bluuebunny/crossref_metadata_2025 huggingface dataset:
Hemodynamic and Angiographic Findings in a Case of Kinking of the Aorta
Authors: Lembo Carlo Maria , Latte Salvatore
Published: November 2007

The authors report a case of aortic kinking associated with abnormalities of the size of aortic arch vessels.

The diagnostic aid of hemodynamic and angiographic techniques is em phasized. The possibility that aortic kinking and the abnormalities of aortic arch vessels may be etiologically related is suggested.
Adventitial Cystic Disease of the Popliteal Artery in Brazil: Additional Data on the Geographical Distribution of the Disease
Authors: Maffei Francisco H.A. , Barbosa Alaer G. , Rollo Hamilton A. , Neser Adnan , Lastoria Sidnei
Published: November 2007

Adventitial cystic disease of the popliteal artery is an uncommon condition. Previous reports show a grouping of cases of this disease in Europe and Australasia. With the purpose of widening the knowledge of the geographical distribution of the disease, 3 cases from Brazil are described, and reference is made to 1 previously reported. It is suggested that not recognizing or not reporting the disease could be the cause for this grouping and that the number of diagnosed cases may increase in different parts of the world due to the greater awareness of the disease.
What Is New In The Clinical Evaluation of Patients With Ischemic Heart Disease?
Authors: Stein Paul D.
Published: November 2007

New information related to the mechanism of heart sounds and murmurs, and a more detailed understanding of some aspects of cardiac function, permit a more complete and accurate interpretation of auscultatory signs in patients with ischemic heart disease. The diminished second sound in such patients is now recognized to reflect isovolumic relaxation, and the diminished first sound probably reflects impaired isovolumic contraction. Ejection murmurs can be interpreted in light of their relation to turbulent flow. The variability of regur gitant murmurs in the papillary muscle dysfunction syndrome seems to be explained by new observations related to the function of the papillary muscle.
Status of Platelets in Complicated and Uncomplicated Diabetes Mellitus
Authors: Malhotra K.C. , Arya R.K. , Chugh S.N. , Singla B.B.
Published: November 2007

Thirty patients with diabetes mellitus of more than 5 years' duration, divided into 2 groups of 15 each depending on the presence or absence of vascular complications, constituted the case material for the study. Fifteen healthy subjects of the same age group and sex served as controls.

The platelet count and morphology were normal in controls as well as in patients with diabetes mellitus. The platelet adhesiveness increased signifi cantly with the increase in age and duration of diabetes and in the presence of vascular complications, irrespective of their type. The platelet aggregation time decreased with the increase in age as well as in diabetic patients with vascular complications, but the duration did not have any effect on it. The subject's sex, severity, and adequate control of diabetes mellitus with any type of therapy did not have any influence on the platelet functions studied.
Nutritional & Pharmacologic Management of Hyperlipoproteinemia
Authors: Pickering J. Edward
Published: November 2007

The results of the nutritional intervention on one of the twenty MRFIT centers is presented. The reduction in cholesterol was 5.78% after four years. Those results were compared with the changes found in serum cholesterol with a similar diet and the administration of either clofibrate or gemfibrozil. The reduction with clofibrate remained at 5%. However with gemfibrozil the reduction in cholesterol was 16%. The HDL level rose in half of these patients treated with either clofibrate or gemfibrozil. The results without concurrent dietary restriction usually show a greater reduction in VLDL and a greater rise in HDL than we found when nutritional and pharmacologic intervention were combined.
The Orthogonal Frank Electrocardiogram In 70 Well-Trained Athletes
Authors: Zenner R.J. , Willems P.L. , Bekaert I. , Clement D.L.
Published: November 2007

Interpretation of the vectorcardiogram in athletes requires normal values based on quantitatively analyzed data obtained in large groups of athletes. Frank electrocardiograms of extensively trained white athletes aged 23 ± 5 years were analyzed by computer. Different sport disciplines were included. Tables are provided describing the results for the complete group of 70 athletes (A), respectively indicating the difference between 27 footballers (F) and 16 endurance athletes (E). A critical comparison with two control groups is also discussed, as for other purposes, vectorcardiograms had been collected in healthy non-trained young men, respectively 68 medical students (MS) and 63 nurse students (NS). The following figures may serve as an example to illus trate the difficulty of constituting and using similar normal limits in athletes: mean QRS spatial maximal amplitude (mV.) was respectively 1.82 (MS), 2.03 (NS), 2.17 (A), 1.97 (E), 2.29 (F). It can often be hazardous to attribute certain deviations of electrocardiological measurements to training effects in the athlete.
Vectocardiographic "Bites" as Possible Early Findings of Cardiac Involvement in Diabetic Patients Without Clinical Evidence of Heart Disease
Authors: Giampietro Ottavio , Santoro Gino , Rossi Marco , Luche Alessandro Dalle , Giusti Costantino , Navalesi Renzo
Published: November 2007

