bluuebunny/crossref_metadata_2025_split huggingface dataset:
Routine pacemaker control, and selective replacement of pulse generators. A cost/benefit analysis
Authors: GRENDAHL HELGE 
Published: August 2010

ABSTRACT. Two hundred and fifty patients with permanent pacemaker have been followed up with routine pacemaker controls in a pacemaker clinic for a 21 months period 1/3–73 to 1/1–75. Ninetyfive pulsegenerators were replaced. Sixtytwo of the replacements were due to impending battery exhaustion, nine elective and 24 for other reasons. Signs discovered by the patients led to replacements in 21 cases for impending battery exhaustion and in 17 cases for other reasons. Fortyone replacements for impending battery exhaustion and 7 other replacements followed a scheduled visit to the pacemaker clinic. The selective replacement policy resulted in an average gain of pulsegenerator lifetime of 6.5 months, compared to a 24 minths elective replacement policy.Increased safety is obtained by routine control of pacemaker patients in a pacemaker clinic.
SEVERE ARTERIAL HYPERTENSION (GRADE III AND IV)
Authors: Gudbrandsson Thorkell , Snorrason Snorri P. 
Published: August 2010

ABSTRACTThe aim of this study was to evaluate the number, outcome, survival time, and causes of death of patients with severe arterial hypertension who were admitted to the Department of Medicine at Landspitalinn [National Hospital) in Reykjavik during the years 1957 to 1971.During this period 117 patients were found to have severe arterial hypertension (12.6% of all cases of hypertension diagnosed) according to the grading of Keith and wagener, 20 patients with grade IV retinopathy and 97 patients with grade III.The case histories were analysed according to age and sex distribution, blood urea, electrocardiographic changes, heart size by X‐ray at the time of diagnosis and final outcome.The survival calculations were done by the decrement method (life tables) and aim taken from patient age 65 years and less. Relatively fewer patients with severe arterial hypertension were admitted during the last five year period (1967–1971) than during the two previous five year periods. The main causes of death were cerebrovascular accidents (26.6%), myocardial infarctions (22.8%), and renal failure (22.8%).Approximately 50% of the men and 60% of the women survived five years. Elevated blood urea values and signs of left ventricular hypertrophy on ECG at the time of diagnosis carried a more sinister prognosis.
Peripheral Haemodynamics in Essential Hypertension
Authors: Sivertsson Ramon 
Published: August 2010

Abstract. Previous studies have indicated the existance of haemodynamically important structural vascular changes in patients and animals with hypertension.Possible pathophysiological implications of these changes are discussed.Two studies dealing with the question of reversibility of the structural changes on long‐term blood pressure lowering therapy are described. The results indicate that the changes are partially but not completely reversible.
Effects of Beta‐Adrenoceptor Blocking Agents on Haemodynamic Parameters
Authors: Hansson Lennart 
Published: August 2010

Abstract. A review is given of some of the important studies dealing with the haemodynamic effects of beta‐adrenoceptor‐blockade in the treatment of hypertension.Emphasis is put on the haemodynamic changes that occur during long‐term beta‐adrenoceptor‐blockade and comparisons are made between acute and long‐term effects, particularly as regards the change of total peripheral vascular resistance.As hypertension is a multifactorial disease, one should not expect to find one single mechanism by which the antihypertensive mode of action of beta‐adrenoceptor‐blocking agents could be explained. However, irrespective of whether a humoral or a neurogenic or other possible mechanism is favoured, it is axiomatic that such mechanisms would have to influence blood pressure through changes of either cardiac output or total peripheral vascular resistance (or both). For this reason the haemodynamic changes will always be of importance.The topic of combined treatment of hypertension using a beta‐adrenoceptor‐blocking agent in conjunction with a vasodilator and the haemodynamic effects thereof is briefly discussed, and finally some data are presented on the effect of beta‐adrenoceptor‐blockade on regional haemodynamics.
Clinical Evaluation of Hepatic Scintigraphy
Authors: Dyrbye Martin 
Published: August 2010

