bluuebunny/crossref_metadata_2025 huggingface dataset:
THE SCALAR κ MESON CONTRIBUTION TO THE NUCLEON STRANGENESS
Authors: CARVALHO F. , LEITE D. M. T. , NAVARRA F. S. , NIELSEN M.
Published: November 2007

The strangeness content of the nucleon electric and magnetic form factors is analyzed in a version of the meson cloud model, including the kaon and the scalar κ mesons. We compare our results with the recent measurements performed at TJNAF.
AMPLITUDES IN pp AND ${\rm \bar{p}p}$ SCATTERING
Authors: FERREIRA ERASMO , PEREIRA FLÁVIO
Published: November 2007

Solutions for the amplitudes that give accurate description of pp and [Formula: see text] scattering at high energies are investigated, with particular attention given to the properties of their zeros and slopes, whose determination is required for the study of the Coulomb interference region. Proper extrapolations of these quantities to the LHC energies are important for the analysis of the forthcoming experiments.
THERMODYNAMICS OF QUASI-PARTICLES
Authors: GARDIM FERNANDO G. , STEFFENS FERNANDO M.
Published: November 2007

We present in this work a generalization of the solution of Gorenstein and Yang to the inconsistency problem of thermodynamics for systems with a temperature dependent Hamiltonian. We show that there are, in principle, an infinite number of solutions.
LINEAR PROGRAMMING MODELS WITH CHANGEABLE PARAMETERS — THEORETICAL ANALYSIS ON "TAKING LOSS AT THE ORDERING TIME AND MAKING PROFIT AT THE DELIVERY TIME"
Authors: CHIANGLIN CHIEH YOW , LAI TSUNG CHIH , YU PO LUNG
Published: November 2007

Corporate competence sets can be expanded through capital investment and be dynamically changed overtime, which can explain the phenomenon of "taking loss at the ordering time and making profit at the time of delivery". Such phenomenon has existed in practice for a long time, but there are no mathematical model that can explain it adequately. This paper utilizes multiple criteria and multiple constraint levels linear programming (MC2LP) model and its extended techniques to explore the linear programming models with changeable parameters. The parameters include: unit profit, available resources, and input-output coefficients of production function. With those parameters changed with capital investment and/or time, we study how to find dynamic best solutions to make "taking loss at the ordering time and making profit at the time of delivery" feasible. For more general cases we also sketch a generalized mathematical programming model with changeable parameters and control variables.
TOWARDS AN INSTITUTIONS-THEORETIC FRAMEWORK COMPARING SOLAR PHOTOVOLTAIC DIFFUSION PATTERNS IN JAPAN AND THE UNITED STATES
Authors: SHUM KWOK L. , WATANABE CHIHIRO
Published: November 2007

This paper studies and compares the actual historic solar photovoltaic (PV) installation data in Japan and the United States and proposes two deployment models to account for the differences. Deployment, along with research, development and demonstration, constitutes what is known as the RD3 (PCAST — President's Council of Advances in Science and Technology, United States) innovative chain of a new technology. Japan deploys PV focusing on the niche of utility grid-tied small-scale system (90 per cent of which is standardised roof-top residential PV system) using highly integrated value chain; this seems to draw upon her strong manufacturing culture and associated social technology and institutions for suppliers-dominated innovations.

The United States deploys PV as a broadly defined innovation emphasising user-oriented customisation in both on and off grid, residential and industrial applications using small independent and intermediary system integrators. Empirical analysis of the diffusion patterns in the grid-tied small system category in respective contexts suggests that Japan's institutions seem to match her mass deployment strategy while the United States' combination of fragmented industry structure and diversity deployment gives rise to a complex diffusion pattern calling for continual institutional innovation or co-evolution. Our research, therefore, highlights that commercialisation of new technology or technical change, in general, is not an autonomous process and has strong institutional underpinnings. We formalise and generalise this "match" (Perez, 1983) argument in accordance with Nelson and Sampat's (2001) framework of physical technology vs social technology and their interactions. Some potential future extensions regarding utilities for this model are then highlighted.
Thrombophlebitis and Cancer
Authors: Oster Martin W.
Published: November 2007

Thrombophlebitis has been associated with virtually all cancers, especially gastrointestinal, urogenital, and lung neoplasms. Although occurring in frequently in cancer patients, thrombophlebitis may appear before the cancer has become symptomatic and may lead to an earlier diagnosis of cancer. The phlebitic syndrome associated with cancer, although not unique, is distinctive. It is often recurrent and migratory, often involves unusual locations, and is often resistant to anticoagulation therapy. Pul monary emboli are frequent complications. The pathogenesis of phlebitis in cancer patients is not well understood. Evidence suggests that many cancer patients are hypercoagulable, with abnormalities in platelets, coag ulation factors, and the fibrinolytic system. These changes may result from the elaboration of thromboplastin-like substances from the cancer tissue.
Spontaneous Changes in Hemodynamics in Uncomplicated Acute Myocardial Infarction: a Prospective Echocardiographic Study
Authors: Aronow Wilbert S. , Prakash Ravi
Published: November 2007

Spontaneous changes in heart rate (HR), systolic and diastolic blood pressure, left ventricular end-diastolic dimension (LVEDD), and left ven tricular end-systolic dimension (LVESD) over a 95-minute period were evaluated in 13 patients with uncomplicated myocardial infarction within 48 hours of infarction. The patients were on no medication at the time of their study. ECGs, blood pressures, and echocardiograms were recorded every 1 minute for 5 minutes (control period) and 1, 3, 5, 10, 20, 30, 45, 60, and 90 minutes (study period) after the control measurements.