We performed a standard vectocardiogram (VCG) in 87 diabetics, aged 20-77 years, orally- or insulin-treated, and in 41 normal subjects. None had cardiac history or symptoms. Among diabetics, 31 had no vectocardiographic abnormalities, 23 had various VCG changes, 33 showed electrical "bites" of various length (6-22 msec) and voltage (0.05-0.3 mV). In 8 normal subjects (19.4%) we found "bites" of similar voltage and length as in diabetic patients. A significantly positive linear relation was found between "bites" length and diabetes duration, in insulin-dependent diabetics only. By step-wise regression analysis we detected, in all diabetic patients with "bites," at a fixed value of diabetes duration, a significantly negative relation between "bites" length and patients' age. Moreover, the insulin treated patients showed a metabolic regu lation index significantly worse than orally-treated diabetics; also diabetes duration was significantly higher in insulin-treated subjects. If "bites" may reflect an early heart involvement in diabetes, insulin-dependent patients seem to have a more severe cardiac damage in dependence of the diabetes duration. Finally, in the younger diabetics the heart disease seems to be earlier and more advanced.
Renovascular Hypertension with Unilateral Atherosclerotic Renal Artery Occlusion: Diagnostic Use of Renal Vein Renins
Authors: Simon Geza , Limas Catherine C. , Miller Robert P.
Published: November 2007

Selective renal vein renin studies were performed in seven male patients with severe hypertension and atherosclerotic occlusion of a main renal artery. In five patients, peripheral plasma renin activity was increased, and there was evidence for hypersecretion of renin from the affected kidney and suppression of renin release from the opposite kidney. In one patient, who had occlusion of one renal artery and a high-degree stenosis of the contralateral renal artery, the two kidneys appeared to contribute equally to the high circulating plasma renin activity. Removal of the atrophic, ischemic kidney from these patients, plus bypass of the contralateral renal artery in one patient, resulted in cure or improvement of their hypertension. In one patient, despite hypersecretion of renin from the atrophic kidney, surgery was not recommended because his systemic blood plasma renin activity was not elevated. Histologic examination of the excised kidneys revealed moderate glomerular scarring and tubular atrophy. The findings indicate that the same criteria, derived from renal vein renin studies, that have been used to predict the outcome of surgical repair of renal artery stenosis in hypertensive patients can be applied to the evaluation of patients with hypertension and complete occlusion of a main renal artery.
Discrete Membranous Sub-Aortic Stenosis in Adult Patient Obtained by Echocardiography and Not Proved by Catheterization
Authors: Grenadier Ehud , Keidar Shlomo , Alpan Gad , Milo Simha , Palant Avraham
Published: November 2007

A case of a 60-year-old patient with discrete membranous sub-aortic stenosis is described. The diagnosis was established based on echocardiog raphic evaluation by demonstration of a premature aortic valve closure and a sub-aortic membrane. No evidence of the sub-aortic membrane was noticed on cardiac catheterization. At operation, a discrete sub-aortic membrane was found 9 mm below the aortic valve, leaving an aperture of 1 cm diameter and a mildly deformed stenotic aortic valve. We stress the importance of careful pre-operative echocardiographic evaluation of every patient suspected of hav ing any kind of left ventricular outflow tract obstruction, even if catheterization data are not contributory.
The Transdermal Administration of Nitrates: An Overview
Authors: Demma Frank J. , Wilson Richard R.
Published: November 2007

Nitroglycerin has been the mainstay of the medical management of angina pectoris for over 100 years. The long-held clinical impression of the efficacy of nitroglycerin has now been clearly documented in controlled clinical trials designed to evaluate objective response to antianginal agents.1-3 Advances in scientific methodology and improved experimental design have contributed to continuing interest in nitrates. Newer uses of nitroglycerin and other nitrates in congestive heart failure and acute myocardial infarction are the result of a developing understanding of the pharmacology of nitrates.
The Digital Circulation in Congestive Heart Failure
Authors: Burch George E.
Published: November 2007

Congestive heart failure (CHF) is a complex clinical entity which is still little understood pathophysiologically. Unless it is in the intractable state it responds well to therapy. It has been known for many years that the peripheral circulation can be dramatically altered when CHF is progressively and rapidly developing and worsening. As compensation develops, these changes gradu ally return to normal. We have long been studying the digital circulation of patients with CHF and have been impressed with the changes in the behavior of the peripheral blood vessels in these patients.
Human Amnion in the Management of Chronic Ulceration of the Lower Limb: A Clinico-Pathologic Study
Authors: Egan T.J. , O'Driscoll J. , Thakar D.R.
Published: November 2007

This study shows that unmodified human amnion can make a useful con tribution to the management of venous ulceration. By suppressing infection, and, by providing a healthy granulating surface, it significantly reduces the pre-skin graft preparation time, when compared with a conventional method of treatment. However, it does not seem to significantly influence the prospects of graft take, or of long term graft survival, in this comparison.

A reversion towards normal of local vasculature, as characterized by vessel wall thinning and widening of the lumen, appears to be a significant tissue change induced by amnion treatment. Such a change may have considerable relevance in any analysis of the basis of the therapeutic efficacy of amnion.
Measurement of Blood Pressure, Blood Flow and Flow Velocity in Arterial Reconstruction of the Lower Extremity
Authors: Shionoya Shigehiko , Matsubara Junichi , Hirai Masafumi , Kawai Seiichi , Seko Toshiyuki , Sakurai Tsunehisa , Ban Ichiro
Published: November 2007

