bluuebunny/crossref_metadata_2025_split huggingface dataset:
An unusual form of mitral insufficiency accompanying atrial septal defect
Authors: Friedensohn A. , Schlesinger Z. , Algom M. , Stryjer D. 
Published: October 2013

AbstractAn unusual case of atrial septal defect secundum type, associated with intermittent severe mitral insufficiency due to billowing anterior mitral leaflet, in a 56‐year old female is described. The degree of mitral insufficiency ranged from severe to none. This phenomenon manifested itself by an intermittent systolic apical thrill and intermittent mitral regurgitation on angiocardiography.Pulling the anterior mitral leaflet at operation through the atrial septal defect demonstrated that this leaflet could be caught in the left atrium, thus causing intermittent mitral insufficiency. Closure of the atrial septal defect and replacement of the mitral valve was performed.
Sustained intra‐atrial reentrant tachycardia. Electrophysiologic study of 20 cases
Authors: Coumel P. , Flammang D. , Attuel P. , Leclercq J.‐F. 
Published: October 2013

AbstractTwenty cases of sustained tachycardia due to intra‐atrial reentry were investigated in patients aged 17 to 80 years (mean 47). The average frequency of the tachycardia was 128.6/min (extremes 95 and 180). Three modes of onset of the tachycardia were observed: atrial extra‐stimulus (19 times), progressively accelerated atrial pacing (9 times) and atrial escape beat (10 times). The tachycardia was stopped in all cases by a premature stimulation. When spontaneous, the termination was either sudden (10 times) or preceded by a progressive slowing (9 times) or an alternating phenomenon of long‐short cycle (13 times). Precise atrial mapping allowed to localize the first atrial depolarization less frequently in the sinus node area (1 case) than in the mean right atrium (21 cases), the low right atrium (2 cases), the interatrial septum (2 cases), and the left atrium (4 cases). The macroscopic size of the reentry circuit was demonstrated in only 3 cases. A junctional reentry was accurately ruled out in all cases thanks to the existence of a second or third‐degree AV or VA block, or by studying the sequence of retrograde atrial activation. A true junctional reciprocating tachycardia was associated with the intra‐atrial reentry in 2 cases.
The acute cardiac electrophysiological effects of intravenous sotalol hydrochloride
Authors: Ward D. E. , Camm A. J. , Spurrell R. A. J. 
Published: October 2013

AbstractThe cardiac electrophysiological effects of sotalol were studied in ten patients (pts) aged 20‐65 years undergoing intracardiac stimulation studies for palpitations (7 pts) or dizzy spells (3 pts). The following measurements were made: 1. basic sinus cycle length (SCL); 2. sinus node recovery time (SNRT) following overdrive pacing; 3. intra‐atrial (PA), atrio‐His (AH) and His‐ventricular (HV) conduction intervals during regular atrial pacing; 4. effective refractory periods of the atria (AERP), AV node (AVERP) and ventricular myocardium (VERP). AV nodal functional refractoriness (AVFRP) was also determined. All measurements were repeated 10‐15 min after i.v. administration of 0.4 mg/kg of sotalol. Results were analysed by the Wilcoxon Signed Rank test. Significant increases in SCL (p < 0.01), AH (p < 0.01), SNRT (p < 0.01), AVERP (p < 0.02) and AVFRP (p < 0.01) were observed. These effects are consistent with the beta‐blocking action of sotalol. The acute increase in AERP (p < 0.01) is, however, not a common property of other betablockers and may be related to the ‘class III’ cellular effect of sotalol. These results are discussed in relationship to the electrophysiological effects of other beta‐blocking drugs.
Noninvasive assessment of cardiac motion: Comparison of the apexcardiogram and cardiokymogram
Authors: Hendel J. , Apstein C. S. , Jabbour S. , Vokonas P. S. , Hood W. B. 
Published: October 2013

AbstractThe apexcardiogram (ACG) and cardiokymogram (CKG) (displacement cardiogram) tracings were compared in 45 patients with a variety of cardiac diseases and in 16 normal subjects. The ACG and CKG were generally comparable in waveform and timing of standard tracing intervals; however, on a case by case comparison frequent discrepancies between the ACG and CKG were observed. In 13 patients where no ACG could be recorded, an interpretable CKG tracing was obtained. However, the CKG produced frequent artifacts, mirror images, was very sensitive to probe position, and was judged to be of limited advantage over the ACG.
Acute myocardial infarction: Intracoronary application of nitroglycerin and streptokinase
Authors: Rentrop K. P. , Blanke H. , Karsch K. R. , Wiegand V. , Köstering H. , Oster H. , Leitz K. 
Published: October 2013

