Mette , Kirchhoff Marianne
Published: November 2007

Of a random sample comprising 4581 subjects from The Copenhagen County, 3608 (79%) attended an interview and a general health examination. The subjects were defined as suffering from subjective postphlebitic syndrome if they claimed of lower extremity pain or cramps at rest and from objective postphlebitic syndrome if varicose veins, edema, lower extremity ulcers, or skin changes were present. By means of logistic regression analysis, subjective postphlebitic syndrome was found independently associated with previous thromboembolism, obesity, increasing age, female sex, hormonal therapy, varicose veins, and previous major abdominal surgery. Objective postphlebitic syndrome was associated with previous thromboembolism, obesity, former birthgiving, and high social status. The findings support the view that subclinical deep venous thrombosis in connection with previous surgery may give rise to symptoms in the lower extremities.
Relationship Between Foot Transcutaneous Oxygen Tension and Ankle Systolic Blood Pressure at Rest and Following Exercise
Authors: Gardner Andrew W. , Skinner James S. , Cantwell Bradford W. , Smith L. Kent , Diethrich Edward B.
Published: November 2007

To determine whether foot transcutaneous oxygen tension (TcPO2) and ankle systolic blood pressure (SBP) measure similar aspects of peripheral vascular occlusive disease (PVOD), the authors examined their relationship at rest and following treadmill exercise. Thirty-seven PVOD patients (mean age 69.2 ± 0.8 years) rested supine for twenty minutes, followed by a progressive treadmill walking test at a constant speed of 2 mph. The initial grade was 0 % ; this increased 2 % every two minutes until maximal claudication pain (n = 19) or until the occurrence of such limiting symptoms as volitional fatigue (n = 6), ST segment depression (n = 4), dyspnea (n = 3), multiple premature ventricular contractions (n = 2), and angina (n = 2). Patients then rested supine for fifteen minutes. Foot TcPO2 was recorded before, during, and after exercise, whereas ankle SBP was measured before and after exercise. At rest, a curvilinear relationship was found between foot TcPO2 and ankle SBP (foot TcPO2 = 41.89 + 0.22(ankle SBP) + 0.0005 (ankle SBP2); SEE = 9.2, R = 0.64, R2 = 0.41, p < 0.001). In contrast, the relationship was stronger and more linear during recovery, particularly at the sixth minute (foot TcPO 2) = 8.33 + 0.35 (ankle SBP); SEE = 13.6, R = 0.86, R2 = 0.73, p < 0.001). At rest, foot TcPO2 and ankle SBP charac terized different aspects of PVOD because they shared only 41 % common vari ance. During recovery, they provided similar information because up to 73 % of the variance was shared. It is concluded that foot TcPO 2 should also be used to assess PVOD patients because unique information is obtained at rest and values can be recorded during exercise.
Transient Pulsus Alternans Induced by Isosorbide Dinitrate: Echocardiographic and Hemodynamic Evidence of Reduced Venous Return—A Case Report
Authors: Matsuhashi Hironobu , Onodera Sokichi , Hasebe Naoyuki , Maruyama Jun-ichi , Honda Hajime , Yamashita Hirohisa , Tobise Katsuyuki
Published: November 2007

Transient pulsus alternans was induced by isosorbide dinitrate (ISDN) in a patient with postmyocarditis congestive heart failure under diuretic therapy. The severity and duration of pulsus alternans depended on the dose of ISDN.

According to the echocardiographic and hemodynamic examinations, the superimposed preload reduction caused by ISDN combined with decreased blood volume owing to diuretic therapy most likely contributed to the development of pulsus alternans.
Vasculitic Skin Ulcers Associated with Myelofibrosis A Case Report
Authors: Schwartz Jacob , Madjar Jack , Habot B.
Published: November 2007

This is the case report of a seventy-seven-year-old woman with ulcerated skin vasculitis of the lower extremities that preceded the appearance of myelofibro sis. No previous report of this association has been found in a survey of the literature.
Thermal Effects and Histologic Changes from Nd:YAG Laser Irradiation on Normal and Diseased Aortic Tissue Using a Novel Angioplasty Catheter with a Mobile Optical Fiber: An in Vitro Assessment
Authors: Weber Helmut , Enders Susanne , Hessel Stefan
Published: November 2007

Although various laser angioplasty devices are currently being examined, thermal damage and perforation of the vessel wall remains the major acute complication of vascular laser recanalization. Consequently, the aim of this study was to investigate the thermal effects and histologic changes from laser irradiation (Nd:YAG, 1064 nm) on normal and diseased aortic tissue using a novel angioplasty device.

During laser emission the coaxially guided optical fiber tip was positioned in reference to the end hole of the metallic capped probe as follows: (1) at the end hole (metal-cap position), (2) protruding 10 mm from that end hole (bare-fiber position), (3) withdrawn 5 mm into the metal cap's lumen (hot-tip position). In total, 96 laser impacts (25 joule: 5 W, 5 s, each) were produced on normal and atherosclerotic aorta in air through a 0.2-mm-core-diameter silica quartz fiber, with direct contact on the intimal surface of the target tissue by both the fiber and the metal cap and by either the fiber or the metal cap (n = 32 each). Tissue temperature was measured by means of special sensors positioned opposite the irradiated intimal spot in direct contact with the adventitial surface. Morphohistologic evaluation of lesions was performed and injury indexes were determined.