ABSTRACT The diagnostic accuracy of liver scintigraphy concerning focal liver diseases was evaluated. Two groups of patients were examined. The first group was examined with a rectilinear scanner and a definite diagnosis was obtained in 176 cases. The predictive diagnostic values of the scintigraphic diagnosis: focal liver lesion present (PV pos.) was 71% (57–83), focal liver lesion not present (PV neg.) was 84% (76–90) (95% confidence limits in brackets).The second group was examined with a gamma camera and a definite diagnosis was obtained in 41 cases. Here the PV pos. was 56% (21–86) and the PV neg. 97% (84–100). A motion correction devise did not improve the interpretation.A survey of the literature indicates that the accuracy despite progressive technological development has not improved during the last 6 or 7 years.Despite its limitations the author finds liver scintigraphy indicated in patients with suspected or proven cancer.
On the pathogenetic role of prostaglandins in Bartter's syndrome.
Authors: Nielsen Ingolf , Hesse Birger , Christensen. Poul 
Published: August 2010

Abstract Two patients, one with Bartter's syndrome and one with severe abuse of diuretics, were investigated before and after indomethacin treatment. Before indomethacin the two patients showed a similar pattern of hypokalaemic alcalosis, secondary hyperaldosteronism, and increased urinary excretion of PGE2 and kallikrein. After a few days on peroral indomethacin medication the hypokalaemia was significantly improved, the plasma renin activity, and the urinary excretion of aldosterone, PGE2 and kallikrein were normalized in both patients. It is concluded that the beneficial effect of indomethacin cannot be used as a proof of prostaglandin overproduction as the primary defect in Bartter's syndrome.Recently Bartter's syndrome (BS) ‐ a condition of hypokalaemic alcalosis, hyperaldosteronism, hyperplasia of the juxtaglomerular apparatus and normal blood pressure without oedema ‐ has been associated with overproduction of renal prostaglandins, and the manifestations of the condition have been successfully treated with agents inhibiting prostaglandin synthesis (4, 6). Consequently it was suggested that prostaglandin overproduction was the primary defect in BS.In 1973 our group presented a report on three cases of BS (9), two adults and one child. Since then one of the adults died suddenly, presumably of cardiac arrest. We found it of interest to review the remaining two cases in a protocol with measurements of prostaglandin (PGE2) and kallikrein excretion before and after indomethacin treatment.
ULTRASOUND FLUOROSCOPY ‐ WHAT IS IT, AND OUR APPROACH TO YOUR REQUIREMENTS
Authors: MCLAIN J.A. 
Published: August 2010

ABSTRACTA discussion on Ultrasound Fluoroscopy and how it relates to the traditional Real Time Instrumentation.This paper covers the various types of Ultrasound Fluoroscopy Instrumentation, a few of the advantages and disadvantages of each and Unirad Corporation's approach to Ultrasound Fluoroscopy. Also detailed discussions on the technical differences between their approach and the traditional Real Time Instrumentation itemizing electronic beam resolution control in some detail as to its advantages, complexity and comparison to Real Time (Non‐focused) and the traditional single element Ultrasound Instruments.
EVALUATION OF THE LEFT VENTRICLE BY TWO‐DIMENSIONAL ECHOCARDIOGRAPHY
Authors: KISSLO J.A. 
Published: August 2010

SUMMARYLeft ventricular wall motion was assessed in 105 consecutive patients both invasively using biplane cineangiography, and non‐invasively, by a real‐time, phased‐array, two‐dimensional echocardiography system. Ventricular wall motion in five anatomic areas of the ventricle (anterolateral, posterolateral, apical, septal and inferior) was analyzed by both methods in a double‐blind manner. Two‐dimensional echocardiographic images were deemed adequate for analysis in 82% of the regions (430 of 525). Firty‐five discrepancies were noted in the comparison of the remaining 430 regions.The reasons for discrepancies in interpretation between the two methods were established for 54 during retrospective review: 33 were due to echocardiography (inadequate target visualization, observer error, or tangential echo views). Fifteen were related to angiography (overlay of silhouettes or observer error), and six were due to other reasons including definition problems or spatial orientation difficulties.Both real‐time, two‐dimensional echocardiography and cineangiography have advantages and disadvantages. The techniques used together could provide more complete information concerning ventricular wall movement than is now currently available.
PULMONARY VALVE MOTION IN VALVULAR PULMONARY STENOSIS IN CHILDHOOD
Authors: REY C. , LABLANCHE J.M. 
Published: August 2010