The mean control LVEDD was 57.4 ± 10.0 mm; the standard deviation (SD) across the control values was 0.9 mm. The mean LVEDD during the 90-minute study period was 57.5 ± 9.7 mm; the SD across the 90-minute study period values was 1.4 mm. The mean control LVESD was 48.3 ± 11.4 mm; the SD across the control value was 1.0 mm. The mean LVESD during the 90-minute study period was 48.9 ± 11.0 mm; the SD across the 90-minute study period was 1.7 mm. No significant differences in HR, systolic or diastolic blood pressure, LVEDD, and LVESD occurred be tween the 5 control values and the 10 values obtained during the 90- minute study period in the 13 patients in this study.

We conclude that (1) reproducible measurements of LVEDD and LVESD can be obtained by echocardiography in stable patients with uncomplicated acute myocardial infarction over a 95-minute period; and (2) the hemodynamic variables are stable in uncomplicated myocardial infarction over a 95-minute period.
Peripheral Venous Platelet Aggregates in Patients With Unstable Angina Pectoris and Acute Myocardial Infarction
Authors: Willerson James T. , Willerson James T.
Published: November 2007

In vivo peripheral venous platelet aggregates (PVPA) have been demon strated in patients with myocardial infarction (MI), transient cerebral ischemic attacks (TIAs), and acute arterial insufficiency by the platelet count ratio (PCR) method. But PVPA determinations have not been reported in patients with unstable angina pectoris (UA), controls have not been specified as acutely ill in earlier studies using this technique, and variability of the method has not been presented in detail. Because platelet aggregation has been mentioned as a possible mechanism for perpetuating myocardial ischemia, we studied 21 acutely ill noncardiac control (NC) patients, 17 UA patients, and 13 MI patients for PVPA.

PCR represents ratio of platelet counts obtained when identical aliquots of blood were drawn into two syringes containing formalin-EDTA and EDTA respectively. Free flow was demonstrated before blood was drawn. Mean PCR was 0.90 ± 0.01 (SE) in NC, 0.85 ± 0.02 in UA, and 0.85 ± 0.02 in MI. In the subset of 7 patients with acute transmural MI, PCR was 0.83 ± 0.02. Only this subset was significantly different from NC (P < 0.001). PCR did not vary significantly with age or sex. Aspirin history was positive in 25-30% of the patients in each group and raised PCR by an average of 0.04 units. When PCR was repeated after 45 minutes in 6 patients, moderate variability with a mean absolute change in PCR of 0.08 was noted.

Our data fail to support an etiologic role for circulating platelet aggre gates in initiating UA. Clinical trials of platelet inhibitors and experimen tal models of arterial insufficiency probably offer the greatest chance of further defining the potential etiologic role of platelet aggregation in initiating or perpetuating myocardial ischemic phenomena.
Plain Roentgenographic Estimation of Systolic Pulmonary Artery Pressure by the Pulmonary Arterial Angle Method
Authors: Rajaram P.C. , Razak Rahamath , Lakshmikanthan C.
Published: November 2007

Chest roentgenograms of 125 patients (115 with pure or predominant mitral stenosis) were studied by the pulmonary arterial angle method to estimate systolic pulmonary artery pressure without prior knowledge of catheterization data. First the angle between the line drawn along the right upper lobe artery and the tangent drawn along the point of junction of superior and lateral borders of the right pulmonary artery was determined. Next the angle between the right middle lobe artery and the descending pulmonary artery is determined. The difference between these angles equals systolic pulmonary artery pressure. Catheter and angle values were identical in 26 patients. There was a 1- to 5-mm difference in 70, a 6- to 10-mm difference in 18, an 11- to 15-mm difference in 8, and a difference greater than 15 mm in 3.
Minoxidil in the Treatment of Refractory Hypertension
Authors: Rosenthal Talma , Swartz Jacob , Teicher Avishai , Boichis Hayim
Published: November 2007

Minoxidil, a powerful vasodilator, is a very effective antihypertensive drug. It was used to treat 22 patients, most of whom were refractory to conventional antihypertensive medication. There was a swift and definite drop of blood pressure in all cases. In 7 patients with renal disease, renal function did not deteriorate during the administration of Minoxidil, and it improved dramatically in the eighth patient. Side effects of the drug were hirsutism, fluid retention, and in 1 patient a pruritic bullous eruption which disappeared when the drug was discontinued.
Digitalis-Induced Cardiac Arrhythmias
Authors: Chia B.L.
Published: November 2007

Six cases of digitalis intoxication pre senting with cardiac arrhythmias are described. Multiple cardiac arrhyth mias consisting of multifocal, or unifo cal, multiform ventricular ectopic beats, bidirectional tachycardia, com plete heart block, accelerated junc tional rhythm with exit block, nonpa roxysmal junctional tachycardia, atrial fibrillation, atrial tachycardia with block, and multifocal tachycardia were observed. The presence of such multi ple arrhythmias occurring simultane ously should always suggest the high possibility of digitalis intoxication.
Acral Diagnosis and Possibilities of Conservative Treatment of Chronic Obstructive Vascular Diseases
Authors: Köenig F.K.
Published: November 2007

One of the main problems which confronts a doctor practicing in the angiology field is the decision if a conservative treatment alone is going to be sufficient for a patient or if he has to decide for vascular surgery.

Concerning the latter, there should be kept in mind that always an additional conservative therapy is of utmost importance since chronic vascular disease is looked at as a generalized phenomenon and surgical therapy can be used only in limited segments.

