bluuebunny/crossref_metadata_2025_split huggingface dataset:
Platelet Half-Life, Plasma Thromboxane B2 and Circulating Endothelial-Cells in Peripheral Vascular Disease
Authors: Sinzinger Helmut , Fitscha Peter , Peskar Bernhard A. 
Published: November 2007

We studied platelet half-life (T/2), plasma thromboxane B2-levels (TXB2) and circulating endothelial cells in 107 patients with a mean age of 63 ± 6.8 years and angiographically proven peripheral vascular disease (PVD). Patients were divided into 4 groups according to Fontaine but also according to additional clinical manifestations of atherosclerosis like coronary heart disease (CHD) and cerebrovascular disease (CVD). Furthermore, the influence of sex and smoking was investigated. Compared to patients without atherosclerotic manifestations we could detect an enhanced platelet consumption measured as shortended platelet half-life time (79.2 ± 9.1 vs 100.9 ± 5.6 hours, p < 0.001 and an increased platelet activity measured as increased TXB2-plasma levels (51.6 ± 20.9 vs 23.2 ± 11.2 ng/ml, p < 0.001). Correspondingly, the amount of circulating endothelial cells was increased 45.2 ± 25.7 vs 20.3 ± 23.4, p < 0.001). Patients with PVD who smoked had the shortest actual platelet half-life, the highest TXB2 plasma levels and the greatest amount of circulating endothelial cells compared to non-smok ing patients and controls. Patients with clinical stage IV according to Fontaine had the shortest platelet half-life, the highest TXB2 plasma levels and the greatest amount of circulating endothelial cells compared to the other clinical stages. Analyzing the influence of additional clinical manifestations of atherosclerosis we could detect only in patients with PVD and CHD significant differences compared to the other groups.
Improvement of Subcutaneous Nutritional Blood Flow in the Forefoot by Hydroxyethylrutosides in Patients with Arterial Insufficiency: Case Studies
Authors: Jelnes Rolf , Gaardsting Ole , Holm Axel 
Published: November 2007

Four patients with bilateral arterial insufficiency were treated with i.v. hy droxyethylrutoside for three days (1.5 grs twice a day). All patients experienced relief of symptoms. By continuous registration of subcutaneous nutritional blood flow in the forefoot (by 133Xenon clearance tech nique) a significant increase in nutritional blood flow of 33% on the average during the second and third hour after medication could be demonstrated. The drug seems to be of use in treating subacute occlusions and thrombosis of arter ies in the lower extremity.
Nitrendipine vs. Long-Acting Nifedipine in Mild, Moderate and Severe Hypertension
Authors: Guazzi Maurizio D. , De Cesare Nicoletta , Galli Claudia , Tamborini Gloria , Salvioni Alessandro 
Published: November 2007

Long-acting nifedipine and nitrendipine, a nifedipine analogue, have been proposed for single-drug therapy of hypertension. In this study we compared the two preparations in three groups (10 subjects in each group) of mild (group 1), moderate (group 2), and severe (group 3) hypertensives. Drugs were admin istered for seven days (20 mg every 8 hr), according to a randomized, double- blind, crossover design. Blood pressure and heart rate readings were taken hourly, from 8 A.M. to 7 P.M., for the duration of the trial. In group 1, pressure was lowered to normal levels by both compounds and did not recover in the interval between one dose and the other, so that it re mained normal throughout the day. In group 2, from an average of 170/109, values were reduced by the two preparations to 140/90 mm Hg within two hours, and then they tended to recover. This tendency was interrupted by the next dose. Because of this pattern, compared with the placebo period, pressure was substantially reduced during the twelve hours of the day; however, for a certain span it remained higher than normal. In group 3, the immediate re sponses to the two drugs were similar (from an average of 208/130, pressure was lowered to an average of 170/95 mm Hg), and then it tended to rise again and recovery was faster with nifedipine. Although pressure was significantly re duced throughout the day by both preparations, normotension was never achieved in this group. Neither drug induced a tachycardia reaction, altered renal or cardiac func tion, or affected body weight or plasma renin activity. The tendency to produce dependent edema was less pronounced with nitrendipine. In conclusion, these calcium channel antagonists were equally effective in mild and moderate hypertension, while in the severe form the action of nitrendi pine was more persistent. Within the limits of the drug regimens used in this study, it seems that both preparations as monotherapy may be satisfactory in mild, questionable in moderate, and inadequate for severe hypertension, al though the action of nitrendipine is more lasting.
Continuous Infusion Treatment with Pentoxifylline in Patients with Severe Peripheral Vascular Occlusive Disease
Authors: Angelides Nicos S. 
Published: November 2007