Seventy-five limbs of 66 patients undergoing arterial reconstruction of the lower extremity were studied. In 41 of 64 limbs that were not involved in early failure, API returned to normal immediately and the increased API was main tained as long as grafts remained patent. The limbs exhibiting a rise in API of 0.1 or more following proximal reconstruction in the cases with combined iliac and femoral arterial occlusion or bypass grafting to an isolated segment ob tained marked improvement of symptoms. Postoperative increase in TPI was not so marked as in API, and TPI remained very low in the limbs with arterial obstructive lesions below the ankle after successful reconstruction. Early or late failure could not be predicted on the basis of preoperative or postoperative API, TPI or A-T gradient. In the limbs with no recovery of TPI, blood flow or flow velocity in the foot was of value predicting which limbs would be sal vaged.
Education in Angiology
Authors: Ishikawa Kaichiro
Published: November 2007

North American cardiologists, as cardiovascular subspecialists in internal medicine, deal with cardiac as well as vascular disease entities.1 Consequently, cardiologists are also angiologists. However, it has been reported that these physicians spend considerably more of their professional time dealing directly with cardiology rather than angiology-related problems.1,2 Such is also the case in Japan. Medical angiology may be too extensive a field to be the responsibil ity of cardiologists alone, although an excellent report was documented con cerning of guidelines for training cardiovascular subspecialists in internal medicine, as proposed by the Council on General Internal Medicine, American Board of Internal Medicine.3 Therefore, the medical angiologist who wishes to function as a subspecialist for patients with vascular disease should be encour aged. Better trained medical angiologists should enable better treatment and management of related clinical disorders.
Percutaneous Transluminal Angioplasty (PTA) as an Adjunct in Vascular Trauma
Authors: Johansen Kaj , Anderson James , Morishima Michael
Published: November 2007

An iliac stenosis causing a pressure gradient of 70 mm Hg proximal to repair of a traumatically divided superficial femoral artery was relieved by per cutaneous transluminal balloon angioplasty (PTA). Though the magnitude of the accompanying crush injury led to massive muscle necrosis and ultimately necessitated mid-thigh amputation, the arterial repair remained patent.
Disopyramide: Six Years' Experience
Authors: Wilson Richard R. , Wallace Andrew G.
Published: November 2007

Since its approval by the FDA six years ago, oral disopyramide has earned a recognized role in the treatment of ventricular arrhythmias. During this time, clinical experience has refined our knowledge of this agent, allowing revision of dosing guidelines and better selection of patients. This review explores the recent therapeutic experience with disopyramide.
Cardiovascular Complications of Enteric Fever
Authors: Siwach S.B. , Nand Nitya
Published: November 2007

A case of a young female having salmonella typhi infection with cardiovascular complications in the form of myocarditis and femoral artery occlusion is reported. The relevant literature on the subject is reviewed, and possible mechanisms discussed.
Triglycerides as a Risk Factor in Extracranial Atherosclerotic Cerebrovascular Disease
Authors: Terrence Christopher F. , Rao Gutti R.
Published: November 2007

A retrospective study was carried out on a group of 138 patients undergoing carotid endarterectomy for extracranial vascular disease. Risk factors of cerebrovascular disease and routine laboratory evaluations were assessed. Of the laboratory evaluations of blood lipids, only mean triglycerides were found to be significantly different from laboratory normals. Stroke as a clinical event has been suggested not to be correlated with blood lipids in a number of large studies, but the present investigation supports the notion that extracranial vascular disease may be associated with blood lipid concentrations. Previous studies of stroke and lipids have not separated out the anatomical site responsible for the cerebral infarction, and thus probably have underestimated the effect of lipids as a risk factor in cervical extracranial atherosclerosis and brain infarction.
Coronary Arteriographic Findings During Early Hours of Acute Myocardial Infarction: Response to Intracoronary Injection of Nitrates
Authors: Omote Shingo , Yasue Hirofumi , Takizawa Akinori , Nagao Masao , Hyon Hiromitsu , Nishida Shinichiro , Horie Minoru
Published: November 2007

We performed coronary arteriography and gave intracoronary injection of nitrates within 8 hours after the onset of symptoms of acute myocardial infarction in eighteen patients. Improved distal filling or patency of the total occluded coronary artery after intracoronary injection of nitrates occurred in 4 of 18 patients. In one of four patients the first intracoronary nitrates injection failed to release the initial total occlusion, but after intracoronary Urokinase administration, the second nitrates injection succeeded to dilate the com pletely occluded coronary artery. Coronary arteriography was again per formed in sixteen patients in the chronic stage (4-15 weeks after the onset of acute myocardial infarction) and ergonovine malaete was injected intraven ously in seven patients. Focal spasm was induced by ergonovine injection in three patients in one of whom intracoronary nitrates failed to release the complete obstruction in the acute stage.

We conclude that coronary spasm as well as intracoronary thrombosis plays an important role in the production of acute myocardial infarction.
Post Embolectomy Thrombosis Treated with Intra-Arterial Streptokinase
Authors: vonRyll Gryska P. , Raker Edmond J.
Published: November 2007

A case is presented which demonstrates the occasional need for selective intra- arterial streptokinase when re-thrombosis has occurred following catheter thromboem bolectomy of a peripheral artery. It is recommended that repeat embolectomy be carried out and all mechanical causes for re-thrombosis be excluded before resorting to fi brinolysis.