In order to make a decision whether conservative or surgical therapy should be applied we used the "Nitrate Test"—described in 1968 by Migliorini, Italy and in 1976 by Böhme, Germany—modified and developed it further.

Migliorini and Böhme stated that an increased blood flow after nitrate application is useful for the determination whether a patient suffers from a functional or an organic vascular disease.
Lack of Effect of Cyclandelate in Peripheral Arterial Disease
Authors: Vyden John K. , Nagasawa Koichi , Kanazawa Masakuni , Rose Harold B. , Seino Yoshihiko , Groseth-Robertson Marsha F. , Lander Elliot B. , Elconin Steven B.
Published: November 2007

While cyclandelate is widely used in the therapy of peripheral arterial disease, objective evidence of its efficacy remains controversial. For this reason, 12 patients with intermittent claudication (average age of 66.8 years) received both cyclandelate 400 mg qid and placebo in a double-blind crossover trial lasting two months.

During the cyclandelate and placebo periods, the following peripheral hemodynamic measurements were obtained using a plethysmograph and treadmill claudication testing: mean calf blood flow, vascular resistance and venous capacitance; finger and toe blood flow, pulsation amplitude and tem perature before and after vasodilating maneuvers; arm and leg arterial pulsa tion amplitudes, one and ten minute calf reactive hyperemia reaction; 30 pound/30 second calf active hyperemia reactions and times of onset of claudi cation as measured on a treadmill.

No major significant difference could be demonstrated between placebo and cyclandelate on any subjective symptom or any objective measurement. It is concluded that cyclandelate 400 mg qid for 4 weeks was of little objective value in treating this group of 12 patients with peripheral arterial disease and suffering from intermittent claudication.
Diagnosis of Tricuspid Insufficiency by Non Invasive Methods
Authors: Luisada Aldo A. , Singhal Achala , Robles Rosalina
Published: November 2007

The diagnosis of tricuspid insufficiency was first made at the end of last century, based on clinical signs. Graphic tracings of the venous system were soon recorded and were demonstrated useful in the forties and fifties. New methods involving invasive procedure or expensive instrumentation have been described in the last twenty years. The present study was made in order to re-examine the value of the non-invasive, graphic methods, which would assure a simple and inexpensive study for these patients.
Peripheral Atherosclerosis in Patients with Myocardial Infarction
Authors: Lamme S. , Johansson B.W. , Lindell S.E.
Published: November 2007

In 260 patients with myocardial infarction the systolic blood pressure gradient from arm to big toe was used as an indirect measure of the degree of generalized atherosclerosis. Arterial insufficiency was found in 12 per cent of the men and in 17 per cent of the women studied. The two year mortality was 19 per cent in males with arterial insufficiency as against 6 per cent in males without arterial insuffi ciency. This difference increased with longer (56-82 months) follow-up. The number of women was smaller but the results were similar. The present study does not support the theory that most patients with myocardial infarction have generalized atherosclerosis. Indeed, this seems to be the case in only a small fraction of such patients, thus supporting the idea that other mechanisms are also important in the etiology of myocardial infarction.
Pulmonary Varix
Authors: Asayama Jun , Shiguma Rieko , Katsume Hiroshi , Ijichi Hamao
Published: November 2007

Pulmonary varix is rare, only 53 cases having been reported. A brief review of the literature is given. Because its radiologic appearance may be indistin guishable from mediastinal or pulmonary lesions, pulmonary angiography is necessary to avoid exploratory thoracotomy, mediastinoscopy, and unnecessary antituberculous therapy.
Deep Venous Thrombosis of the Upper Extremity Five Years Experience at a University Hospital
Authors: Painter Thomas D. , Karpf Michael
Published: November 2007

All patients with deep vein thrombosis of the arm seen at one University Hospital over a 5 year period were reviewed. The 17 cases could be divided into distinct patient groups. The first group (primary thrombosis) consisted of 7 patients primarily healthy young males (mean age 23) who had vocations or avocations which involved vigorous physical activity of the arms. The 10 pa tients with secondary thrombosis tended to be older (mean age 47.3) and to be ill or hospitalized at the time of onset of their illness. Followup information could be obtained in 9 of the cases and 7 of these patients had persistence in their symptoms consisting of residual discomfort and edema of the involved arm es pecially after exercise. None of the patients treated with anticoagulation were asymptomatic. The only patients who were symptomatic were one patient who received streptokinase and another who underwent thrombectomy. Three illus trative case studies are included.
Hydrodynamic Flow in U-Shaped and Coiled Glass Loops Simulating Carotid Arterial Configurations
Authors: Stehbens William E. , Fee Conan J.
Published: November 2007

The dye injection technique was used to study flow patterns in ten U-bends and two helical coils. These models were manufactured of glass and designed to simulate abnormal arterial configurations in man. In each model flow distur bances were observed below the critical Reynolds number of 2000 for flow in a straight tube with one reading as low as 250. The disturbances in the flow were sensitive to external disturbances. Their periodicity was relatively regular but the frequency increased with augmentation of flow rates and some irregularity was apparent. The results indicate that they could have applicability to the human vascular system.
Iliac Artery Aneurysm in Behçet's Disease: A Case Report
Authors: Dündar-Kaldirimci Semra V. , Ates K. Bahri , Akpolat Tekin , Nazli Nasih
Published: November 2007

Today, Behçet's disease is known as a multisystem disorder.1-4 Eye lesions, mouth and genital aphthous lesions, and skin lesions are accepted as major lesions. The disease also attacks the locomotor system, central nervous system, gastrointestinal system and also arteries and veins. According to available data, some 30% of the patients have vascular lesions; mostly thrombosis of the veins. Arterial thromboses have been rarely reported; and only a few number of arte rial aneurysms are noted.5-13

Here we present an iliac artery aneurysm in a case of Behçet's disease.
Budd-Chiari Syndrome: Some Pathologic-Anatomic Aspects
Authors: Sons Hans U. , Borchard F.
Published: November 2007

The obstruction of the outflow of blood from the hepatic veins is generally called the Budd-Chiari syndrome. In the present work the most important pa thologic-anatomic findings concerning this rare disorder are discussed as are its possible causes.
Atherosclerosis
Authors: DeCarvalho Sergio
Published: November 2007

For a historical survey of the pathogenesis of atherosclerosis the reader is referred to references 1 and 2.