The effect of continuous i.v. infusion of pentoxifylline, administering 1,200 mg/24 hours through 15 days, was studied in 22 patients (19 m, 3 f) with arterio graphically confirmed extensive occlusion in the femoro-popliteal segment, as sociated with marked intermittent claudication and rest pain of varying sever ity. The following parameters were used for the verification of the therapeutic response: Flow resistance factor (RF), pressure indices at rest (RPI) and after exercise (PPI and recovery time (RT) assessed by means of ultrasonic Doppler technique; muscle and skin blood flow at rest and after exercise using 99m Technetium Clearance Technique (TC); toe skin temperature (TST) by electric thermometer; painfree walking distance (WD) assessed on treadmill (horizon tal, 4 km/h); rest pain (RP) was assessed by a 4-step-relief-scale. There was an overall good response to treatment, the studied parameters showing the following changes: RF improved in 12/17 patients (= 70%); RT decreased in 14/22 patients (= 63%) RPI and PPI showed no change; TC (mus cle) increased after exercise in 17/22 patients (= 77%); TC (skin) increased after exercise in 20/22 patients (= 90%); WD increased on average by 80% (from 115 m to 206 m); TS increased in 16 limbs; RP showed an overall relief. The results of this study indicate that the continuous infusion of pentoxifyl line is safe and effective in improving the condition of patients with severe pe ripheral vascular disease.
Aortic Connective Tissue in Atherosclerotic Aorta— A Biochemical Study
Authors: Andreotti Lupo , Bussotti Alessandro , Cammelli Daniele , di Giovine Francesco , Sterrantino Gaetana , Varcasia Giuseppe , Arcangeli Paolo 
Published: November 2007

Biochemical analysis of the extracellular matrix of human aortas was per formed on samples of ascending and descending aortas affected by atherosclero sis in comparison with a control group of nonatherosclerotic aortas. Ulcerated or heavily calcified atheromas were excised and excluded from the analysis in order to differentiate biochemical alterations leading to the forma tion of atheromas from those due to complications of already formed athero mas. Our results show that the development of atheromas brings about an exten sive destruction of elastic fibers and muscular cells, and their place is occupied by other components of the extracellular matrix, most notably, collagen, non uronic sugars, water, and lipids, which were found significantly increased.
Angina Pectoris and Acute Myocardial Infarction Due to "Slow-Flow Phenomenon" in Nonatherosclerotic Coronary Arteries: A Case Report
Authors: Przybojewski Jerzy Z. , Becker Peter H. 
Published: November 2007

A 51 year-old White woman with angina pectoris and nonatheromatous cor onary artery disease is presented. Cardiac catheterization demonstrated a "slow-flow phenomenon" in the left coronary artery accompanied by severe angina pectoris and anterolateral ST-segment elevation and culminating in an acute nontransmural myocardial infarction. At repeat coronary arteriography, ergonovine maleate provocation proved negative. This patient is unique, since the previously documented 6 cases with this coronary cineangiographic response did not exhibit angina pectoris or ECG evidence of myocardial ischemia during the "slow-flow phenomenon," and none was complicated by an acute myocardial infarction. Various aspects of the pathophysiology of angina pectoris in this patient, including the recently de scribed "reduced vasodilator reserve" concept, are briefly outlined.
Arteriosclerotic Carotid Lesions in Hyperlipoproteinemia
Authors: Mannarino E. , Susta A. , Tazza D. , Pistola L. , Senin U. 
Published: November 2007

An ultrasonographic study was performed in 187 hyperlipoproteinemia pa tients to evaluate the incidence of atheromatous lesions in the extracranial ca rotid tract. A high-resolution, real-time, B-mode instrument with two probes (4- and 8- MHz) was used. Fifty-five subjects had high blood cholesterol levels, 70 high triglyceride values, and 62 both. Arteriosclerotic disease was present at other sites in 39% of the patients. Atheromatous carotid lesions were revealed in 37% of the patients, and there seemed to be no significant correlation with the type of hyperlipoproteinemia. There was also no correlation between blood cholesterol levels and the presence or absence of atheromatous lesions. Increasing age and arteriosclerotic disease at other sites were the factors most frequently associated with atheromatous lesions in the extracranial carotid tract.
Laser-Doppler Examinations in Persons with Healthy vasculature and in Patients with Peripheral Arterial Occlusive Disease
Authors: Ranft J. , Heidrich H. , Peters A. , Trampisch H. 
Published: November 2007

Recently, a new procedure for noninvasive measurement of the microcircu lation has been developed in the form of a helium-neon-laser Doppler apparatus with which the total erythrocyte flow through a cubic millimeter of skin is quan tifiable. The authors used the procedure to examine 17 persons with healthy vessels, 36 patients with a degenerative occlusive disease of the peripheral arteries in Fontaine stages II-IV, and 5 patients with endangiitis obliterans. It is concluded that single measurements do not permit an assessment of microcirculatory conditions but that provocative tests (which are described), especially occlusion tests, make possible valid and reproducible statements and have a high selectivity with respect to the different stages of disease. By repeated measurements followed by calculation of mean values, a further reduction in intraindividual variability among the measurement results can be obtained. Laser-Doppler examinations of the skin constitute a new procedure with which quantitative statements on the blood flow through skin are feasible and from which interesting results can be expected, especially when used as an acute test.
Felodipine Compared to Nifedipine as "Third-Line Drug" in Resistant Hypertension
Authors: Maclean Derek , Mitchell Elizabeth Thomson , Sandilands Readman Ann 
Published: November 2007