The literature citing other indications for selective arterial use of streptokinase is reviewed.
Pulmonary Vascular Disease — Overview
Authors: Cordasco E.M.
Published: November 2007

Some intriguing advances in the diagnosis of pulmonary vascular diseases have been made in the past decade. Moreover, developments in treatment of recurrent thromboembolic disease have come to the forefront, with a consider able reduction in morbidity and mortality rates in the past few years.1
Fibrinolytic Therapy Urokinase for Myocardial Infarction
Authors: Nakano Minoru
Published: November 2007

In recent years, the incidence of myocardial infarction has increased re markably in Japan, possibly because life styles have become westernized. Coronary care units have been established in many institutions, and various therapeutic modalities combining different drugs and surgical procedures are being used in the treatment of coronary artery disease with fairly good results. However, such medical treatment involves only preventive therapy against the progression of coronary arteriosclerosis or symptomatic therapy for myocar dial infarction. As for positive therapy, only the thrombolytic method using urokinase (UK) is considered to be therapeutically justified or effective.

UK is believed to lyse thrombi appearing in the coronary artery and to prevent the extension of infarct by inhibiting the occurrence of secondary thrombi. The author has reported the results of previous studies using UK for treatment of myocardial infarction.1-3 In the present study, UK was adminis tered to patients with myocardial infarction who went coronary angiography.
Ocular Pneumoplethysmography (OPG-Gee) in Noninvasive Evaluation of Carotid Artery Stenosis
Authors: Riles Thomas S. , Eikelboom Bert C. , Pauliukas Povilas , Folcarelli Patricia , Baumann F. Gregory , Imparato Anthony M.
Published: November 2007

Carotid artery stenosis can be evaluated noninvasively by ocular pneumo plethysmography (OPG-Gee). This simultaneously measures both ophthalmic artery pressures and is therefore capable of detecting pressure-reducing or hemodynamically significant carotid lesions. An OPG-angiography correlation was made for 200 carotid arteries in 110 patients. Sensitivity, specificity and overall accuracy were 91%, 89%, and 90% respectively, if calculated per artery. On a per patient basis these figures were 94%, 88%, and 91%. Applica tions of this rapid and simple technique in clinical practice include selection of patients for angiography and carotid endarterectomy, as well as early and late control of the operative results.
Transient Ischemic Attacks with External Carotid Artery Stenosis and a Normal Internal Carotid Artery
Authors: Weinberger Jesse , Robbins Anthony , Jacobson Julius
Published: November 2007

Transient ischemic attacks have been attributed to emboli from the external carotid artery in patients with complete occlusion of the internal carotid artery. We report a patient with an external carotid stenosis and normal internal carotid who developed ipsilateral transient ischemic attacks. Real time B-mode ultrasonography demonstrated that the plaque obstructing the exter nal carotid artery extended into the carotid sinus. This may have served as a source of emboli into the internal carotid circulation.
Clinical Significance of Doppler Velocity and Blood Pressure Measurements in Peripheral Arterial Occlusive Disease
Authors: Hirai Masafumi , Schoop Werner
Published: November 2007

In 20 normals and 50 limbs with arterial occlusive disease, Doppler flow velocity and blood pressure in different levels of the leg were determined at rest and during reactive hyperemia. While blood pressure measurement at the ankle and flow velocity analysis at the posterior tibial artery were of use in the diagnosis of arterial occlusion, recording the mean femoral flow velocity during reactive hyperemia showed less diagnostic value. Ankle blood pressure was determined after two different exercises — knee exercise and ankle exercise. A greater decrease of blood pressure was observed after ankle exercise than after knee exercise in limbs with isolated occlusion of the femoral artery, and a less decrease in limbs with isolated occlusion of the iliac artery. These findings indicate that comparison of ankle blood pressure after two exercises is useful as a screening test to detect the combined ilio-femoral diseases.
Persistence of the Left Superior Vena Cava: A Case Report
Authors: Lembo Carlo Maria , Latte Salvatore
Published: November 2007

A 38-year-old man with persistent left superior vena cava associated with the absence of the hepatic portion of inferior vena cava was reported. Angiography revealed the enlargement of the coronary sinus. In this respect the correlation between the enlarged coronary sinus and a history of precordial palpitation was suggested.
Hemodynamics and Gas Exchange During Angioscopy in the Dog
Authors: Shure Deborah , Moser Kenneth M. , Konopka Ronald G.
Published: November 2007

We have previously developed a technique for the in vivo visualization of the pulmonary arteries in the experimental animal with a fiberoptic instrument (angio scope). To assess the potential hemodynamic and gas exchange effects of angioscopy, we studied five dogs before and after pulmonary embolization. Sequential observations were made of arterial blood gases, mean arterial pressure, pulmonary artery pressure, heart rate, cardiac output, and the electrocardiogram. The most common arrhythmias were ventricular premature contractions which were comparable to those seen with right heart catheterization. Statistically significant, but clinically minor, effects were found on cardiac output, mean arterial pressure, and heart rate in dogs when angioscopy was performed after pulmonary embolization. We conclude that fiberoptic angioscopy does not induce deleterious effects on hemodynamics or gas exchange in the experimen tal animal, prior to or after embolization.
Hypertensive Crisis Induced by Metoclopramide in Patient with Pheochromocytoma
Authors: Abe Masayoshi , Orita Yasuhiko , Nakashima Yasuhide , Nakamura Motoomi
Published: November 2007

A hypertensive crisis associated with evidence of catecholamine release was induced following intravenous administration of 10 mg metoclopramide in a woman with pheochromocytoma and in whom the tyramine test was nega tive.