Comprehension of the vessel-blood interface homeostasis hinges upon an un derstanding of the pathophysiology of angio-lymphoid relationships.

Even in the smooth contact of the intact hydrophobic intimal lining with the marginal flow of the circulatory stream, small amounts of thrombin and small aggregates of aging platelets float by under physiologic conditions. Since endo thelial cells of the vascular intima contain receptors for thrombin, filling these receptors with thrombin becomes a stimulus for the production of prostacyclin (PGI2) by the endothelial cells; PGI2 in turn inhibits adherence of the small platelet aggregates by ADP; homeostasis is maintained. The size of physiologic thrombin-producing platelet microaggregates is controlled by physiologic levels of antithrombin III.
Graphic Representation of Carotid Artery Bruits
Authors: Leonberg Stanley C.
Published: November 2007

Auscultation of the neck for detection of bruits over the carotid arteries has become a necessary part of any complete physical examination. Early detection of atherosclerotic occlusive disease in these vessels can play a major role in prevention of stroke. Such findings have previously been recorded as word descriptions in varying degrees of detail.

A method is presented for quickly and easily recording the presence and character of cervical bruits, plus additional important information, including blood pressure, pulse, heart rhythm, prior vascular surgery, and known occlusion in these vessels. The figure used allows others to rapidly perceive this information and enables ready comparison on successive examinations.
Three-Dimensional Vectorcardiography (3-D VCG) by Computer Graphics in Old Myocardial Infarction
Authors: Morikawa Junichiro , Kitamura Kazuto , Habuchi Yoshizumi , Tanaka Nobuyuki , Nishimoto Youichi , Hirano Masaaki , Tsujimura Yoshinori , Hamamoto Hajime , Takanashi Tadahiro
Published: November 2007

By using computer graphics we rotated the vector loop and three coordinate axes to find the viewpoint where the infarctional changes are maximally exposed and demonstrated the advantage of the "3-D VCG" over the conventional VCG by defining the quantitative "MI index."

The orthogonal electrocardiogram recorded by the Frank lead system was digitally measured and processed by a microcomputer. The loops and axes were rotated about the X axis (X-rot) and the Y axis (Y-rot). The spatial vector loop and orthogonal coordinates can be presented as viewed from any spheric direc tion. Eight quadrants were illustrated with four colors and red circles.

The subjects consisted of 30 patients with old anterior myocardial infarction (MI) and 15 patients with old inferior MI. We measured the area of "Bite" in anterior MI and superior displacement in inferior MI. The MI index was de fined and averaged in 361 directions.

In anterior MI, the maximum mean index was obtained when X-rot is +90° and Y-rot -40°, viewed from upward and leftward, whereas in inferior MI it was obtained when X-rot is -50° and Y-rot -80°, viewed from downward and leftward.

These values were significantly higher than those in conventional VCG pro jections, substantiating superior diagnostic sensitivity of 3-D VCG.
Raynaud's Phenomenon in a Female Population: Prevalence and Association with Other Conditions
Authors: Leppert Jerzy , Aberg Hans , Ringqvist Ivar , Sörensson Stefan
Published: November 2007

In a random sample of 3000 women of ages eighteen to fifty-nine years in the city of Västerås, Sweden, 19% of the 2705 responders to a questionnaire com plained of cold and white fingers with or without numbness. On the basis of interview and examination, 79% of these women were diagnosed as having Ray naud's phenomenon (RP), giving a prevalence of 15.6%. A significantly higher rate of family members with cold, white fingers was found only in the group of women with pronounced RP (p < 0.001). A significantly higher frequency of women with pronounced RP than of the control group had a history of recur rent muscle/joint pain (p < 0.05). Laboratory tests that might indicate an active connective tissue disease did not, however, confirm a diagnosis of rheumatoid arthritis. All three subgroups differed significantly from the control group in terms of recurrent chest pains; subgroups 2 and N differed significantly from controls in terms of recurrent headaches.
Improvement of Walking Distance in Patients with Intermittent Claudication by Chronic Local Therapy with Isosorbide Dinitrate Ointment
Authors: Testa Roberto , Biagini Andrea , Michelassi Claudio , Emdin Michele , Mazzei Maria Giovanna , Carpeggiani Clara , l'Abbate Antonio
Published: November 2007

