bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Aging and Hematocrit on Cerebral Blood Flow Velocity in Patients with Unilateral Cerebral Infarctions: A Doppler Ultrasound Evaluation
Authors: Titianova E.B. , Velcheva I.V. , Mateev P.S. 
Published: July 2008

By means of conventional continuous-wave (CW) (4 MHz) and transcranial pulsed (2 MHz) Doppler sonography 50 patients (34 men and 16 women, mean age 58.6±7.6 years) who survived unilateral cerebral infarctions (UCI) in the middle cerebral artery (MCA) territory were investigated. The control group consisted of 30 presumed healthy age-matched persons. The main quantitative sonographic parameters of the major arteries of the head and the basal cerebral arteries were evaluated. On the day of the neurosonographic investigations, hematocrit (Hct) was determined. Low-degree stenoses of the internal carotid arteries were found in 26 (52%) of the patients. Increased intracranial vessels' resistance in the MCA on the infarction side was usually obtained. Decreasing of Doppler shift frequency with advancing age and increasing of Hct was established in the controls. In patients with UCI the effects of aging and Hct on the sonographic parameters of the collateral arteries were more pronounced. Obviously, in patients with UCI, the alterations of the sonographic parameters are caused by parallel influence of vessels' disease, age-defmed changes of vessels' walls, and viscosity variations.
Effects of Lovastatin on High-Density Lipoprotein Subfractions in Hypercholesterolemic Patients with Peripheral Vascular Disease
Authors: Tilly-Kiesi Marju , Mattila Severi P. , Tikkanen Matti J. 
Published: July 2008

The effects of lovastatin treatment on high-density lipoprotein subfractions (HDL2 and HDL 3) were investigated in 34 patients with severe peripheral vascular disease and type IIa or type IIb hyperlipoproteinemia by use of a density gradient ultracentrifugation method. Lovastatin therapy caused greater percentage changes in HDL2 than in HDL3. In HDL2 the increases of cholesterol, total lipid, apolipoprotein AI (apoAI) and apoliproprotein AII (apoAII) concentrations were 23% (p < 0.05), 28% (p < 0.01), 24% (p < 0.01) and 11 % (p < 0.01), respectively, in subjects with the type IIa phenotype. In patients with the type IIb phenotype the corresponding increases were 42% (p < 0.01), 44% (p < 0.01), 38% (p < 0.01) and 21% (p < 0.05), respectively. The apoAI/apoAII weight ratio in HDL2 rose by 11% and by 13% in type IIa and type IIb patients, respectively. The present results suggest that during lovastatin treatment the slight increase in serum HDL-cholesterol concentration was due, not to cholesterol enrichment by high-density lipoproteins, but more probably to an increase of the number of HDL particles. The observed changes were more pronounced in type IIb than in type IIa patients.
Vasodilative Response to Hypoxia and Simulated Ischemia Is Mediated by ATP-Sensitive K + Channels in Guinea Pig Thoracic Aorta
Authors: Gasser Robert , Klein Werner , Kickenweiz Elisabeth 
Published: July 2008

Local vasodilation in response to hypoxia or ischemia improves perfusion and O2 supply of the affected tissue. This local vasodilation thus constitutes the most important mechanism in the prevention of ischemic cell injury. The regula tion of vascular tone has mainly been attributed to changes of cytoplasmatic Ca2+ ((Ca2+)i) concentrations in vascular smooth muscle cells. The mechanism underlying these changes has not, however, been elucidated so far. Using aortic strips of guinea pigs (transversally cut in spirals; normal Tyrode, in mM: NaCl 150, KCI 4.5, MgCl2 2, CaCl2 2.5, glucose 10; buffered with 10 mM HEPES at pH 7.4; equilibrated with 100% O2 at 31°C) the authors could show that metabolic blockade (glucose replaced by 10 mM 2-deoyglucose (DOG) led to a relaxation of the preparation. Thus, in four experiments, resting tension decreased from 0.75 g by 27% ± 12% within two hours (% of maximal contractile force developed by each prepa ration when depolarized with 43 mM KCI and 101.5 mM NaCl). When the same experiment was carried out in the presence of 1 mM tolbutamide (a known blocker of ATP-dependent K+ channels) in vascular smooth muscle no such re laxation could be seen (n = 4). Furthermore, in the same type of preparation, similar results have been obtained upon hypoxic relaxation (100% O2 replaced by 100% N2), where 1 mM tolbutamide also prevented vasodilation. Thus, hypoxic/ischemic vasodilation in response to glycolytic inhibition (DOG) and hypoxia (N2) is based upon the opening of K+ATP channels and hence can be prevented by sulfonylureas (the opening of K+ATP channels would lead to hyperpolarization (increased K+ conductance, Goldmann equation), thus di minishing the open probability of voltage-gated Ca2+ channels with subsequent vasodilation). This inhibition by sulfonylureas of vasodilative response to ischemia may also constitute the so far unknown cause of the increased cardiovascular mortal ity seen under sulfonylurea treatment.
Cardiac Depressant Effects of Oxygen Free Radicals
Authors: Prasad Kailash , Kalra Jawahar , Bharadwaj Lalita 
Published: July 2008