After removal of the tumor, blood-pressure and plasma catecholamine concentrations were not influenced by the administration of metoclopramide. It is suggested that the mechanism of hypertensive crises induced by metoclo pramide may not be due to a direct catecholamine releasing effect from the tumor or sympathetic nerve endings, but rather to its presynaptic dopaminer gic blocking effect which would indirectly release catecholamines.
Femoro-Popliteal Bypass Simplified
Authors: Halsted George O.
Published: November 2007

There is increasing emphasis on carrying femoro-popliteal bypass grafts below the knee and most vascular surgeons agree that reversed saphenous vein makes the best graft.

However, some other considerations have become important and deserve consideration.

P.T.F.E. grafts in this location have almost as good a long term patency rate as autologous vein grafts.

Some very experienced vascular surgeons have indicated their preference for this type of graft, citing some of these pertinent reasons:

Peripheral vascular disease usually is associated with lesions in other vessels. Since coronary artery bypass has become so commonly used to stave off myocardial infarction some thought should be given to preservation of suitable saphenous veins for this purpose.

Harvesting the saphenous vein adds additional surgical trauma, time, exposure to sepsis, lymphatic interruption and extra incisions.

Once we opt for preferential P.T.F.E. grafts, then we start to search for a simpler technique.
Effect of Hypocalcemia on Isoproterenol Induced Cardiotoxicity in Dogs
Authors: Darsinos John Th. , Karli Joan N. , Stathaki Stamatina N. , Ziroyannis Panayotis N. , Pistevos Anastasios C. , Levis Gabriel M. , Moulopoulos Spyridon D.
Published: November 2007

The effect of serum calcium on the myocardial damages produced by isoproterenol was studied in the dog. Hemodialysis for 80 min in the absence of calcium was used to alter serum calcium concentration in seven experimental animals. The same number of animals were dialysed in the presence of calcium and were used as controls. After hemodialysis all animals were infused with isoproterenol 2.0 μg/kg/min for 4 hours. The myocardial damage was assessed by comparing serial measurements of the serum cardiac enzyme activities CK and CK-MB and the electrocardiographic findings of the two groups, before, during and after isoproterenol infusion. Serum calcium decreased significantly after dialysis only in the experimental group (1.15 vs 2.19 mmolL-1).

Total C K activities of the experimental group during and after isoproterenol infusion were 2 to 3 times lower than in the controls (190-360 vs 410-1370 IU.L-1). Changes of the C K-MB isoenzyme activities were more profound, these were detectable and measured only in 4 of the experimental animals and in much lower activities than in the controls (25-61 vs 45-445 IU.L-1). A positive correlation was found (r=0.673, p<0.05) between the highest value of C K-MB of both groups and the serum calcium concentration after hemodialysis. In accordance to the differences of the biochemical estimates the effect of serum calcium on the cardiotoxic effect of isoproterenol has been further emphasized by the electrocardiographic findings. Thus arrhythmias, negative T-waves and significant ST segment depression were observed only in one experimental animal. In contrast these electrocardiographic disturbances were common and marked findings in all but one of the control animals. In both groups these electrocardiographic findings were reversed one to three hours after the termination of the isoproterenol infusion. Myocardial calcium at the end of the experiment was lower in the experimentals compared to the controls (0.23 vs 0.30 mmol.kg-1 wet weight). On the contrary magnesium concentration increased respectively. It is concluded that low serum calcium has a protective effect against the cardiotoxic action of isoproterenol. This protective action may be relevant to the decreased calcium and increased magnesium of the heart of the animals hemodialysed in the absence of calcium.
Abnormal Reflex Vasoconstriction to Cold Stimulation in Forearm of Patients with Variant Angina
Authors: Nakamura Yukio , Ikeda Takayuki , Takada Shigeo , Yamamoto Masakazu , Horikawa Kiyohiro , Kitamura Takashi , Kubota Kooji , Hattori Nobu
Published: November 2007

The responses of the blood vessels of the forearm to cold pressor test and mental stress were examined in patients with variant angina and in control subjects.

In response to cold pressor test, blood pressure, heart rate and forearm vascular resistance increased with statistical significance in both groups. Percentage changes in blood pressure and heart rate were not significantly different in patients and control ubjects. Percentage change in forearm vascular resistance in patients with variant ngina (120±101%) was significantly greater (p<0.05) than that in control subjects 47±26%). In response to mental stress, percentage change in forearm vascular resistence was -20±19% in patients with variant angina and -24±18% in control subjects and there was no significant difference in the two groups.

We conclude that, in some patients with variant angina, not only the coronary artery but the forearm vessels show the abnormal reflex vasoconstriction and it may be ostulated that it represents the generalized abnormality of vascular smooth muscle or of their neural control which exists in some patients with variant angina.
Giant Right Atrial Myxoma With Rheumatic Mitral Valve Disease
Authors: Pores Ira H. , Abel Ronald M. , Gray Lewis , Jacobs Glen P.
Published: November 2007

A patient with a 456 Gram right atrial myxoma is described. Associated rheumatic mitral valvular heart disease obscured the presence of the tumor and only with presentation of bradyarrhythmias leading to pacemaker implantation was the diagnosis suspected. Successful surgical removal of the tumor and correction of the intracardiac valvular dysfunction were performed. The role of echocardiography in the early detection of these tumors is reinforced.
Noninvasive Methods in the Diagnosis of Extracranial Carotid Artery Disease: A Correlation with Carotid Arteriography in Eighty Patients
Authors: Ramesh Adiga K. , Fresso Susan J. , Nayden John
Published: November 2007

Five hundred fifty-nine patients were evaluted for carotid artery disease in the Blood Flow Laboratory by the following direct and indirect noninvasive methods: 1. Periorbital doppler examination; 2. Ocular pneumoplethysmography (Gee); 3. Pulsed doppler ultrasonic arteriography; and 4. Sound spectral analysis with a pulsed doppler.