Isosorbide dinitrate ointment (100 mg tid) was directly applied to 30 male patients with stable, documented intermittent claudication on the areas where ischemic pain was experienced. The symptom-free distance walked (DWA) and the maximum distance reached (MDR) basally, after one, three, six, and twelve months were evaluated by means of treadmill stress tests (TSTs) (angle 0°-velocity constant/patient). After the basal TST, patients were randomly divided into two groups: placebo group and therapy group (double blind), and a further TST was administered one month later. DWA results were 74±8 m vs 297 ±83 m and MDR results were 163 ±22 m vs 506 ±86 m in the therapy group (basal vs one month TST: p < .01) and 94±24 m vs 96±15 m and 232±53 m vs 183±26 m in the placebo group, respectively (basal vs one month TST: NS). Being confident that a significant placebo effect was absent, the authors opened the trial and treated all patients, repeating further TSTs at three, six, and twelve months. The following results were obtained: DWA was 84±13 m, 316±63 m, 374±55 m, and 452±61 m; and MDR was 197 ±29 m, 431 ±59 m, 514 ±57 m, and 547 ±59 m, respectively, in basal conditions and after three, six, and twelve months of treatment (p < .01 for all the values for both DWA and MDR vs basal values). These results suggest the effectiveness of this treatment, independently from a placebo effect, in improving walking tolerance in patients with intermittent claudication.
An Unusual Case of Budd-Chiari Syndrome—A Case Report
Authors: Corrêa de Araujo Rosaly , Bestetti Reinaldo B. , Oliveira J. Samuel M.
Published: November 2007

The authors report a rare case of congenital Budd-Chiari syndrome in a twenty-eight-year-old male mongoloid. The patient was submitted to azygous- portal disconnection, because of the syndrome of portal hypertension suppos edly due to cirrhosis of the liver. He died of hemorrhage of the liver on the third postoperative day. Autopsy revealed a congenital fibrotic obstruction of all su prahepatic veins, with a wide, round ligament containing a functional umbilical vein, which had been routinely ligated during surgery. An extensive review of the literature showed no similar report. The authors speculate that the inadver tent interruption of the round ligament, which until then had served as a path way for venous draining of the liver, followed by ligation of the anastomoses between the portal and azygous systems, was the factor that triggered the lethal outcome. Thus, this appears to be the first case of congenital Budd-Chiari syn drome predominantly maintained at the expense of the round ligament of the liver, with a patent vascular branch.
Neovascularization in Recurrence of Varices of the Great Saphenous Vein in the Groin: Phlebography
Authors: Glass G.M.
Published: November 2007

A method of improving radiologic definition in phlebography of recurrent varicose veins in the groin is described. Before injection of contrast material, venous return from the distal part of the limb was temporarily suspended by inflating a tourniquet surrounding the lower part of the thigh to a level higher than the systolic pressure. Toward the end of the injection procedure the patient performed a valsalva maneuver. Phlebography showed that the recurrent varices were more frequently in continuity with the great saphenous vein than collateral to it. Their tortuous or irregular outline did not usually correspond in position or appearance to normal tributaries of the vein. Radiographs of excised great saphenous vein injected with barium sulfate suspension showed that the valves of tributaries proximal to the site of surgical interruption of the vein remained competent. The findings provide further evidence of neovascularization in recurrence of varices of the great saphenous vein at the site of transection.
Late Chronic Hemolysis after Valve Replacement for Aortic Stenosis. Relation to Residual Hypertrophy and Impaired Left Ventricular Function
Authors: Lund Ole
Published: November 2007

The relationship between intravascular hemolysis induced by aortic valve pro steses and patient status/left ventricular (LV) function (radionuclide cardiography) was examined in 63 patients of 65 who were alive ten to seventeen years after valve replacement (1965-1973) for aortic stenosis. Serum-lactic dehydrogenase (LDH) exceeded upper reference limit in 62 patients and S-haptoglobin (HAPTO) was reduced in 62. One patient with normal LDH had reduced HAPTO and elevated plasma-hemoglobin. Anemia was noted in 4 patients (6%). S-LDH was higher in men than in women (p<0.05), in patients with increased ECG hypertrophy score than in those with a normal score (p<0.05), in patients with NYHA class II-III than in those with class I (p<0.05), in patients with abnormal LV function than in those with a normal radionuclide study (p<0.05), in patients with a pathologic Q wave in the ECG than in those without (p<0.05), and in patients with a Starr Edwards cloth-covered (SECC) prosthesis than in those with other types (p = 0.07). ECG hypertrophy score correlated directly with LDH (r=0.33, p = 0.008) and inversely with LV ejection fraction (r = -0.57, p<0.0001), peak ejection rate (r = -0.47, p<0.0001), and peak filling rate (r = -0.41, p<0.001). Multiple linear regression analysis revealed that LDH was accounted for by ECG hypertrophy score (p = 0.001), SECC prosthesis (p = 0.04), and male gender (p = 0.05).

Hypertrophic malfunctioning left ventricles may be responsible for higher degrees of turbulent flow characteristics in the vicinity of prosthetic valves in the aortic position and, by inference, explain the increased tendency toward hemol ysis in these patients.
Hindbrain Ischemia Produced by Bilateral Vertebral Artery Occlusion and Moderate Hypotension in Spontaneously Hypertensive Rats
Authors: Yao Hiroshi , Sadoshima Seizo , Okada Yasushi , Ibayashi Setsuro , Fujishima Masatoshi
Published: November 2007

