bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Significance of Chlamydia pneumoniae in Symptomatic Carotid Stenosis
Authors: Katsenis Constantin , Kouskouni Evangelia , Kolokotronis Ludovikos , Rizos D. , Dimakakos P. 
Published: July 2008

An association between symptomatic carotid stenosis and recent infection with Chlamydia pneumoniae is reported. Thirty-five patients (20 symptomatic and 15 asymptomatic) with carotid stenosis of 70% to 90% underwent carotid endarterectomy. Endarterectomy was performed without patch and shunt; the average occlusion time of the internal carotid artery was 14 ±3 min. The atheromatic plaque and a portion of the thyroid artery were examined with polymerase chain reaction and peripheral vein blood was obtained for serologic detection of systematic infection, and IgG and IgM antibodies to C. pneumoniae by enzyme-linked immunosorbent assay. Twenty of 35 patients (57.1 %) had increased titers of IgG antibodies to C, pneumoniae. Eight patients revealed IgG plus IgM antibodies; two of the eight had IgG, IgM, and positive findings on polymerase chain reaction. No C pneumoniae was detected on the thyroid arteries. Sixty-five percent (13/20) of the patients with increased IgG antibodies to C. pneumoniae, 87.5% (7/8) with IgG + IgM, and 100% with IgG + IgM + positive polymerase chain reaction were symptomatic. Plaque morphology in association with symptoms did not reveal a significant correlation between soft plaques and symptoms, whereas the majority of the symptomatic patients had plaques of type III-V. Patients having recent contamination and positive poly merase chain reaction had a significant relationship between C. pneumoniae infection and symptomatic carotid disease. This supports the hypothesis that C. pneumoniae infection can produce a kind of instability of the carotid plaque. The results of this study demonstrate that patients with advanced atherosclerotic carotid disease have an increased incidence of C. pneu moniae infection. Recent infection could be responsible for instability of the carotid plaque, causing cerebral ischemic episodes.
Mitral Leaflet Billowing and Prolapse: Its Prevalence Around the World
Authors: Cheng Tsung O. , Barlow John B. 
Published: July 2008

Primary mitral leaflet billowing, or so-called mitral valve prolapse, has become the most common valve anomaly in the United States and is also frequently found throughout the world. Its prevalence varies from less than 1% to 38%, differing not only between countries but also within the same country. The prevalence de pends on whether the study is clinical or echocardiographic, based on au topsy or surgical material, or of hos pital or non-care-seeking population. Other explanations for the varying prevalence are the age, sex and weight differences of the study popu lation, imprecise terminology, the care with which auscultation and/or echocardiography are carried out and interpreted, and some selection biases. Although prevalent throughout the world, the condition is generally benign and can often be regarded as a normal variant. Among the compli cations of mitral valve prolapse, pro gressive mitral regurgitation and in fective endocarditis are particularly noteworthy. Primary mitral valve prolapse is currently a leading cause of mitral regurgitation and also of in fective endocarditis.
Abdominal Aortic Aneurysm with Inferior Vena Cava Obstruction: Case Report
Authors: Demircioglu Fatma Ferkan , Böke Erkmen , Demircin Metin , Dagsali Sabri , Küçükali Türkan 
Published: July 2008

Behçet's syndrome, a multisystem disorder, is characterized by recurrent oral and genital aphthous ulcerations, eye lesions, and skin changes. Other manifestations, although rare, may affect the nervous, gastrointestinal, or loco- motor system, as well as veins and arteries. Vascular lesions occur in approxi mately 30% of reported cases. Although thrombosis in the larger veins is frequent, arterial thrombosis is somewhat less likely to occur. Only a few cases of arterial aneurysm have been documented in the literature. This report describes a patient who had suffered from Behçet's syndrome for fifteen years and in whom a complete obstruction of the inferior vena cava was demonstrated. An aortailiac bypass was performed successfully, and the patient had had a good clinical recovery at long-term follow-up.
Overall Tolerance and Safety of Quinapril in Clinical Trials
Authors: Frank G.J. , Knapp L.E. , McLain R.W. , Frank Graham J. 
Published: July 2008