SUMMARY:Echocardiography tracings of the pulmonary valve was recorded in 16 patients with pulmonic stenosis (PS) ranging in ages from 6 to 14 years (average 10 years). 11 patients had an isolated PS and 5 had a PS associated with atrial septal defect.In 2 patients with mild PS (gradient 15 mm Hg) the depth of the “a” wave was normal: 3 and 4 mm.In 14 patients with moderate or severe PS (gradient 40 mm to 200 mm Hg), the maximal depth of the “a” wave was less than 6 mm in 2 patients, and more than 6 mm in 12 patients (range 7 to 15 mm, average 10 mm). The motion of both anterior and posterior pulmonary valve leaflets was well recorded in 3 patients with severe PS. The “a” wave showed a posterior motion of the posterior leaflets and an anterior motion of the anterior leaflet. This motion is due to the premature pulmonary valve opening.
ECHOCARDIOGRAPHIC FINDINGS IN VENTRICULAR SEPTAL RUPTURE AND ANTERIOR WALL ANEURYSM COMPLICATING MYOCARDIAL INFARCTION
Authors: EGEBLAD H. , HAUNSØ S. 
Published: August 2010

ABSTRACTEchocardiographic findings in a patient with ventricular septal rupture and anterolateral wall aneurysm complicating myocardial infarction are presented. The findings were confirmed by cardiac catheterization and surgery. Using M‐mode ultrasonocardiography one was able to demonstrate and localize the aneurysm as well as the ventricular septal defect which presented as an oblique interventricular communication appearing only during systole. Thus echocardiography supplemented the invasive examinations in exactly revealing the site of ventricular septal rupture. Other echocardiographic features of ventricular septal rupture were right ventricular dilatation, pathological septal motion and abnormal tricuspid valve motion as recently reported by other authors.
QUANTITATIVE ANALYSIS OF LEFT VENTRICULAR FILLING PHASE BY ECHOCARDIOGRAPHY
Authors: BRUN P. , ODDOU C. , BERALDO E. , KULAS A. , LAURENT F. , PHILIPPON A. , DE VERNEJOUL F. 
Published: August 2010

ABSTRACTThe ultrasonic method was used in an attempt to correlate the different mechanical events occuring during left ventricular rapid filling phase, concerning anterior mitral leaflet, posterior wall and interventricular septal motions.Signals were recorded on a line scan recorder. The M‐mode records were placed on a digitizing tablet under the control of a minicomputer for continuous measurements throughout the cardiac cycle. Q waves were indicated to identify end‐diastole and heart rate. The left ventricular internal diameter (minor axis) and its rate of change were calculated from anterior and posterior endocardial echos together with posterior wall and septal thickness, external and mid‐wall diameter. The analysis was made on data obtained from 40 normal subjects.The results suggest that our echographic measurements of the left ventricular internal diameter rate of change and the electromagnetic transmitral flow time variation present a high temporal correlation:

Peak rate of change of the internal diameter lengthening and peak mitral flow occur shortly after the anterior mitral leaflet E wave (echographic data: 26± 30 ms).
In the case of long diastole, rapid lengthening and filling phase ends before, mitral F point (echographic data: 43 ± 37 ms).

The abrupt slope change of the posterior wall occuring during early diastole precedes significantly the end of rapid filling (50 ± 30 ms), which is indicated by an abrupt slope change of the interventricular septum.
Cortisone‐Induced Remission of Hypothyroidism in Schmidt's Syndrome
Authors: Petersen Hans Draminsky , Bergman Mozes 
Published: August 2010

ABSTRACT.A patient with autoimmune Addison's disease, hypothyroidism and primary gonadal insufficiency is described. Initial treatment with cortisone improved his thyroid function, probably through cortisone suppression of the autoimmune reactions. It was, however, not possible to normalize the thyroid function completely. The decreased testicular function did not improve during the cortisone treatmen.Schmidt's syndrome
Epidemiological Studies in the Upernavik District, Greenland
Authors: Kromann Niels , Green Anders 
Published: August 2010