Hindbrain ischemia was induced by bilateral vertebral artery occlusion and moderate hypotension in spontaneously hypertensive rats (SHRs). Mean arterial blood pressure was lowered to 80 mmHg in SHRs and to 50 mmHg in Wistar- Kyoto rats (WKYs) by a controlled hemorrhage, and then the vertebral artery was bilaterally occluded through alar foramina of the first cervical vertebra. Following vertebral occlusion, blood flow of the cerebellum was significantly decreased to 9.4±2.0 mL/100g/min ( ± SEM) while flow of the cerebrum remained at 32.1±5.4 in SHRs. In contrast, cerebellar blood flow in WKYs was preserved at 24.2±2.9 mL/100g/min. Brain lactate, pyruvate, and adenosine triphosphate (ATP) were determined in SHRs after sixty minutes of hypotension with or without vertebral occlusion. Although infratentorial metabolites were actually unaltered in rats with hypotension alone, infratentorial lactate and lactate/pyr uvate ratio significantly increased to 14.38±3.61 mmol/kg and 67.7±12.1, re spectively, with a concomitant decrease in ATP in SHRs with hypotension and vertebral occlusion. Bilateral vertebral artery occlusion, together with moderate hypotension, was shown to produce a marked reduction of cerebellar blood flow and to induce ischemic metabolic changes in the infratentorial brain in SHRs.
Angioplasty of Renal Arteries: A Report of Ten Year's Experience
Authors: Löhr E. , Bock K.-D. , Eigler F. , Verhagen V. , Sievers K. , Phillip Th. , Stuschke M.
Published: November 2007

Report of PTA of renal arteries in 288 patients. Primary results show good to optimal dilatation of the arteries (60.6% to 78.6 % ). One third of all cases achieved optimal blood pressures. In about 40 % antihypertensive drugs had to be admin istered, in about 30% blood pressure remained unchanged although PTA was effective. PTA of renal arteries ins the best method of treating renal hypertension, also because of the low rate of complications.
The Acute and Chronic Effects of G-Lasing on Femoral Vein Grafts in Dogs
Authors: Burger Andrew J. , Peart Brenda , Freeman David , Alfonso Gilbert , Wheeler William , Touchon Robert
Published: November 2007

Each year, 5 % of all coronary artery bypass operations are repeat procedures, and 15 % -30 % of coronary artery vein grafts occlude within the first eighteen months postoperatively. To evaluate the macroscopic and histologic effects of G-lasing on vein grafts and their patency, femoral veins were used to bypass bilaterally induced stenoses of femoral arteries in 10 dogs. The left vein grafts were G-lased with a 1.5 mm, hot-tipped argon laser at 5 watts for ninety seconds, while the right grafts were used as the controls.

Acutely, each vein graft demonstrated no evidence of charring or perforation. The percentage of endothelium present in the G-lased vein grafts was consistently less than 5 %, whereas the control vein grafts had an average of 70%. After ten weeks, the animals were sacrificed, and the vein grafts were evaluated for histologic changes and patency. There were no significant microscopic differences between the G-lased and control vein grafts. A statistically significant difference in graft patency was not achieved between G-Lased and control vein grafts at 10 weeks, but only a small number of grafts were studied. Further studies will be needed to evaluate the effects of G-lasing on the long-term patency of vein grafts.
Sustained Supraventricular Tachyarrhythmias Following Coronary Artery Bypass Surgery Comparing Mammary Versus Saphenous vein Grafts
Authors: Salem Bakr I. , Chaudhry Abdul , Haikal Maged , Gowda Siddhesh , Campbell Amy , Coordes Cordie , Leidenfrost Ronad
Published: November 2007

This retrospective study was designed to determine the incidence of sus tained supraventricular tachyarrhythmias (SVTs) in patients undergoing coro nary artery bypass grafting (CABG) with internal mammary artery (IMA) grafts, Group A, compared with those with saphenous vein grafts (SVG), Group B.

Among 569 consecutive patients who underwent CABG surgery in the same institution, a total of 80 cases from Group A and 80 cases from Group B were selected for this study after application of exclusion criteria. Excluded from this study were the following: patients wth preexisting or prior history of SVTs, significant left ventricular dysfunction (ejection fraction less than 40%), postop erative myocardial infarction, drug toxicity or electrolyte imbalance, and ad vanced chronic obstructive lung disease.

Group A consisted of 63 men and 17 women and Group B consisted of 52 men and 28 women. All patients were monitored either in ICU or by telemetry for a period of three to six days after surgery and all had a predischarge 12-lead electrocardiogram. Both groups were fairly comparable in most of their clinical profile and number of grafts. The incidence of SVTs in Group A was 31 % (25 of 80 patients) and in Group B was 24% (19 of 80 patients). Furthermore, the incidence of postoperative pericarditis was noted in 35% (28 of 80 patients) of Group A and in 19% (15 of 80 patients) in Group B.

The authors conclude that male tobacco smokers of Group A tended to have a significantly higher incidence of postoperative pericarditis with a higher trend for postoperative SVTs than patients from Group B.
Systolic Ejection Murmurs in the Elderly: Aortic Valve and Carotid Arteries Echo-Doppler Findings
Authors: Vigna Carlo , Impagliatelli Matteo , Russo Aldo , Pacilli Michele , De Rito Vincenzo , Perna Gian Piero , Villella Alessandro , Langialonga Tommaso , Fanelli Raffaele , Rinelli Gabriele , Lombardo Antonella , Loperfido Francesco
Published: November 2007

Two-dimensional echographic and color Doppler studies of the heart and carotid arteries (CA) were performed in 45 patients > sixty-five years old without aortic stenosis, 23 with (Group 1) and 22 without (group 2) precordial ejection systolic murmur (SM). Aortic cusps thickening was found in 11 Group 1 (48%) and 2 Group 2 (9%) patients (p < 0.001). Aortic root and aortic arch size were similar in the two groups. Maximum aortic flow velocity was significantly greater in Group 1 (200 60 cm/sec) than in Group 2 (120 20 cm/sec) (p < 0.001). Left ventricular outflow systolic maximum velocity was similar in the two groups. A bilateral neck murmur was heard in 10/23 Group 1 patients (43%); in this group, patients with cervical SM had a greater maximum aortic flow velocity than those without cervical SM (230 + 60 cm/sec vs 172 + 32 cm/sec, p < 0.001). In Group 1, 3 patients had a cervical SM louder on one neck side; only in these 3 patients were ipsilateral obstructive CA plaques found. A unilateral neck SM was heard in 4/22 Group 2 patients (18%); in these 4, ipsilateral obstructive CA were found.