AbstractIn five patients with acute myocardial infarction, the effects of both intracoronary nitroglycerin (NTG) and subsequent intracoronary streptokinase application were evaluated. In addition, transluminal recanalization was performed in one of these patients. Injection of NTG into the infarct‐related coronary artery resulted in improved distal filling of the subtotally occluded left circumflex artery in one patient, and in transient patency of the completely occluded right coronary artery in a second patient. In a third patient patency of the totally occluded left anterior descending artery (LAD) was achieved by transluminal recanalization with a guide wire. In a fourth patient with occlusion of the LAD, there was no response to intracoronary NTG and mechanical recanalization was not attempted. Subsequent intracoronary infusion of streptokinase (1,000‐2,000 U/min for 15‐60 min) resulted in a further and long‐term reduction of narrowing at the site of acute occlusion in patients I—III and in opening of the completely occluded LAD in patient IV. Improvement of lumen was paralleled by alleviation of symptoms. In a fifth patient, in whom the LAD was subtotally occluded, the degree of coronary obstruction could not be changed by intracoronary application of NTG or by lysis. In this patient, symptoms and ECG changes improved with reduction of pathologically elevated blood pressure values. The findings suggest that myocardial infarction had been caused by thrombotic occlusion in four patients, and that spasm of the infarct vessel could have been an additional factor in two of these patients. In the fifth patient, an increase of afterload in the presence of a subtotal lesion might have caused the critical imbalance between oxygen supply and demand, resulting in cell death.
Isolated chronic tricuspid insufficiency due to closed chest trauma: Report of a case with long‐term follow‐up
Authors: Vijayanagar R. , Bognolo D. A. , Harrison E. , Raju B. M. , Eckstein P. F. , Sbar S. 
Published: October 2013

AbstractA case of isolated chronic tricuspid insufficiency due to closed chest trauma is described in this report. Studies for carcinoid syndrome were negative. At surgery the posterior leaflet of the tricuspid valve appeared to be torn and disrupted. The other leaflets were shortened and atrophic. The results of pre‐ and postoperative cardiac catheterization with long‐term follow‐up to the present, and the available literature on this rare entity has been briefly reviewed.
Hemoptysis, recurrent cerebrovascular accident, and emergency mitral valve replacement
Authors: Sambasivan V. , Edmiston W. A. , Veluz C. , Mendez M. A. 
Published: October 2013

AbstractHemoptysis in mitral stenosis may occur frequently, but massive pulmonary hemorrhage is uncommon. We describe a patient with mitral stenosis who had severe hemoptysis and required anticoagulation for recurrent embolic cerebrovascular accidents. The patient underwent successful mitral valve replacement with a Hancock bioprosthesis. There was no evidence of pulmonary bleeding following operation. This case illustrated that mitral valve operation may be performed in acutely ill patients for the relief of hemoptysis.
Usefulness and limitations of myocardial oxygen consumption indices
Authors: Baller D. , Zipfel J. , Hellige G. 
Published: October 2013

AbstractIndirect indices of myocardial oxygen consumption (MV̇O2) are frequently applied to humans, both in health and disease, to estimate the energetic state of the myocardium. Despite widespread use, the validity of the previously reported oxygen consumption parameters has not yet been proven. Therefore, we designed experiments to examine any indices under maximal variations of hemodynamics and oxygen consumption with special reference to clinically applicable indices.
Effective use of captopril in postoperative paradoxical hypertension of coarctation of the aorta
Authors: Casta A. , Conti V. R. , Talabi A. , Brouhard B. H. 
Published: October 2013

AbstractSevere systemic hypertension may complicate the postoperative course of patients undergoing surgical repair for coarctation of the aorta. The sympathetic and the renin‐angiotensin systems have been demonstrated as underlying mechanisms for this paradoxical phenomenon (Farrell et al., 1979; Rocchini et al., 1979). We recently utilized captopril, a competitive inhibitor of angiotensin converting enzyme, with success in the management of severe hypertension that developed in a 15‐year‐old male after successful surgical repair for coarctation of the aorta. To our knowledge, this is the first report on the use of captopril for the treatment of this paradoxical phenomenon.
The clinical diagnosis of nonanginal chest pain: The differentiation of angina from nonanginal chest pain by history
Authors: Constant J. 
Published: October 2013