In many clinical situations, including cardiac ischemia/reperfusion, elective cardiac arrest, and renal dialysis, the chances of increased production of oxygen free radicals (OFR) exist. OFR have been implicated as a causative factor of cell damage in several pathologic conditions. The effects of exogenous OFR, gener ated by xanthine plus xanthine oxidase, in the absence and in the presence of OFR scavenger (superoxide dismutase [SOD]) on the contractility of isolated perfused heart of rabbit were studied. OFR produced concentration-dependent decreases in the contractility of perfused heart. SOD prevented the OFR-in duced decreases in the left ventricular contractility. Xanthine produced an in crease in the contractility of isolated perfused rabbit's heart. Xanthine oxidase produced a marked decrease in the left ventricular contractility. Repeated ad ministration of xanthine oxidase produced accelerated and greater decreases in the contractility of perfused heart when compared with that of the initial admin istration of the drug. Effects of xanthine or xanthine oxidase on the cardiac function and contractility were also studied in anesthetized dogs. Xanthine alone had no significant effect on the cardiac function and indices of myocardial contractility. However, xanthine oxidase produced a marked decrease in the mean aortic pressure, left ventricular work index, heart rate, cardiac index, left ventricular systolic pressure, left ventricular end-diastolic pressure, (+) and ( — ) dp/dt of left ventricular pressure, and other indices of myocardial contrac tility [(dp/dt)/PAW (pulmonary arterial wedge pressure)]; and an increase in the total systemic and pulmonary vascular resistance. Repeated administration of xanthine oxidase in anesthetized dogs had lesser effects on the cardiovascular system when compared with those from the initial dose of the drug.These results suggest that OFR are cardiac depressant. Clinical situations wherein there is an increased production of OFR or increased formation of xanthine and xanthine oxidase may be associated with decreased cardiac func tion and contractility. Scavengers of OFR may protect the heart from the delete rious effects of OFR in such clinical conditions.
Serum Magnesium and Potassium in Acute Myocardial Infarction: Relationship to Existing β-Blockade and Infarct Size
Authors: Landmark Knud , Urdal Petter , Landmark Knud 
Published: July 2008

Patients (n = 314) with acute myocardial infarction (AMI) were divided into three groups according to the time elapsed from onset of chest pain to when the first sample for determination of magnesium (s-Mg1) and potassium (s-K1) was drawn (A: hours 0-6; B: hours 6-10, and C: hours 10-24). Potassium and Mg were also measured in a second sample drawn three to twelve days (mean 6.3 days) later (s-Mg2, s-K2). Whereas s-Mg1 was lower than s-Mg2 in all three groups, s-K1 was reduced only in group A. Ten patients in group A receiving nonselective β-blockers had an attenuated drop in s-Mg1, whereas the drop in s-K1 was completely inhibited. The differences between s-Mg2 and s-Mg1 (Δ s-Mg) in all groups, and between s-K2 and s-K1 (Δ s-K) in group A, increased with increasing mean peak creatine kinase (CKmax) levels to approximately 1300-1800 U/L. In conclusion, these observations suggest that the initial drop in s-Mg and s-K in the early phase of AMI is due to increased stimulation of β2-adrenergic receptors; these changes can be prevented partly or completely by the use of nonselective β-blockers.
Clinical and Angiographic Features of Patients with an Occluded Versus a Patent Infarct Vessel After Intravenous Streptokinase for Acute Myocardial Infarction
Authors: Chouhan Lalit , Hajar Hajar A. , George Thomas , Pomposiello Juan Carlos 
Published: July 2008