Carotid arteriograms were available for comparison with one hundred fifty- seven vessels (80 patients). Sensitivity, specificity and overall accuracy was established for each noninvasive modality by correlation with the angiographic findings.

For detection of stenoses greater than 50% by diameter reduction, sensitivity was 98%. Sound spectral analysis and ultrasonic arteriography were found to yield a higher sensitivity when compared to the other noninvasive methods in detecting stenoses of less than 50%. In our hands, disturbed spectral flow patterns do not always correlate with the degree of stenosis in non-hemodynamic lesions.

Our results indicate that proper patient selection for angiographic examina tion can be made through noninvasive screening.
Delayed, Distant Arterial Injury After Brachial Artery Catheterization
Authors: Berardis John Michael , Knight Peter , Grossi Robert J. , Ferraro Ms. Lisa , Farrell Joseph T.
Published: November 2007

The occurrence of iatrogenic arterial injury secondary to catheterization for angiographic studies has been well documented in the literature for over a decade. 1-4It has been well established that patients should be carefully evaluated post-catheterization and if absence of the pulse distal to the arteriotomy site is discovered, most should undergo exploration for identification and correction of the problem. Between 0.3 and 24% of patients undergoing brachial artery catheterization have been found to have a diminished or absent radial pulse after the procedure. 5 In the vast majority of cases the problem has been solved by local exploration of the arteriotomy site. However, in a small but definite number of cases late thrombotic complications have become manifest, 4 and in two cases reported in 19815 and in the case report to follow, thrombotic complications have become manifest months later, secondary to injury well proximal to the ar teriotomy site.
Pharmacology of Pentoxifylline A Hemorheologic Agent for the Treatment of Intermittent Claudication
Authors: Aviado Domingo M. , Dettelbach Harold R.
Published: November 2007

Physiological and pathophysiological aspects of systemic and cardiac haemodynamics are reviewed with appraisal of Carl J. Wiggers merits and contributions to the research and developments in this field and his early recognition of the significance of the flow properties of blood in impaired circulation. Pharmacological agents involved in treatment of peripheral vascular diseases are discussed with special regard to the haemorheologically active xanthine derivative pentoxifylline. The profile of pentoxifylline as it emerges from experimental pharmacological and clinical studies is presented paying special attention to the haemorheological properties of the drug. Pharmacokinetic features of pentoxifylline are surveyed touching absorption, blood levels, metabolism and excretion aspects. Basing on the available data pentoxifylline is regarded as a promising drug in the treatment of circulatory ischemic disorders, especially in intermittent claudication.
Red Cell Flexibility and Platelet Aggregation in Patients with Chronic Obstructive Vascular Disease (COAD) and Study of Therapeutic Approaches
Authors: Ambrus J.L. , Ambrus C.M. , Taheri S.A. , Gastpar H. , Reddington M.M. , Taheri P. , Kahn E.A. , Schattman G.L. , Dean L.S. , Moore R.H.
Published: November 2007

The red blood cell flexibility was studied in the blood of twenty patients with severe peripheral vascular disease and twenty matched controls. Patients exhibited significantly less red cell flexibility than controls. In both groups there was an inverse relationship between age and red cell flexibility. No correlation was found between red cell flexibility and sex or smoking history. Pentoxifylline, a xanthine derivative which inhibits phosphodiesterases and platelet aggregation, was found to increase red cell flexibility. This effect of the drug was greater on red cells with impaired flexibility than on normal cells. Various prostaglandins by contrast were found to decrease red cell flexibility, this could be compensated for by pentoxifylline. Forty patients with COAD were treated intravenously with PgE1. Significant inhibition of platelet aggregation and clinical improvement was noticed. It is suggested that combinations of PgE1 and pentoxifylline should be explored in clinical studies.
Prevention of Post-Operative Thrombosis in Peripheral Arteriopathies. Pentoxifylline vs. Conventional Antiaggregants: A Six-Month Randomized Follow-up Study
Authors: Lucas Miguel Angel
Published: November 2007

The patency rate and reocclusion incidence were studied in 97 patients following vascular surgery necessitated by occlusion in the aortoiliac or femoropopliteal regions or both. Forty-nine patients were treated orally with a combination of acetylsalicylic acid and dipyridamole (1050 mg + 150 mg/day) and 48 patients with the haemorheologically active agent pentoxifylline (1200 mg/day, Trental® 400 tds.) for uniform periods of 6 months. Reocclusion occurred in 10 patients receiving ASAD and in 5 patients receiving pentoxifylline. Adverse reactions were recorded in 12 patients with ASAD (discontinuation in 11) and in 3 patients with pentoxifylline (discontinuation in 2). Patency and tolerability rate were significantly superior in those patients treated with pentoxifylline, suggesting that the combination of haemorheological effects with antihaemostaseological and antithrombotic properties offered by pentoxifylline may be of benefit in the prevention of reocclusion after vascular surgery.
Post-Arterial Reconstruction Edema, Are Lymphatic Channels to Blame?
Authors: Fernandez M.J. , Davies W.T. , Tyler A. , Owen G.M.
Published: November 2007