A comprehensive analysis of the reporting of adverse events, with drawals due to adverse events, and serious adverse events has been con ducted on 2,010 patients treated with quinapril hydrochloride. An analysis of all events (from both double-blind and open label studies combined) showed no increase in the incidence of events reported in congestive heart failure (CHF) patients compared to hypertensive patients. When the data for all studies were combined, an age analysis showed no increase in the total reporting of ad verse events in the 379 elderly pa tients studied. The incidence of events was lower in those patients who did not take concomitant di uretic therapy. A comparison of the double-blind phases showed quinapril to have a lower incidence of adverse events than captopril, enalapril, or chlor thalidone. An analysis of the onset of events, or withrawals, did not show an increase with time on quinapril therapy, and no dose-relationship. A review of serious adverse events did not reveal an unexpected occurrence or a high incidence of serious events considered to be related to quinapril therapy. The proportion of patients who experienced "first-dose" hypo tension, or symptomatic hypotension was similar to captopril or enalapril. Quinapril, a nonsulfhydryl ACE inhibitor, has been extensively stud ied and is equally well tolerated in the young and elderly for the treatment of hypertension and CHF.
Blackfoot Disease in Taiwan: A 30-Year Follow-up Study
Authors: Tseng Wen-Ping 
Published: July 2008

Blackfoot disease is an endemic peripheral vascular disease found among the inhabitants of a limited area on the southwest coast of Tai wan, where artesian well water with a high concentration of arsenic has been used for more than eighty years. The natural history of blackfoot dis ease, based on a prospective study of 1,300 patients, is presented. The overall male/female ratio was 1.5:1. Although the clinical onset was usu ally insidious, it may be quite sudden and almost always begins with numb ness or coldness in one or more ex tremities, usually the feet. Ultimately, rest pain develops and progresses to gangrene. In this series, 68% of the patients underwent spontaneous or operative amputation, and the reamputation rate was 23.3%. Lower extremity in volvement in blackfoot disease was observed in 97.7% of the cases. The average annual rate for major ampu tation was 3.81 per 100 patient-years. The factors influencing the progno sis, such as amputation in relation to age and disease onset, are analyzed. The case fatality rate was 66.5% during thirty years; 44% of these were cardiovascular deaths. The an nual death rate was 4.84 per 100 pa tient-years. Other reported case fatality rates for vascular insuffi ciency are reviewed. A dose-response relationship between blackfoot dis ease and the duration of water intake was also noted. The survival rates af ter the onset of blackfoot disease were: five years, 76.0%; ten years, 59.5%; twenty years, 38.2%; thirty years, 28.6%. The 50% survival point was 13.5 years after onset of the dis ease.
Stress Testing in Patients One Year After Orthotopic Cardiac Transplantation
Authors: Hidalgo R. , Alegriá E. , Castelló R. , Aparicí M. , Peteiró J. , Sáenz de Burugaga J. , Martínez-Caro D. 
Published: July 2008

To evaluate the circulatory re sponse of the denervated heart to ex ercise, the authors studied 15 patients with an orthotopic transplanted heart (TH). Mean age was 48±10 (range twenty-five to sixty-two) years. All patients underwent a symptom-lim ited bicycle stress testing following a continuous protocol increasing the work load by 30 watts every three minutes. Exercise test was performed 16±9 months after operation. Fifteen healthy subjects matched for age were used as the control group. There were significant differences (p < 0.01) in heart rate, at rest, peak exercise, and at five minutes of the recovery period, in maximal oxygen consumption (VO2 max) and in dura tion of exercise between TH patients and controls. Synchronization between recipi ent and donor sinoatrial nodes was observed in 10 of 15 patients. A case of silent myocardial ischemia was also observed in a patient with vascu litis and acute rejection. In conclusion, the lack of neural control in TH patients allows them to maintain a normal resting cardiac output but precludes attaining a nor mal maximum oxygen uptake, de spite a normal contractile state. The high resting heart rate due to para sympathetic denervation constitutes an important limiting factor for an adequate chronotropic reserve. Functional capacity of transplanted patients is slightly impaired, but it does not preclude a good quality of life.
Microvascular Evaluation of the Effects of Nifedipine in Vascular Patients by Laser-Doppler Flowmetry
Authors: Belcaro Giovanni , Nicholaides Andrew N. 
Published: July 2008