Despite early treatment with thrombolytic agents for acute myocardial in farction, a significant portion of patients fail to achieve a patent infarct artery. To study the various factors related to achieving patency in the infarct vessel, 201 patients who received streptokinase within six hours of symptoms were studied. All patients underwent cardiac catheterization during the same hospi talization at 5.40±3.26 days after admission. Forty five (22.4%) patients were found to have an occluded infarct artery (group 1) and 156 (77.6%) had a patent infarct vessel (group 2). There was no difference in the time from onset of symp toms to receiving streptokinase between the two groups. The two groups were to each other with regard to age, gender, history of myocardial infarc tion or angina, and major risk factors for coronary disease. Coagulation pa rameters before and after streptokinase therapy, reflecting the lytic state, were similar in both groups. The left ventricular end diastolic pressure was signifi cantly higher and the left ventricular ejection fraction was significantly lower in group 1 than in group 2. These observations suggest that despite early initiation of thrombolytic ther apy in patients with acute myocardial infarction, a significant portion of pa tients fail to achieve a patent infarct artery. This failure cannot be explained by the observed clinical parameters or the lytic state after streptokinase.
A Botanical Compound, Padma 28, Increases Walking Distance in Stable Intermittent Claudication
Authors: Drabaek Hans , Mehlsen Jesper , Himmelstrup Holger , Winther Kaj 
Published: July 2008

Thirty-six patients with a median age of sixty-seven years and a median duration of intermittent claudication of five years were randomized to either active treatment with Padma 28 or placebo. The effect of treatment was quanti fied by measurements of systemic and peripheral systolic blood pressures and by measurements of the pain-free and the maximal walking distance on a tread mill. The ankle pressure index (ankle systolic pressure/arm systolic pressure) was calculated. The group randomized to active treatment received two tablets bid contain ing 340 mg of a dried herbal mixture composed according to an ancient lamais tic preparation (Padma 28). After active treatments, administered over a period of four months in a double-blinded, randomized design, the patients allocated to this group attained a significant increase in the pain-free walking distance from 52 m (20-106) to 86 m (24-164; P < 0.05) and in the maximal walking distance from 115 m (72-218) to 227 m (73- > 1,000; P < 0.05). The patient-group receiv ing placebo treatments did not show any significant changes in either the pain- free or the maximal walking distance. The authors could not demonstrate any significant changes in the ankle pressure index either during active or during placebo treatment. In conclusion, this study has shown that treatment with Padma 28 over a period of four months significantly increased the walking distance in patients with stable, intermittent claudication of long duration.
Precise Assessment of Myocardial Damage Associated with Secondary Cardiomyopathies by Use of Gd-DTPA-Enhanced Magnetic Resonance Imaging
Authors: Matsuoka Hiroshi , Hamada Mareomi , Honda Toshio , Kawakami Hideo , Okayama Hideki , Abe Mitsunori , Shigematsu Yuji , Sumimoto Takumi , Hiwada Kunio 
Published: July 2008

To evaluate the myocardial damage in patients with secondary cardiomy opathies, the authors examined gadolinium-diethylenetriaminepentaacetic acid (Gd-DTPA)-enhanced magnetic resonance imaging (MRI) in 5 patients (2 with cardiac amyloidosis, 2 with acute myocarditis, 1 with cardiac thyrotoxicosis). MR images were performed at 1.5-T by using a spin echo pulse sequence before and after intravenous administration of Gd-DTPA (0.2 mmol/kg). All patients revealed distinct high-intensity areas on postcontrast images. Moreover, MRI with Gd-DTPA could determine the severity and precise regions of myocardial damage associated with secondary cardiomyopathies. It is suggested that gated cardiac MRI with Gd-DTPA enhancement is useful for detecting the myocardial damage in secondary cardiomyopathies.
99Tcm-Sestamibi Uptake in the Leg Muscles and in the Myocardium in Patients with Intermittent Claudication
Authors: Boström Per-Ake , Diemer Henrik , Leide Sigrid , Lilja Bo , Bergqvist David 
Published: July 2008