AbstractFor the first time an attempt has been made to systematize nonanginal pain questions so that physicians will ask the nonanginal questions and not simply divide all angina‐like symptoms into the two categories of typical and atypical angina. A definite nonanginal chest pain category is defended with the possibility of avoiding diagnoses such as “atypical chest pain” or “atypical angina.” Confidence in diagnosing chest pains as nonanginal can be attained if attention is paid to new criteria for duration, the effect of respiration, arm or chest movement, local compression, and body position. Because of this novel approach to the diagnosis of chest pain, it has become necessary to point out many of the pitfalls into which the unwary may fall with each nonanginal question.
Correlation between R‐wave amplitude and left ventricular volume at rest and with exercise
Authors: Ohlmeier H. , Mannebach H. , Gleichmann U. 
Published: October 2013

AbstractIn 52 patients with exercise angiography (12 normals, 31 with coronary heart disease, 9 with congestive cardiomyopathy) exercise ECGs were examined for R‐wave changes. An increasing R‐wave amplitude was found an insensitive sign of ischemia in patients with coronary heart disease (sensitivity 29%, specificity 81%). Sensitivity and specificity of the observed ST depression in this study were 83% and 71%, respectively, as reported by others. There was no positive correlation between the changes in the R‐wave amplitude and left ventricular end‐diastolic volume during exercise, thus there was no proof of the existence of the so‐called Brody effect in humans.
Reliability of two‐dimensional echocardiography in diagnosing fungal endocarditis
Authors: Sarma R. , Prakash R. , Kaushik V. S. , Oparah S. S. , Mandal A. 
Published: October 2013

AbstractAlthough the techniques of M‐mode and two‐dimensional (2D) echocardiography (echo) have been found to be useful in patients with bacterial endocarditis, the 2D findings of fungal endocarditis are not known. In this report, we present the case of a young female narcotic addict with Candida albicans endocarditis in whom we diagnosed a large vegetation by 2D echo. Decision for surgery was made solely on the basis of the 2D‐echo findings. We feel that 2D‐echo findings are reliable in diagnosing fungal endocarditis because, with this technique, the size, shape, mobility, and exact location of the vegetation can be better identified than by the M‐mode echo. In addition, early diagnosis of fungal endocarditis helps in treating the patients with medical and surgical therapy which may result in lower mortality.
Echocardiographic evaluation of responses to left ventricular volume loading by principal components and nomographic analysis
Authors: Conetta D. A. , Carter R. L. , Geiser E. A. , Conti C. R. 
Published: October 2013

AbstractChanges in performance of left ventricles (LV) with volume overloads are difficult to determine by conventional clinical methods. This information, however, is important for the proper timing of therapeutic interventions to preserve LV function. Seven size‐adjusted (by regression with end‐diastolic diameter, EDD) LV performance parameters from 100 normal echocardiograms (echos) were entered into a principal component analysis (PCA). Two factors (linear combination of the 7 parameters) were obtained from the analysis. Prediction limits (95%) about these two factors used in combination, correctly classified 92% of the normal echos. More detailed analysis of the two PCA factors revealed that the majority of the variability within the factors was explained by size‐adjusted parameters resultant from the EDD posterior wall (factor 1) and EDD septal excursion (factor 2) regressions, respectively. Plots of the 95% prediction limits about these two regression lines provided nomograms. These nomograms used in combination, correctly classified 95% of the normal echos. When the performance parameters of 64 volume loaded ventricles were evaluated by PCA, four groups were identified. Ten ventricles (16%) were hypokinetic, 29 (45%) were hyperkinetic, 23 (36%) were nomokinetic, and 2 (3%) could not be classified. These classifications were supported by significant between group differences of shortening fraction, velocity of circumferential shortening, and velocity of circumferential expansion. Nomographic classification of the same volume loaded hearts was in excellent (94%) agreement with PCA classification. Nomographic analysis (derived from the PCA) is offered as a less complex, more clinically applicable echo method for evaluating LV performance of volume loaded hearts.
Precordial ST—Segment mapping: 6. Evaluation of serial changes in ST‐segment elevations and QRS complexes of precordial maps and standard ECGs in patients with acute myocardial infarction
Authors: Madias J. E. 
Published: October 2013