ABSTRACT. An epidemiological survey of several chronic diseases in the Upernavik district, Northwest Greeland, is reported. The study population (ap‐prox. 1 800 inhabitants) is one of the remaining whaling and sealing populations in Greenland. It was observed over the 25‐year period 1950–74 as to the incidence of the diseases, which was based on all cases diagnosed in hospital during this period. The disease pattern of the Greenlanders differs from that of West‐European populations, having a higher frequency of apoplexy and epilepsy but a lower frequency or absence of acute myocardial infarction, diabetes mellitus, thyrotoxicosis, bronchial asthma, multiple sclerosis and psoriasis. The distribution of cancer types differs from that of the Danish population, but the total incidence of cancer is of the same magnitude. Further comparable studies should be performed in Greenlandic districts that are characterized by more profound changes in life style, in order to elucidate the effect of these changes on the disease pattern.Acta Med Scand 208: 401, 1980.
BLOOD PRESSURE AND PULSE RESPONSE TO INSULIN‐INDUCED HYPOGLYCEMIA DURING NON‐SELECTIVE AND SELECTIVE β‐BLOCKADE
Authors: Pape J. , Jervell J. , Anker E. , Bergrem H. , Dahle K. , Leivestad T. , Lippe A. vd. , Myrseth L. , Thaulow E. , Urving H. 
Published: August 2010

ABSTRACTHypoglycemia was induced in ten healty male volunteers during medication with atenolol, metoprolol and propranolol. The β‐blockers abolished the tachycardia during hypoglycemia. In some subjects bradycardia, and in two nodal bradycardia was observed on propranol. The physiologic blood pressure responses were dam‐pend during the β1‐selective blockade. With propranolol a rise in blood pressure was recorded, in two subjects up to 160/105. The blockers had no effect on degree of hypoglycemia or glucose recovery.
Thiazide diuretics, Hypokalemia and Cardiac Arrhythmias
Authors: Hollifield John W. , Slaton Paul E. 
Published: August 2010

AbstractThiazide diuretics are widely accepted as the cornerstone of antihypertensive treatment programs. Hypokalemia is a commonly encountered metabolic consequence of chronic thiazide therapy. We treated 38 patients (22 low renin, 16 normal renin) with moderate diastolic hypertension with hydrochlorothiazide (HCTC) administered on a twice daily schedule. Initial dose was 50 mg and the dose was increased at monthly intervals to 100 mg, 150 mg and 200 mg daily until blood pressure normalized. The serum K during the control period was 4.5 ± 0.2 mEq/I an on 50, 100, 150 and 200 mg HCTZ daily 3.9 ± 0.3, 3.4 ± 0.2, 2.9 ± 0.2, and 2.4 ± 0.3 mEq/I, respectively. Corresponding figures for whole body K were 4107 ± 208, 3722 ± 319, 3628 ± 257, 3551 ± 336, and 3269 ± 380 mEq, respectively.In 13 patients we observed the effects of HCTZ therapy (100 mg daily) on the occurrence of PVC's during rest as well as during static and dynamic exercise. During rest we observed 0.6 ± 0.08 PVC beats/min ± SEM and during static and dynamic exercise 0.6 ± 0.06 and 0.8 ± 0.15, respectively. Corresponding figures during HCTZ therapy 100 mg daily were 1.4 ± 0.1, 3.6 ± 0.7 and 5.7 ± 0.8, respectively.The occurrence of PVC's correlated significantly with the fall in serum K+ observed r = 0.72, p < 0.001.In conclusion we found that thiazide diuretics cause hypokalemia and depletion of body potassium. The more profound hypokalemia, the greater the propensity for the occurrence of PVC's.
Potassium Maintenance Potassium Supplements or Potassium Sparing Agents
Authors: Morgan Trefor , Myers John 
Published: August 2010

AbstractThis paper reviews and presents data from a series of studies evaluating the extent of potassium depletion that occurs in various disease states and a comparison of the efficacy of potassium supplementation or potassium sparing diuretics in its correction. Changes in serum potassium levels are common after diuretics but are relatively minor in most people if small doses of diuretics are used. Total body potassium deficit is uncommon in people treated with a diuretic for hypertension and the fall in serum potassium results from alkalosis and a shift of potassium into the cell. Potassium sparing diuretics correct the potassium abnormality more readily than potassium supplements. Evidence is also presented that suggests that a high salt, low potassium diet may be an important cause of hypokalaemia in people given diuretics.
PROTECTION OF ISCHEMIC MYOCARDIUM FROM METABOLIC PRODUCTS
Authors: Ichihara Kazuo , Robishaw Janet D. , Vary Thomas C. , Neely James R. 
Published: August 2010