Skin blood flow in the microcirculation of the distal foot was evaluated in patients with vascular disease and diabetes and compared with that in normal volunteers by use of laser-Doppler flowmetry. Resting flow (RF) and the flow on standing (SF) were measured in a room at constant temperature (20-22°C). RF was significantly different in the five groups, being increased in patients with diabetes (in comparison with normal volunteers) and decreased in patients with intermittent claudication, rest pain, and ischemic limbs. The venoarteriolar reflex (in response to standing) was also decreased or abolished in diabetic and in all vascular patients. After treatment of all vascular patients with nifedipine (10 mg tid) for one week, there was a significant increase in RF in all patients. The venoarteriolar reflex was improved but still remained below the normal limit. In conclusion laser-Doppler flowmetry is useful both for differentiating classes of different vascular patients and for evaluating the microcirculatory changes induced by nifedepine.
Increased Arterial Pulse Wave Reflections and Pulsatile Energy Loss in Acute Hypertension
Authors: Li John K.-J. 
Published: July 2008

Increased afterload is normally associated with hypertension. The work of the heart increases to overcome this load, but whether this is beneficial for pulse transmission has not been examined. Experimental measurements were obtained in induced acute hypertension in dogs. Results show that increased pulse wave reflections compound the increase in arterial blood pressure, and the increased work output by the left ventricle is compromised by the reduced efficiency of pulsatile energy transmission to organ vascular beds.
Free Calcium in Rat Papillary Muscle at Contraction Assessed with Ca-Selective Microelectrodes
Authors: Gasser R. , Frey M. , Fleckenstein-Grün G. 
Published: July 2008

Direct measurements of free intracellular calcium (Ca)i are needed for an understanding of the regulation of contractility. An on-line measurement of (Ca)i with Ca-selective microelectrodes in intact muscle strips provides a suitable means of investigating this problem, although considerable methodologic difficulties exist. Measurements of (Ca)i concentrations during muscle contraction have been carried out by different methods such as Ca-binding techniques and aequorin luminescence, but remain unsatisfying, since they were not performed on intact muscle strips. The authors' measurements were carried out with Ca-selective microelectrodes on rat papillary muscles (stretched to optimal length in a perfusion bath of 1.54 mL at 30°C). The impalement of electrodes was considered adequate when the heights of Ca-electrode potential and membrane potential remained constant for more than twenty minutes. For provoking contractile responses, the authors replaced the normal Tyrode solution by a caffeine-containing contracture solution (content in mM: 0 NaCl [choline], 4 CaCl2, 30 KCI, 25 caffeine, 1.05 MgCl2). Ca-se- lective microelectrodes were calibrated before and after each measurement and only those impalements were taken as adequate that showed identical calibration curves before and after the experiment. They measured the (Ca)i at 20%, 50%, and 80% of maximal contractile force and obtained (Ca)i concentrations of 1.1 ± 0.3 μM (at 20%), 3.6 ± 1.2 μM (at 50%), and 11.8 ± 0.27 μM (at 80%) (n=6, ±SEM). These results represent the first on-line measurements of the myocardial (Ca)i concentrations with Ca++selective microelectrodes in intact muscle strips during various degrees of contraction. It can be seen that contractile response does not occur below a (Ca)i concentration of 1 μM. Maximal contractile response is reached at (Ca)i concentrations beyond 10 μM.
Rate-Dependent ST Segment Depression—A Case Report
Authors: Akgün Güneş , Diker Erdem , Kaymakalan Sabahat , Kervancioglu Celal 
Published: July 2008

A patient with resting heart rate over 100 beats per minute (bpm) displayed 1.5-2 mm ST segment depression in her ECG during daily activities. She had unprovoked further increase in her heart rate up to 145 bpm, and during these episodes, her ECG displayed further ST segment depression up to 3 mm and of 0.12 second duration. An organic cause could not be found to explain her sinus tachycardia. Results of all laboratory investigations, including coronary angiography, were normal. It was observed that during an episode of reflex vagotonia, when her heart rate was below 95 bpm, her previously depressed ST segments became isoelec tric. With the thought that this patient's ST segment depression was rate depen dent, carotid sinus massage was performed, and when the heart rate slowed to 95 bpm her depressed ST segments became isoelectric. The same response was accomplished with beta blockers. Sympathetic hyperactivity was thought to be the most likely mechanism of ST segment depression in this patient. A critical increase in heart rate caused these ECG abnormalities.
Clinical Efficacy of Picotamide in Long-Term Treatment of Intermittent Claudication
Authors: Coto Vincenzo , Cocozza Manlio , Oliviero Ugo , Lucariello Antonio , Picano Tommaso , Coto Francesco , Cacciatore Luigi 
Published: July 2008