AbstractA total of 21 patients, 10 with anterior and 11 with inferior myocardial infarction (MI) had serial precordial 49‐lead ECG maps or standard ECGs on admission, and 2, 6, 12, 24 hours, and 7 days thereafter, to evaluate the natural course of ST‐segment elevation (index of ischemic injury) and QRS changes (index of necrosis), and their relationship. ECG parameters used included the sum of ST‐segment elevations, number of sites showing such changes, the sum of R waves from all leads with ST‐segment elevations, and a QRS score of all leads showing ischemic injury on admission. Sums of ST‐segment elevations either did not show statistically significant change throughout the study or showed unexplained re‐elevation (anterior MI), or completed their downward course in 6 hours (inferior MI). The number of sites showing ST‐segment elevations either remained unchanged (inferior MI), or declined at 2 hours without further change. However changes in the sum of R waves or QRS scores were gradual and completed most of their overall course within 24 hours. Decline of sums of R waves correlated well with sums of ST‐segment elevations on admission (inferior MI), and the number of sites showing changes (anterior MI). The course of changes in QRS complexes is more reliable than the alterations of ST‐segment elevations for the monitoring of evolution of MI. The former, assessed frequently in the first 24 hours, should be useful in the evaluation of therapies for patients with MI.
Serial echocardiograms in patients with congestive cardiomyopathies: Lack of evidence for thrombus formation
Authors: Tobin R. , Slutsky R. A. , Higgins C. B. 
Published: October 2013

AbstractWe studied 90 patients with congestive myocardial disease documented at cardiac catheterization (46 idiopathic, 39 ischemic, and 5 hypertensive) who underwent M‐mode and two‐dimensional echocardiograms every 2–3 months for up to 7 years (mean 3.4 ± 1.6 years, ± 1 S.D.). All had angiographic evidence of severe left ventricular dysfunction (left ventricular ejection fraction < 40%), and were on a variety of inotropic, diuretic, and vasodilating drugs. Only 9 were ingesting anticoagulants (5 warfarin and 4 aspirin), those on warfarin had documented pulmonary emboli or deep venous thrombosis. All but 4 patients were in normal sinus rhythm. Only one subject in this group was found to have a myocardial (left ventricular) thrombus. Postmortem examinations of 27 patients confirmed the ultrasound data. Thus, we conclude that cardiac thrombi are unusual in patients with congestive cardiomyopathies and rarely develop over the course of the illness even in the absence of chronic anticoagulation.
PET Radiotracers for Imaging P‐glycoprotein: The Challenge for Early Diagnosis in AD
Authors: Leopoldo Marcello , Contino Marialessandra , Berardi Francesco , Perrone Roberto , Colabufo Nicola Antonio 
Published: October 2013

AbstractPET radiotracer development to target in vivo P‐glycoprotein (P‐gp) could be an important strategy for the early diagnosis of neurodegenerative disorders such as Alzheimer’s disease (AD). Indeed, as a dysfunction of P‐gp is responsible for the accumulation of β‐amyloid plaques (a hallmark of AD) in brain parenchyma, P‐gp is the cause of AD onset. P‐gp substrates and inhibitors are useful for imaging the activity or expression of this protein, respectively; herein we discuss the in vivo evaluation of some 11C radiotracers with P‐gp‐inhibitory activity, such as [11C]MC18 and [11C]MC113, as well as P‐gp substrates [11C]MC266 and [11C]MC80. Moreover, the radiosynthesis of all these P‐gp probes is reported.
A Novel Mechanism for the Extraction of Metals from Water to Ionic Liquids
Authors: Janssen Camiel H. C. , Sánchez Antonio , Witkamp Geert‐Jan , Kobrak Mark N. 
Published: October 2013

AbstractWe present a novel mechanism for the extraction of metals from aqueous phases to room‐temperature ionic liquids (ILs) by use of a high‐temperature salt as an extraction agent. The mechanism capitalizes on the fact that charged metal complexes are soluble in ILs; this allows for extraction of charged complexes rather than the neutral species, which are formed by conventional approaches. The use of a well‐chosen extraction agent also suppresses the competing ion‐exchange mechanism, thus preventing degradation of the ionic liquid. The approach permits the use of excess extractant to drive the recovery of metals in high yield. This work presents both a thermodynamic framework for understanding the approach and experimental verification of the process in a range of different ILs. The method has great potential value in the recovery of metals, water purification and nuclear materials processing.
Anticoagulation and Monitoring of a Novel and Reversible Factor IXa Inhibitor
Authors: Becker Richard C. , Chan Mark Y. , Vavalle John P. , Povsic Thomas J. 
Published: October 2013