Edema which follows successful arterial reconstruction of a previously is chemic lower limb is a common observation. Most patients have no long term difficulty, but this side effect requires considerable attention to leg care and frequently delays resumption of normal activity. Earlier studies suggested vari ous causes. This study looked into lymphatic causes.125I RIHSA clearance was monitored in 4 patients who developed edema following femoropopliteal bypass, and 5 patients who did not develop edema following other vascular procedures. In the edematous limbs following successful femoropopliteal bypass grafting, the mean T1/2was 18.4 hours when compared to 52.7 hrs. in other procedures (p<.025). This indicates increased lymphatic flow of the distal superficial lym phatics. It is concluded that post reconstruction edema is not due to lymphatic disruption but is instead of multifactorial origin.
Extrinsic Innervation of the Canine Superior Vena Cava, Pulmonary, Portal and Renal Veins
Authors: Uematsu Toshihiko , Takiguchi Yoshiharu , Nakashima Mitsuyoshi
Published: November 2007

The responses of the superior vena cava, portal, pulmonary, and renal veins to electrical stimulation of sympathetic nerves were investigated in dog. The vascular response was measured by the method with an intravascular cuff. The contractile responses to neural stimuli were mediated mainly by adrenergic mechanism in the four veins and that of the portal vein was, in addition, medi ated in part by cholinergic one. The latter mechanism was also found in some cases of the pulmonary vein. As for the superior vena cava and the left renal vein the right-side dominancy in innervation was observed. These observations suggest a possible correlation between the embryogenesis of vein and its inner vation.
Buflomedil in Arterial Occlusive Disease: Results of a Controlled Multicenter Study
Authors: Trübestein G. , Balzer K. , Bisler H. , Klüken N. , Muller-Wiefel H. , Unkel B. , Mahfoud Y. , Ziegler W.
Published: November 2007

In a double-blind, randomised multicentre study buflomedil, a vasoactive substance, was compared with placebo in the treatment of 93 patients with chronic arterial occlusive disease. After a run-in period of four weeks the patients received either buflomedil (600 mg daily) or placebo over 12 weeks. The pain-free and the total walking distances improved significantly in both groups. However, the differences in the improvement between the two groups were highly signifi cant and in favour of buflomedil: for the pain-free walking distance p<0.001 and for the total walking distance p<0.01.

The results indicate that buflomedil has a beneficial effect on the symptoms and lengthens the walking distance in patients with arterial occlusive disease.
Deep Vein Thrombosis Detection by 99m TC-MDP Scanning
Authors: Moallem Anita , Lichsztral Regina
Published: November 2007

A new observation is reported wherein 99m Tc-MDP is incorporated into recanalizing thrombophlebitis. In one patient with subacute disease, inflamma tory vascularity is appreciated during the first one to two minutes after injec tion. Both patients showed evidence of late phosphate uptake in their greater saphenous veins two hours later. Intravenous isotope injections may be given in an arm vein: foot injections are not required.
Nitroglycerin Concentration in Plasma: Comparison Between Transdermal Therapeutic System and Ointment
Authors: Chu Li-chiang , Gale Robert M. , Schmitt Leonore G. , Shaw Jane E.
Published: November 2007

This double-blind cross-over study evaluates in 12 male volunteers the time course of nitroglycerin concentration in plasma with use of the TTS-nitroglyc erin, a controlled-release transdermal dosage form for nitroglycerin, and com pares the bioavailability of nitroglycerin delivered from the transdermal system with that from three successive applications of 0.5 inch of 2% nitroglycerin ointment placed at 8 hr intervals over 10 cm 2 of skin. The mean amounts of nitroglycerin available when subjects wore the TTS-nitroglycerin or received successive applications of ointment were 15.8 mg ± 1.8 (SE) and 9.8 mg ± 0.8, respectively. Mean plasma concentrations for both treatments ranged from 10- 18 pg/ml-cm2. The normalized areas under the curves — 353 and 410 pg/hr/ml cm2, respectively — did not differ significantly. The ratio of clearance from the two dosage forms was 0.98±0.12. All subjects experienced mild-to-moderate side effects of nitrate therapy with both dosage forms and also decrease in blood pressure and increase in heart rate.
Effect of Nitroglycerin on Regional Myocardial Blood Flow Following an Experimental Coronary Spasm
Authors: Dumont Louis , LeLorier Jacques , Stanley Paul , Chartrand Claude
Published: November 2007