ABSTRACTMyocardial ischemia results in two major alterations in cellular metabolism that eventually may affect every cellular function. The primary and major alteration is a decrease in oxidative production of ATP and consequently a decrease in all ATP dependent processes as cellular ATP declines to very low levels. The second alteration is accumulation of metabolic products secondary to both decreased coronary flow (washout) and decreased oxidative metabolism. High levels of metabolic products result in inhibition of several enzymatic reactions. Glycolytic inhibition by high NADH results in the loss of anaerobic ATP production. Inhibition of β‐oxidation by high levels of NADH and FADH2 results in a accumulation of long‐chain acyl CoA and acylcarnitine esters and free fatty acids. These compounds are very active detergents and may alter several membrane functions such as Na+ K+ ATPase, and sarcoplasmic reticular, Ca++‐stimulated ATPase. Inaddition, the structure and function of mitochondria may be disrupted. Long‐chain acyl CoA is an effective inhibitor of lipolysis which may contribute to triglyceride accumulation in ischemic hearts.It is well known that K+ arrest and hypothermia prevents many of the detrimental effects of ischemia. Tissue levels of high energy phosphates and the ability of the heart to recover mechanical function with reperfusion are preserved for much longer periods during hypothermic than during normothermic, hypoxic arrest. Other metabolic consequences of hypothermia and K+ arrest were studied in isolated rat hearts. Hypothermia (10°C) without ischemia completely inhibited glycolysis and reduced fatty acid oxidation to about 7% of the normothermic rate. This suggests that attempts to improve energy production by ischemic tissue during hypothermia will not be successful. Hypothermia (10°C) with ischemia not only preserved ATP levels but reduced tissue levels of lactate, acyl CoA and acylcarnitine and increased tissue glycogen. These observations suggest that hypothermia decreases energy production to the same extent as energy utilization and tissue stores of high‐energy phosphates are preserved. In addition, the lack of accumulation of metabolic products decreases the potential for damage to membranes and metabolic pathways. Low levels of lactate and NADH coupled with high levels of glycogen provides a condition for rapid glycolytic rates with reperfusion and rewarming.
THE MULTIFACTORIAL APPROACH TO MYOCARDIAL SALVAGE THE EXPERIENCE FROM DIVING SEALS
Authors: Kjekshus J.K. , Blix A.S. , Elsner R. , Millard R. , Hol. R. 
Published: August 2010

ABSTRACTThe survival of ischemic myocardium is critically dependent on effective adjustments between myocardial residual flow and energy requirement in the ischemic regions. The quantitative and qualitative changes for optimal adjustments may be studied in diving animals, normally exposed to long periods of hypoxemia and anaerobiosis.A series of studies have therefore been performed in seals in order to examine the regulations of myocardial blood flow, metabolism and left ventricular mechanics during diving asphyxia.Unanesthetized animals instrumented with catheters in the left ventricle and in the coronary sinus were submerged for periods of 10 to 16 minutes. The heart rate decreased from 135 to 12 beats/minute. End diastolic and systolic ventricular pressures were almost unchanged while LVdP/dt was reduced by 25%. Myocardial distance gauges implanted in the left ventricular wall showed that left ventricular dimensions during diastole and systole remained essentially constant. Consequently dilatation of the heart and developed wall tension were strictly controlled during diving asphyxia. Average myocardial blood flow, determined by microsphere injections, decreased to 10% of predive values and remained constant during the dive.Animals instrumented with mineature flow probes on the left circumflex coronary artery demonstrated that blood flow during diving ceases abruptly after the animal is submerged.Small bursts of flow are periodically observed in steadily increasing magnitude at 30 to 45 second intervals throughout dives lasting up to 15 minutes. The progressive reduction in arterial oxygen content was associated with a time dependent increase in myocardial lactate and hydrogen ion production. Glucose extraction was reduced while free fatty acid extraction remained unchanged. Following restoration of breathing a reactive myocardial hyperemia was observed along with an immediate return to myocardial uptake of lactate. Arterial lactate concentration increased temporarily after emergence. Despite increased glycolytic activity throughout the dive, coronary flow distribution was fully controlled and no evidence of ischemic dilatation of the left ventricle or ST‐segment elevation in the electrocardiogram was observed. Thus, coronary flow during diving was regulated jointly by a marked reduction in myocardial oxygen requirement (metabolic) and vasoconstrictor control (neurogenic).Glycolytic energy production became increasingly important througout the dive and was not associated with depressed myocardial function. These adaptations to diving asphyxia in the seal myocardium permit a reduction of coronary blood flow which is comparable to that in the infarcted dog myocardium, and therefore have relevance for therapeutic approaches to reduction of myocardial ischemic injury in man.