Abstract

Clinical Development Phases I‐III Regulatory, Quality, Manufacturing

Thrombosis as a clinical phenotype is ubiquitous in human diseases and conditions, ranging from atherosclerosis and other vascular disorders to trauma, surgery, malignancy, infections, blood dyscrasias, auto‐immunity, and complications of pregnancy. While each condition carries its own distinct signature and predisposition for thrombosis as a nonphysiological event, there are several common themes that center on cellular and noncellular elements, including well‐characterized coagulation proteases. Over the past decade, our group has been actively involved with the development of a factor IXa inhibitor, pegnivacogin, and its complementary antidote or control agent, anivamersen. The following review provides a summary of fundamental constructs, milestones, and the current status of our translational journey.
The contrasted evolutionary fates of deep‐sea chemosynthetic mussels (Bivalvia, Bathymodiolinae)
Authors: Thubaut Justine , Puillandre Nicolas , Faure Baptiste , Cruaud Corinne , Samadi Sarah 
Published: October 2013

AbstractBathymodiolinae are giant mussels that were discovered at hydrothermal vents and harboring chemosynthetic symbionts. Due to their close phylogenetic relationship with seep species and tiny mussels from organic substrates, it was hypothesized that they gradually evolved from shallow to deeper environments, and specialized in decaying organic remains, then in seeps, and finally colonized deep‐sea vents. Here, we present a multigene phylogeny that reveals that most of the genera are polyphyletic and/or paraphyletic. The robustness of the phylogeny allows us to revise the genus‐level classification. Organic remains are robustly supported as the ancestral habitat for Bathymodiolinae. However, rather than a single step toward colonization of vents and seeps, recurrent habitat shifts from organic substrates to vents and seeps occurred during evolution, and never the reverse. This new phylogenetic framework challenges the gradualist scenarios “from shallow to deep.” Mussels from organic remains tolerate a large range of ecological conditions and display a spectacular species diversity contrary to vent mussels, although such habitats are yet underexplored compared to vents and seeps. Overall, our data suggest that for deep‐sea mussels, the high specialization to vent habitats provides ecological success in this harsh habitat but also brings the lineage to a kind of evolutionary dead end.
Trinuclear Diamagnetic Nickel(II) Complexes with Bridging 3‐Arylpyrazolato Ligands
Authors: Salih Kifah S. M. , Bergner Susann , Kelm Harald , Sun Yu , Grün Anneken , Schmitt Yvonne , Schoch Roland , Busch Mark , Deibel Naina , Bräse Stefan , Sarkar Biprajit , Bauer Matthias , Gerhards Markus , Thiel Werner R. 
Published: October 2013

AbstractOrange‐red trinuclear nickel(II) complexes are obtained by reacting Ni(ClO4)2(H2O)6 with 3(5)‐arylpyrazoles in the presence of a base. Herein, the diamagnetic nickel centers are coordinated in a square‐pyramidal manner by four pyrazolato ligands, each of which bridges two nickel sites. The structurally unique complexes were investigated by NMR, IR, fluorescence, and X‐ray spectroscopy. All seven compounds described here were structurally elucidated by single‐crystal X‐ray diffraction. With 3(5)‐ferrocenylpyrazole as the substrate, a nonametallic system that possesses six redox‐active ferrocenyl moieties was obtained.
Donor‐Stabilized Silylenes with Guanidinato Ligands
Authors: Mück Felix M. , Junold Konstantin , Baus Johannes A. , Burschka Christian , Tacke Reinhold 
Published: October 2013

AbstractThe first donor‐stabilized silylenes with guanidinato ligands, compounds 4 and 6, were synthesized and structurally characterized in the solid state and in solution. As demonstrated by single‐crystal X‐ray diffraction studies, compound 4 contains a bidentate and a monodentate guanidinato ligand of the type [iPrNC(NiPr2)NiPr]–, and compound 6 contains the bidentate guanidinato ligand [ArNC(NMe2)NAr]– (Ar = 2,6‐diisopropylphenyl) and the monodentate amido ligand [(Me3Si)2N]–. Both silicon(II) complexes exist also in solution.