Thermal injury (on normal aorta) for the metal-cap position was 0.063 ± 0.02 versus 0.42 ± 14 and 0.13 ± 0.03 for bare-fiber and hot-tip position, respectively (p< 0.001). In the metal-cap position of the optical fiber tip the metal cap appears to act as a "heat sink" to decrease the lateral spread of thermal injury and thereby reduce the risk of perforation and enhance the safety of tissue ablation for potential vascular laser recanalization.
Effect of L-dopa in Young Patients with Hypertension
Authors: Saito Ikuo , Kawabe Hiroshi , Hasegawa Chika , Iwaida Yasushi , Yamakawa Hiroshi , Saruta Takao , Takeshita Eiko , Nagano Shiro , Sekihara Toshio
Published: November 2007

The effects of L-dopa on blood pressure, heart rate, plasma renin activity, norepinephrine, epinephrine and prolactin were studied in a randomized single-blind trial in 36 patients with essential hypertension. In response to L-dopa, 250 mg administered orally, the blood pressure decreased significantly as compared with the results of placebo treatment. The heart rate and plasma norepinephrine and epinephrine were unchanged. The plasma renin activity and prolactin decreased as a result of L-dopa administration. The administration of a peripheral DA2 dopamine receptor blocker, domperidone (20 mg, orally) prevented the L-dopa-induced reduction in plasma prolactin but failed to block the fall in blood pressure and plasma renin activity. These results suggest that the blood pressure-lowering effect of L-dopa may be mediated through multiple sites involving D1 dopamine receptors, the central nervous system, and the renin-angiotensin system.
Reliability of Three Computer Methods in the Analysis of ECG-Gated Radionuclide Left Ventriculography: Interrecording, Interobserver and Intraobserver Variability
Authors: Jensen Finn Taagehøj , Lund Ole , Erlandsen Mogens
Published: November 2007

Three different computer methods for analysis of systolic and diastolic left ventricular function (ejection fraction, peak ejection rate, time to peak ejection rate, peak filling rate, time to peak filling rate, duration of fast filling phase, and fast filling fraction) as derived from ECG-gated radionuclide cardiography were compared in 30 patients with various diseases. The patients had two gam ma camera recordings of the left ventricle performed immediately following one another during radionuclide (99mTc) equilibrium (3 x 106 counts, 16 frames/cy cle, 64 x 64 pixels). Mean ECG R-R interval of the patients remained unchanged from first to second recording. The three computer methods were: (1) end-diastolic (ED) region of interest (ROI) analysis based on manually defined ED-ROI; (2) multi (M) ROI, manually defined ROI for each frame; and (3) semiautomatic (SA) ROI, ROI for each frame defined by an SA edge detection technique. With the 16 frame points as nodes, a 160-point time-activity curve was constructed for each of the three methods by use of a spline function. A tailored multiway analysis of variance showed that the M-ROI method had the highest interindividu al range of values of the function parameters and the smallest interrecording, interobserver, and intraobserver variabilities. In theory this implies a better di agnostic sensitivity and specificity for the M-ROI method as compared with the other two methods.
Influence of Sympathetic Nerve Activity on Ventricular Arrhythmogenicity in the Dog with Chronic Hypokalemia
Authors: Yano Katsusuke , Matsumoto Yoriaki , Hirata Masanobu , Hirata Tetsuya , Hano Osamu , Mitsuoka Takao , Hashiba Kunitake
Published: November 2007

To examine the influence of sympathetic nerve activity on ventricular arrhyth mogenicity in the dog with chronic hypokalemia, an electrophysiologic study was performed before and after bilateral stellectomy (BS) in 10 dogs with chronic hypokalemia (2.8 ± 0.1 mEq/L), which was created by feeding a low-potassium diet and by administering furosemide over a four-week period, and the results were compared with those obtained from 10 dogs with normokalemia (4.7 ± 0.3 mEq/L) from being fed an ordinary diet over a four-week period.

Before BS the incidence of electrically induced ventricular arrhythmias was higher in the hypokalemic than in the normokalemic dogs. After BS it was decreased considerably in the hypokalemic but not in the normokalemic dogs. Heterogeneity of effective refractory period (ΔERP), which was determined as the difference between the longest and shortest effective refractory periods in three sites of the right and left ventricles, was greater in the hypokalemic than in the normokalemic dogs before BS. The ΔERP decreased slightly in the two groups both before and after BS. There was, however, no significant difference in ΔERP in the two groups both before and after BS. Ventricular fibrillation threshold (VFT) was significantly lower in the hypokalemic dogs than in the nor mokalemic dogs before BS (p< 0.005). VFT was elevated in the two groups after BS. Percent increase in VFT after BS was significantly greater in the hypoka lemic than in the normokalemic dogs. In conclusion, sympathetic nerve activity may play an important role in the increase in ventricular arrhythmogenicity in the presence of chronic hypokalemia.