Conclusions: (1) in the elderly, precordial ejection SM is related to mild increase in maximum aortic flow velocity and thickening of aortic cusps; (2) in patients with precordial SM radiated to both neck sides, maximum aortic flow velocity tends to be more markedly increased; (3) in patients with precordial SM, a cervical SM louder on one neck side should suggest coexistent ipsilateral CA stenosis.
Compression Therapy of Limb Edema Using Hydrostatic Pressure of Mercury
Authors: Palmer Arthur , Macchiaverna June , Braun Amy , Hendrix Ronald , Miller Albert J.
Published: November 2007

A new apparatus for the treatment of edema of the extremities is described. The extremity is placed in a cylindrical vertical tank and isolated by a circum ferential synthetic rubber membrane. The equipment is programmed to create a mold of the extremity using a slurry of plastic granules from a reservoir. Mer cury is then pumped between the mold and the extremity, thereby exerting a pres sure gradient on the extremity equal to the hydrostatic pressure of the mercury column. A computerized program forms the mold and runs several compres sion cycles for each treatment session.

Twelve patients were treated (8 upper extremities, 4 lower extremities) on a weekly or semiweekly basis. Progress was followed with computed axial tomog raphy scans, as well as measurements and photographs. Ten patients experienced significant immediate decrease in edema with each treatment. Wrapping or elas tic support was required to prevent the return of edema between treatments. No pain, skin injury, or other complication of treatment was noted.

The apparatus can safely provide short-term, immediate, significant improve ment of extremity edema. Further studies will be necessary to determine long- term benefit.
Silent Ischemia and Severity of Pain in Acute Myocardial Infarction
Authors: Nielsen Finn Erland , Nielsen Sören Loumann , Knudsen Freddy , Hædersdal Carsten
Published: November 2007

An overall low tendency to complain of pain, due to a low perception of pain, has been suggested in the pathogenesis of silent ischemia, independent of the extent of the diseased coronaries and a history of previous acute myocardial infarction. This hypothesis has been tested indirectly in this retrospective study by comparison of the use of analgesics during admission for a first acute myocardial infarction with the occurrence of silent ischemia at exertion tests four weeks after discharge from hospital. The study did not show a lower use of analgesics in patients with silent ischemia, but this may be due to methodologic problems. Suggestions are given for another study design to overcome these problems.
Effects of Ticlopidine on Erythrocyte Aggregation in Thrombotic Disorders
Authors: Hayakawa Michihiko , Kuzuya Fumio
Published: November 2007

The authors investigated the involvement of red blood cell aggregation in thrombosis by comparing erythrocyte aggregation in patients with myocardial infarction (28 patients) or cerebrovascular accidents (68 patients) with that in a normal control group (38 subjects). The erythrocyte aggregation was assessed by light transmission aggregometer, and aggregation was induced by hexadimethrinebromide. Increased erythrocyte aggregation was detected in all patients with thrombotic disorders. In addition, patients with diabetes mellitus showed a marked increase in erthrocyte aggregation as compared with those without diabetes. The effect of ticlopidine on erythrocyte aggregation was also studied. It was demonstrated that ticlopidine inhibited aggregation in vitro. An inhibitory effect was shown to be dose dependent, with 10μ M ticlopidine inhibiting aggregation completely. After four weeks' oral administration of 200 mg ticlopidine, there was significant decrease of abnormally increased erythrocyte aggregation in patients with thrombosis.
The Simon Nitinol Filter: Evaluation by MR and Ultrasound
Authors: Kim Ducksoo , Edelman Robert R. , Margolin Chaim J. , Porter David H. , McArdle Colin R. , Schlam Bertrand W. , Gianturco Laurie E. , Siegel Jeffrey B. , Simon Morris
Published: November 2007

In this prospective blinded study of inferior vena caval (IVC) patency, 18 patients underwent 25 duplex ultrasound (US) and magnetic resonance (MR) angiography examinations over an eight-month period following Simon nitinol filter placement. Clinical examination for lower extremity venous stasis and plain abdominal radiography were also performed. Twenty-three of 24 MR ex aminations and 11 of 24 US examinations were judged technically adequate by the blinded observers. One technically adequate US exam was false positive for intraluminal caval thrombus. Thirteen technically inadequate US examinations missed 3 complete caval occlusions and 2 partial occlusions. MR identified all patients with complete or partial caval occlusion.