99Tcm -Sestamibi has now replaced 201Tl as a cardiac imaging agent. In addi tion to the myocardial uptake there is also a considerable uptake in the striated muscle, which may be used for analyzing the muscular perfusion. Sixteen pa tients with intermittent claudication were investigated with 99Tcm -Sestamibi- SPECT (single photon emission computerized tomography) in order to visualize coronary ischemic disease. After the registration of the myocardial perfusion they were also studied regarding their leg muscle perfusion. This was done at rest and during standardized stress test using a bicycle ergometer. In 10 of the patients there was an increase in the isotope uptake in the myocardium from work to rest > 10% reflecting pronounced myocardial ische mia, which, however, was symptomatic in only 4 of the patients. The muscular uptake in the myocardium of 99Tcm -Sestamibi in the thigh in creased significantly from rest to exercise (P < 0.01), while it remained un changed in the calf muscle. There were no significant correlations at rest between the ratio of the right and left systolic blood pressure in the ankles and the ratio between the right and left isotope uptake in the calves, but the increase in the isotope uptake from rest to work correlated with the blood pressure ratio at r = 0.79, P< 0.01 (anterior projection) and r = 0.71, P< 0.01 (posterior projection). This study demonstrates the possibility of using 99Tcm -Sestamibi to analyze myocardial and muscular perfusion impairment in intermittent claudication.
Role of Transesophageal Pacing in Recurrent Atrial Fibrillation. Experience with Propafenone
Authors: Turco Pietro , Guarino Pietro , Parente Antonella , Viola Vincenzo , Candelmo Fiore , Bellizzi Gennaro , Foffa Antonio , Morella Alessandro , Martino Domenico F. 
Published: July 2008

To assess the role of transesophageal pacing (TP) at very high rates in the follow-up of patients with recurrent and sustained paroxysmal atrial fibrillation (AF) on therapy, the authors studied 15 patients (10 women, 5 men; aged forty- four to seventy-seven years old). Of them only 1 had a mild mitral regurgita tion; none had hyperthyroidism or acute ischemic heart disease. They tested propafenone (P) at a dose of 1.4-2 mg/kg over ten minutes as an intravenous bolus and 0.5 mg/minute as intravenous maintenance for two hours and then 300 mg twice daily orally and chronically. Serial TPs at very rapid rates (up to 600 bpm) were performed to test the long-term efficacy of P to prevent paroxys mal AF. The mean follow-up was fifteen months (nine to twenty-four months). Results: Intravenous P converted AF in five to ninety minutes (mean twenty- one minutes) in 9/15 patients (conversion rate of 60%); in an additional 4 pa tients oral P converted AF in two to fifteen hours. In the other 2 patients P failed to convert AF. Three patients experienced recurrence of AF in the early follow- up. Of the 10 patients who completed the entire protocol, only 1, who had mild mitral prolapse regurgitation and AF induction by TP, experienced new epi sodes of AF during follow-up. No significant side effects were noted during P therapy. Conclusions: Propafenone appears safe and effective for controlling and pre venting recurrent and sustained AF. Transesophageal pacing is a valid tool for predicting the efficacy of long-term therapy in the follow-up of patients with paroxysmal atrial fibrillation.
Alcohol and Coronary Spasm
Authors: Oda Hiroyuki , Suzuki Makoto , Oniki Toshiyuki , Kishi Yukio , Numano Fujio 
Published: July 2008

Alcohol is known to sometimes cause coronary spasm, the mechanism of which is still unknown. The authors monitored changes in plasma levels of prostanoids (thromboxane [TX B 2], 6-keto prostaglandin F1α [PGF1α]), catecholamines (CA), serotonin (5-HT), cyclic nucleotides (cyclic adenosine monophosphate—cAMP, cyclic guanosine monophosphate— cGMP), and platelet aggregation after alcohol ingestion (Japanese rice wine 400 mL) in 8 patients with alcohol-induced variant angina and 8 healthy men as controls. Coronary spasm was confirmed to have been induced in 4 patients nine hours after alcohol challenge (VA[+]), when their plasma ethanol levels had already returned to a null level. Neither CA nor 5-HT levels showed any change after alcohol ingestion either in patients or controls, though controls showed high levels of CA during alcohol ingestion. TX B2 in VA (+) patients increased gradually after alcohol ingestion to reach up to a statistically signifi cantly high level just before attack, as compared with those of controls and VA(-) patients, who, on the contrary, did not show such changes. The levels of 6-keto PGF1α, however, which were significantly lower in patients than in controls before the test, exhibited a gradual increase in VA (+) patients in parallel with the increase in TX B2. No significant changes in cAMP levels between either controls or patients were present. On the contrary, cGMP levels had a gradual decrease in patients after alcohol ingestion. Especially six hours after alcohol ingestion, cGMP levels in VA (+) patients decreased so much as to make a statistically significant difference, as compared with the level in controls. Platelet aggregability in controls showed a decrease after alcohol ingestion, in spite of no change or even increase in patients. These data suggest that low levels of PGF1α and the decrease of cGMP levels from alcohol ingestion play important roles in the mechanism of coronary spasm induced by alcohol ingestion.
Transcutaneous Oxygen Tension Measurement in Patients with Chronic Arterial Obstructive Disease: Reliability and Long-Term variability of the Method
Authors: Melillo Elio , Catapano Giosue' , Ferrari Mauro , Pedrinelli Roberto 
Published: July 2008