This study was designed to evaluate the effect of nitroglycerin (30 μg given as an i.v. bolus) on regional distribution of myocardial blood flow in conscious dogs, following an acute coronary occlusion similar to a coronary spasm. The left anterior descending (LAD) coronary artery was acutely occluded with a balloon cuff occluder. The distribution of blood flow between the endocardium and the epicardium of both the normal and ischemic area of the left ventricle was determined by means of the radioactive microsphere technique. Acute oc clusion of the left anterior descending coronary artery produced a significant decrease of blood flow reaching the area irrigated by this artery; this decrease was of a lesser magnitude after administration of nitroglycerin. In addition, ischemia produced a disproportionate decrease in endocardial blood flow. This decrement was also of a lesser magnitude following administration of nitroglyc erin. Blood perfusion to the non-ischemic myocardium was not altered. These results indicate that an intravenous bolus of nitroglycerin, given after a brief coronary occlusion simulating a coronary spasm, increases blood flow to the ischemic myocardium, induces a favorable redistribution of blood flow toward the ischemic endocardium and does not produce any decrement of blood perfu sion to the non-ischemic myocardium.
Iliofemoral Thrombosis in a Case of Chicken Pox Dr. Mir Sadat Ali, M.B.B.S., D.Orth, F.I.C.a.*, Dr. M. Sankaran Kutty, M.Ch. (Orth)*, F.I.C.a., Dr. J.R. Corea, M.Ch. (Orth)*, and Dr. K. Kutty, M.D., M.R.C. Path.† Alkhobar, Saudi Arabia
Authors: Mir Sadat Ali
Published: November 2007

A case of iliofemoral thrombosis possibly related to chicken pox infection is reported. Treated with rest and anti-coagulants, the pa tient made a satisfactory recovery.
Evaluation of Quinidine Short and Long-Acting in Control of Arrhythmias
Authors: Coodley Eugene , Pugash Neil , Toppo Frank
Published: November 2007

Twenty-one patients with arrhythmias responsive to quinidine were studied both with regard to consistency of response as determined by repeat Holter Monitoring and in half of these patients a comparison of short and long-acting quinidine was made. Holter Monitoring demonstrated greater than 60% reduc tion of ectopic activity in all but one patient and reproducibility varied by less than 10% in nineteen of twenty-one patients. Nine of eleven patients showed the same response to long-acting quinidine as compared to short-acting. Eight of nine patients having significant numbers of ectopic pairs showed a significant reduction with quinidine therapy, both short-acting and long-acting.
Cardiac Tamponade from Central Venous Catheters Report of a Case and Review of the English Literature
Authors: Collier Paul E. , Ryan John J. , Diamond Daniel L.
Published: November 2007

A case of acute cardiac tamponade caused by an internal jugular central venous catheter which was successfully treated is reported. The English litera ture is reviewed and shows that tamponade can occur up to 37 days after inser tion and has a 65% mortality. The tamponade is usually caused by the actual infusate and not by blood.
Pressure Rise at Arterial Bifurcations
Authors: Zamir M. , Brown N.
Published: November 2007

The increase in cross-sectional area within an arterial bifurcation is shown to be much larger than that predicted by the conventional area ratio β. Modified area ratios which better describe this increase are presented and their values are assessed both from theoretical considerations and from physiological data. The results suggest that the pressure rise within an arterial bifurcation may be much more severe than that suggested by the conventional area ratio β, and that local flow separation may be far more common. These conditions may adversely affect endothelial tissue and orderly flow within the bifurcation region.
Varicose Veins of the Abdominal Wall in a Child. A Case Report
Authors: Antebi E. , Freund E.
Published: November 2007

A case of a venous malformation of the abdominal wall in a 13-year-old boy is hereby presented. This malformation, manifesting as varicosities which were present from infancy caused no disturbances other than cosmetic. Clinical, laboratory and radiological examinations revealed no underlying pathology linked with this malformation. Considering the patient's history, we assumed the varicosities to be sequelae of a deep thrombophlebitis of the right leg in infancy, although a congenital etiology was not excluded. The varicose veins were surgically excised with excellent postoperative results. To the best of our knowledge, no such case was previously reported in literature.
Atherosclerosis and Cerebral Ischemic Attacks: Intakes of Cerebrography With Xenon133 Inhaled and Platelet Tests in the Diagnosis, Clinical and Therapeutic Monitoring; The Preventive Role of Dipyridamole
Authors: Solvay H. , Kahn M. , Selosse P. , Carlier J. , Cloarec M. , Delwiche J.P. , Fenollar J.
Published: November 2007

A study of patients to develop the significance of the role of the blood plate lets in the recurrence of transient cerebral ischemic attacks in patients with cerebral atheromatous, develop the effectiveness of dipyridamole in the prophy lactic therapeutic regimen. In the group treated with dipyridamole, a 76.3% clinical improvement was recorded (mean increases of 11.2 ml/min. and 11.4 ml/min. of the cerebral hemispheric flows), 15.8% of cases stabilized (mean increases of 1.7 ml/min. and 1.2 ml/min.) and 7.9% failures (mean decreases of 10.4 ml/min. and 14.3 ml/min.) of these same flows. The cerebrography with xenon 133 inhaled as well as the platelet tests used, constitute unfailing means of diagnosing and monitoring the clinical development.
Therapeutic Efficacy of Alpha-Adrenoceptor Blockade in Primary and Secondary Raynaud's Syndrome
Authors: Cleophas Ton J.M. , van Lier Henk J.J. , Faaber Peter , Fennis Jan F.M. , van 't Laar Albert
Published: November 2007

Twenty patients with primary and 11 with secondary Raynaud's syndrome were treated with the alpha-adrenoceptor blocker phenoxybenzamine (10-20 mg daily). In the secondary group mean age and mean duration of symptoms as well as presence of positive ANA and positive Clq blinding test were signifi cantly higher than in the primary group. In both groups a beneficial effect of the medication on finger temperature 12 min after finger cooling and on clinical symptoms was established. Secondary Raynaud's syndrome reacted at least as well as primary syndrome.