The authors conclude that duplex US reliably confirms IVC patency only when strict criteria for technical adequacy and interpretation are met (good visualization of filter and IVC above and below filter). MR, although expensive, more reliably identifies nonoccluding intraluminal thrombus and caval occlu sion. It should be the noninvasive study of choice in symptomatic patients with venous stasis and patients with recurrent pulmonary emboli.
Physical Manipulation of Subcutaneously Implanted Cardiac Muscle in Rat Increased Plasma Atrial Natriuretic Peptide Concentration
Authors: Gu Jiang , Daloisio Connie , D'Andrea Michael , Muralidharan S. , Yu Cheng-Zhi , Cichon Romuald
Published: November 2007

To examine the effects of physical stretch on cardiac muscle endocrine activ ity, the authors transplanted whole neonatal hearts subcutaneously into the back and the ears of the correspondent mother (n=9). Seven days later, physical manipulation was applied on the implanted heart by stretching the skin and the subcutaneous tissue encasing the implanted cardiac muscle, for a period of five to ten minutes. Such manipulation was repeated approximately every seven days postoperatively for a total of two to four times for each rat. The plasma atrial natriuretic peptide (ANP) levels were measured by radioimmunoassay prior to and immediately following manipulation. Postmanipulation plasma ANP levels were found to increase from the premanipulation levels. At two weeks postimplant, the average increase was 290% with the highest single-speci men increase being nearly twelvefold. The increases observed at two and three weeks following implantation had Signed Rank Test p values of 0.015 and 0.042 respectively. The viability of the implanted hearts was confirmed by cell culture. Light microscopic immunocytochemistry detected ANP immunoreactivity in the implanted cardiocytes. The elevated plasma ANP concentration induced by the manipulation appeared to be correlated with the functional status of the im planted cardiocytes.

In conclusion: (1) Subcutaneously transplanted neonatal myocardiocytes survived for at least three to four weeks while retaining the ability to produce ANP. (2) Physical manipulation of implanted heart induced ANP release. There fore, cardiac ANP production and release is indeed stimulated by physical stretching.
Critical Degree of Renal Arterial Stenosis That Causes Hypertension in Dogs
Authors: Imanishi Masahito , Akabane Satoshi , Takamiya Makoto , Kawamura Minoru , Matsushima Yohkazu , Kuramochi Morio , Omae Teruo
Published: November 2007

The minimum degree of renal arterial stenosis needed to cause hypertension was identified by renal arterial angiography of anesthetized dogs. The effects of renal nerves and prostanoids on the critical stenosis were also examined.

The left renal artery was constricted concentrically by a radiolucent con strictor device, and the stenosis of the artery was evaluated by cineangiography with the kidney either innervated or denervated. At this time, renal blood flow, renal perfusion pressure, and systemic blood pressure were serially monitored. In another group of dogs, renal venous and aortic blood samples were taken as the stenosis increased; these were assayed for prostaglandin E2 and plasma re nin activity. The same experiments were done again after treatment with a cyclooxygenase inhibitor, aspirin DL-lysine (54 mg/kg).

With the kidney either innervated or denervated, systemic blood pressure began to increase when the stenosis was more than 70% of the diameter of the renal artery; the renal blood flow decreased when the stenosis was more than 75% of the diameter. Aspirin treatment attenuated the increase in blood pres sure but did not affect the autoregulation of the renal blood flow when stenosis was 70% or less. Prostaglandin E2 production increased in the stenotic kidney when the stenosis was more than 70%; aspirin inhibited prostaglandin synthesis and suppressed the stimulation of renin release.

These results suggest that whether there is innervation or not, the critical degree of renal arterial stenosis that causes hypertension is more than about 70% of the diameter in the presence of renal prostaglandins; in their absence, the critical point above which hypertension occurs is 75% or more.
A "Hickey"
Authors: Rao Murli , Steele Russell W. , Ward Kenneth J.
Published: November 2007

The following Brief Report was written by a resident. A discussion by members of the resident's faculty follows. We invite any resident to submit such articles, together with commentary by a faculty member.
The Innocent (Functional) Cardiac Murmurs of Childhood
Authors: Friedman Sidney
Published: November 2007

Making the distinction between an innocent cardiac murmur and one indicating the existence of heart disease is the most common of all problems in Pediatric Cardiology.
An Outbreak of Diphtheria
Authors: Corotherst T.E. , Zatlin Gabriel S.
Published: November 2007

A small outbreak of 18 cases and 48 carriers of diphtheria in Sioux City, Iowa, is here briefly reported, along with a de scription of the multidirectional control program instituted by the Health Depart ment which is credited with preventing further spread of the outbreak.
Suppurative Pericarditis
Authors: Folger Gordon M.
Published: November 2007

Think of suppurative pericarditis in in stances of fever of unknown origin—it is a treatable disease if recognized before the terminal events.

Suppurative pericarditis is still with us despite the wider use of antibiotics. These two recent cases serve to remind the prac titioner of the details of diagnosis and management of this persistent pediatric problem.
Neurologic Sequelae of Plumbism in Children
Authors: Perlstein Meyer A. , Attala Ramzy
Published: November 2007

Prevention is still the best treatment for lead poisoning and its sequelae.

Here is a survey on the nature and in cidence of the neurologic sequelae of lead intoxication among 425 patients over a ten-year period.
Premature Rupture of Fetal Membranes
Authors: Alexopoulos K.
Published: November 2007

The study here described represents another attempt to estimate under con trolled conditions the value of prophylac tic treatment with antibiotics for normal infants born to otherwise healthy moth ers after premature rupture of the am niotic membranes.
Lead Poisoning From Home Remedies
Authors: McNiel J.R. , Reinhard M.C.
Published: November 2007

This paper calls attention to the for merly frequent use of ill-advised home remedies, and describes several recent cases in which the source of lead was identified as a home remedy.
Erythema Nodosum Occurrence in Two Siblings and Mother
Authors: Tahernia A. Cyrus
Published: November 2007

Erythema nodosum is an allergic response clinically associated with certain disease states, tuberculosis and streptococcal infec tions being most often incriminated. One family, including two siblings and their mother, developed erythema nodosum within one week of each other. The importance of primary tuberculosis as the etiology in the two sibs and the possibility of a double eti ology in one are stressed. This author also reviews this fascinating problem for us.