The clinical efficacy of picotamide was investigated in a randomized, double- blind, placebo-controlled study in patients with peripheral occlusive arterial disease of the lower limbs at functional stage II of the Fontaine classification. Forty patients with a history of claudication for at least six months were admit ted to the study and were given either 3 x 300 mg tablets of picotamide (20 subjects) or three identical placebo tablets (20 subjects) for six months. The two groups of patients were similar in regard to clinical features and potential risk factors. At the end of treatment painfree walking distance and systolic ankle-arm pressure ratio improved more in the picotamide than in the placebo group (p=0.05). Systolic ankle pressure curves, determined before and after the six- month treatment, showed a positive trend to a higher postexercise ankle pres sure and a faster return to the preexercise levels in the picotamide group; however, the difference was not statistically significant. Laboratory monitoring revealed a slight prolongation of bleeding time, a significant decrease in arachi donic acid-induced platelet aggregation, and an enhanced fibrinolysis with ab sence of interference with hemostasis in the picotamide group. One patient in the placebo group developed a major cardiovascular event (angina pectoris) during the study. These results indicate that picotamide is an effective drug that may modify the natural course of intermittent claudication and associated vascular prob lems.
Behçet's Disease in the Etiology of Budd-Chiari Disease
Authors: Saatci Isil , Ozmen Mustafa , Balkanci Ferhun , Akhan Okan , Senaati Sassan 
Published: July 2008

Hepatic venous outflow obstruction (Budd-Chiari syndrome—BCS) was diagnosed in 30 patients during the period from March, 1987, to May, 1991, in Hacettepe University Hospital, Turkey. Patients with Behçet's disease constituted the major group (12/30) in the etiologic distribution. Although the vascular manifestations of Behçet's disease, including venous and arterial occlusions, varices, and aneurysms, are well known, the hepatic vein involvement has been reported in only 22 cases in the literature so far. The authors present 30 cases of BCS, of whom patients with Behçet's disease comprise the largest group (40%). The angiographic findings are not specific to Behçet's disease. It is noted, however, that inferior vena cava involvement is more common in these patients (83.3%) than it is in the rest of the group (61.1%). It is suggested that Behçet's disease should be included among the diagnostic possibilities in a case of BCS, particularly in the countries in which it is prevalent.
Hyperhidrosis—A Case History
Authors: Rosenblum Jay A. , Cohen Jeffrey M. , Lee Mathew 
Published: July 2008

The authors present a case report on hyperhidrosis. The social and occupa tional consequences of this disease entity are discussed as well as the genetic implications of this disorder. The medical and surgical treatments of hyperhidrosis are evaluated. The use of infrared imaging techniques as a cost-effective, rapid, noninvasive procedure to diagnose this disorder is described.
Changed Blood Rheology in Patients With Idiopathic Dilated Cardiomyopathy
Authors: Gustavsson Carl Gunnar , Persson Sylvi U. , Larsson Hans , Persson Stig 
Published: July 2008

Rheologic properties of blood were studied in 8 patients with dilated car diomyopathy (DCM) and in 10 healthy subjects. Whole-blood viscosity was measured at four different shear rates, by means of a computer-controlled rota tional viscometer. The patients had significantly higher blood viscosity at all shear rates, both at their natural hematocrits and after an in vitro adjustment of sample hematocrits to 45%. Erythrocyte filterability (5 μm pore size) was significantly lower, fibrinogen concentration significantly higher, and HDL-cho lesterol concentration significantly lower in the patient group. No significant differences were found regarding hematocrit, mean corpuscular volume, hemo globin concentration, leukocyte count and filterability (8 μm pore size), plasma viscosity, and total cholesterol concentration. The measured hemorheologic abnormalities may contribute to the previ ously reported reduction of coronary blood flow reserve in DCM patients and to myocardial microcirculatory disturbances, which have been suggested as a cause for DCM.
Hemodynamic, Hemorheologic, and Hemocoagulative Changes After Treatment With Picotamide in Patients Affected by Peripheral Arterial Disease (PAD) of the Lower Limbs
Authors: Neirotti Massimo , Molaschi Mario , Ponzetto Maria , Macchione Carmine , Poli Leone , Bonino Flavio , Fabris Fabrizio 
Published: July 2008