Although transcutaneous oxygen tension (TcpO2) measurement may be useful for assessing changes in regional perfusion induced over time by drug or surgical treatment in patients with chronic arterial obstructive disease (CAOD), the reliability of the method over a long-term period is not know To approach this problem, the authors evaluated retrospectively the behavior of TcpO2 measurement over time in patients with CAOD. To eliminate confounding influences due to the concomitant vascular disease at the limb level, data analysis was performed on TcpO2 measured at the right infraclavicular position. The median length of follow-up ranged from twenty days in 34 patients to 832 days in 3 patients (n=2 and n=10 individual sequential replications respectively). Initial and final TcpO 2 values did not differ significantly even at the longest follow-up term, which indicates that the parameter is constant over time. The intrapatient variation coefficient of TcpO2 (calculated over at least three individual replications) ranged between an average of 11% to 16.2%. The corresponding interpatient variation fluctuated between 15.5% and 33.4%, a variability explained to some extent by sex-related influ ences, but, at least in the range of this sample, not by age, arterial oxygen levels, or disease status. Thus TcpO2 levels per se are stable, implying that TcpO2 measurement has the potential to record consistent changes caused by specific therapeutic interventions or the clinical evolution of patients with CAOD. However, the intrapatient and interpa tient variability of the method has to be taken into account when TcpO2 is used for the follow-up and the physiopathologic study of patients with CAOD.
Recurrent Embolization During Intravenous Administration of Tissue Plasminogen Activator in Acute Cardioembolic Stroke
Authors: Yasaka Masahiro , Yamaguchi Takenori , Yonehara Toshiro , Moriyasu Hideki 
Published: July 2008

Treatment with recombinant tissue plasminogen activator (rt-PA) has been applied in acute cardioembolic stroke to reopen the occluded vessel and improve the patient's neurologic deficit. However, the effect of this therapy on intracardiac thrombus has not been documented previously A forty-five-year-old man with dilated cardiomyopathy developed acute cardioem bolic stroke with disturbance of consciousness, right hemianopia, right hemiplegia, and global aphasia. Cerebral angiography demonstrated occlusion of the left middle cerebral artery trunk. Intravenous administration of 30 megaunits (MU) of recombinant tissue plasminogen activator was commenced two hours after the ictus and completed within sixty minutes. Cerebral angiography was repeated just after this treatment and demon strated a new occlusion of the left intracranial internal carotid artery along with occlusion of a branch of the left external artery. The authors subsequently performed two-dimen sional echocardiography and found a mobile thrombus in the left ventricle. In patients with intracardiac mobile thrombi, recombinant tissue plasminogen activator seems to accelerate breakup or detachment of the thrombi and subsequent recurrent embolization. Therefore, it seems better to pay attention to the presence of mobile intracardiac thrombus before commencing intravenous infusion of rt-PA.
Dietary Treatment of Lymphedema by Restriction of Long-Chain Triglycerides
Authors: Soria P. , Cuesta A. , Romero H. , Martinez F.J. , Sastre A. 
Published: July 2008

Two patients suffering from idiopathic unilateral lower limb lymphedema were treated with a diet in which long-chain triglycerides (LCT) were drastically restricted. From the beginning of the treatment, a distinct improvement was observed in both patients, with reduction of the affected limb perimeters, decrease of edema tension, and decrease of skin turgescence. Patient A underwent weight loss, and the reduction of the diameter of the affected limb was greater than that in the nonaffected limb. In patient B, whose weight remained stable during the study, the diameter of the affected limb underwent a remarkable diminution, while no changes were detected in the nonaffected limb. To the authors' knowledge, this is the first report of dietary treatment of idiopathic lymphedema, these being preliminary results of an ongoing study in a group of patients suffering from lymphedema treated with a low LCT diet.