Effects of picotamide on platelet activity and on some hemorheologic, coagu lative, and hemodynamic parameters were investigated in a randomized, dou ble-blind, placebo-controlled study for eighteen months. Twenty patients, average age 61.5±9.6 (SD) years, with peripheral arterial disease (PAD) at functional stage 2 of the Fontaine classification and with intermittent claudica tion for at least six months were studied. Ten patients received tablets of picotamide, 300 mg three times a day, and 10 subjects received three identical placebo tablets each day. Similar atheroscler otic disease risk factors were present in both groups. Picotamide induced a significant decrease of plasma viscosity, fibrinogen, and beta-thromboglobulin and an increase of amplitude of the photoplethysmo graphic wave.
Study of the Antiischemic Action of EGb 761 in the Treatment of Peripheral Arterial Occlusive Disease by TcPo2 Determination
Authors: Mouren X. , Caillard Ph. , Schwartz F. 
Published: July 2008

In a randomized, placebo-controlled, double-blind, parallel study of 20 patients, the anti ischemic effect of EGb 761 (Ginkgo biloba Extract) was studied by measuring the tran scutaneous partial pressure of oxygen (TcPo2) during exercise. Transcutaneous oximetry during exercise provides a good, noninvasive estimation of local arterial perfusion and constitutes a real index of local and regional capillary perfusion. Twenty patients between the ages of forty-four and seventy-three years suffering from claudicating atherosclerotic arterial occlusive disease in stage II according to the Leriche and Fontaine classification, diagnosed for more than a year and stable for three months, were included. The eligible patients received placebo for fifteen days under single-blind conditions. At the end of this preinclusion period, the eligibility criteria were checked and the patients were randomized to two treatment groups. The first group received 320 mg per day of EGb 761 for four weeks and the second group received placebo. The treadmill walking test was performed under standardized conditions at the same time of day and by the same investigator. In a comparison of the differences before and after treatment, the areas of ischemia decreased by 38% in the EGb 761 group but remained essentially stable (+5%) in the placebo group. This difference between groups is significant (F [1.18] =4.91; P=0.04) and the 95% confidence interval for the difference ranges from 0.89 to 3.87. This study confirmed significantly the rapid antiischemic action of EGb 761 and its value in the management of peripheral arterial occlusive disease at the stage of inter mittent claudication.
Combined Type B Aortic Dissection and Fusiform Abdominal Aortic Aneurysm
Authors: Van Schil P. , De Vries D. , Vanmaele R. , Demey H. 
Published: July 2008

Two patients are described with a combined type B aortic dissection and a fusiform abdominal aortic aneurysm, the dissection not involving the aneurysm. In a seventy- year-old man a type B aortic dissection and a large abdominal aneurysm were found. An infrarenal aortic bifurcation graft was inserted. He died fifteen months later of cardiogenic shock. In a sixty-six-year-old man diagnosis of a primary aortoduodenal fistula was made together with a limited type B dissection. A straight aortic interposi tion graft was inserted. He died eleven months later of the complications of a secondary aortoduodenal fistula. Although combination of aortic dissection and abdominal aneurysm is a rare occur rence, conservative management of the aortic dissection and interposition graft for the abdominal aneurysm was successful as initial treatment in these 2 patients.
Three-Dimensional Surface Display in Blood Pool Gated SPECT
Authors: Indovina Angelo G. 
Published: July 2008

In 14 patients (4 in good health and 10 with coronary heart disease) a blood pool gated single photon emission computed tomography (SPECT) was executed. The transaxial slices of the cardiac blood pool were reconstructed. A three-dimensional surface display was employed for the analysis of the tomographic data. A fixed distance, a fixed threshold (50%), and some different planes of view were employed. The test permitted visualiza tion of the ventricular and the atrial movements in all patients. The right ventricle was clearly seen in the right anterior oblique plane of view. The aortic beating was seen. In normal patients the left ventricle, clearly seen in left anterior oblique plane, shrank to a thin shank. In 4 patients with septum infarct the blood pool was seen to persist in the septum area in front of the lateral wall shrinking (akinesis). The opposite happened in patients with anterolateral wall coronary artery disease. Three-dimensional surface display of blood pool gated SPECT shows a real three- dimensional picture of the dynamic heart and is a new noninvasive approach to the heart patient.