Felodipine is a new dihydropyridine calcium antagonist, and in hypertension it is a much more effective "third-line" drug than hydralazine. Nifedipine, on the other hand, is the established dihydropyridine calcium antagonist that has been increasingly used to treat hypertension. Information is now needed on the relative merits and demerits of these two drugs. This study appraised, there fore, the therapeutic utility of twelve months' treatment with nifedipine 20-60 mg twice daily in 55 patients with previous drug-resistant hypertension who had been successfully treated for the previous year with felodipine 5-20 mg twice daily, each calcium antagonist being used in combination with atenolol 100 mg daily with or without chlorthalidone 25 mg daily. Initially, nifedipine main tained comparable blood pressure control to that which had been achieved by felodipine, although in the longer term (over eight months) nifedipine proved less effective than felodipine had (p < 0.02) and more patients became uncon trolled (supine diastolic blood pressure, Phase V, ≥90 mmHg) on the maximum tolerated dose of the calcium antagonist (χ2=4.13, p < 0.05 > 0.025). The former degree of blood pressure control was, however, reestablished by increas ing the dose of nifedipine or reintroducing the diuretic as necessary, and this control was maintained over the next four months. Minor side efects were less common on nifedipine than they had been during the preceding felodipine treatment phase. Felodipine thus has more pronounced and sustained antihypertensive effects than nifedipine, though its side effect burden may appear to be greater. Because of possible treatment order effects and the development of tolerance to dihydro pyridine side effects, formal comparison of these two compounds is warranted.
The Influence of R-Wave Amplitude on the Degree of ST-Segment Depression in Exercise Electrocardiography in the Individual Patient
Authors: Cokkinos Dennis V. , Papantonakos Apostolos , Perrakis Costas , Argyrakis Spyros , Kouvaras George , Tzonou Anastasia , Patsouros Kyriakos 
Published: November 2007

Many factors have been found to influence the magnitude of ST-segment depression in the exercise electrocardiogram. We investigated whether R-wave amplitude is a significant factor. We studied the exercise electrocardiogram of 20 patients with angiographically documented coronary artery disease, including ≥ 70% stenosis of the left anterior descending artery, who had an ischemic response to exercise but no previous anterior myocardial infarction. Precordial leads V1-6 were taken into account. When all 120 leads were measured, those with ST-segment depression ≥ 2.0mm at peak exercise had a mean resting R-wave amplitude of 19.03±5.81mm; those with ST-segment depression 2.0-1.0mm, R 11.42±5.99mm; and those with ST-segment depression < 1.0mm, R 5.9±5.21mm (p < 0.001 between groups). When the R-wave amplitude was correlated with the ST-segment depression in each precordial lead, the correlation was 1.0. In leads V1-6, when 67 tracings with ST-segment depression > 0.5mm were measured, the correlation was 0.537 (p < 0.001). In each precordial lead the t values of R-wave differences correlated very strongly (r < 0.883) with the differences in ST-segment depression. We conclude that precordial R-wave amplitude significantly influences the magnitude of ST-segment depression.
Platelet Resistance to Prostacyclin. Enhancement of the Antiaggregatory Effect of Prostacyclin by Pentoxifylline
Authors: Manrique R.V. , Manrique V. 
Published: November 2007

With regard to existence of high prostacyclin (PGI2) levels during atheromatosis and thrombus formation, resistance of platelets to prostacyclin and its analogues seems to play an important pathophysiologic key role for the clarifying of vasoocclusive phenomena. Platelet resistance to prostacyclin was studied in vitro and ex vivo in 160 atherosclerotic patients (assessed by objective diagnostic criteria) with and without thrombotic complications and in 50 controls. Prostacyclin resistance phenomena were more pronounced and frequent in patients with occlusive complications, the difference from controls being statistically significant. However, there was no significant difference between the controls and the nonthrombotic patient sample. The intraplatelet cAMP levels might be the metabolic basis of the PGI2 resistance phenomenon, because in the patient group, platelet cAMP levels were decreased by 50% after Ca2+ stimulation. Compared to controls β-thromboglobulin and thromboxane B2 plasma levels were significantly increased (30±9 to 87±26 ng/ml and 9±5 to 54±21 pg/ml, respectively), confirming the hyperreactivity state of resistant platelets. From the therapeutic point of view, patients with resistant platelets require PGI2 doses that cause, however, increased side effects. We were able to demonstrate in vivo that IV pretreatment with pentoxifylline—a known stimulator of cAMP formation in platelets—followed by a simultaneous and continuous IV infusion of PGI2 + pentoxifylline, permitted us to reduce significantly the mean PGI2 doses needed for triggering an antiplatelet effect, without inducing side effects. In ex vivo studies, PGI2 resistant platelets of atherosclerotic patients pretreated with pentoxifylline showed normalized stimulation response, and platelet cAMP levels increased from 7.8±2.7 to 15.2±1.9 pmol/108 platelets. Our data disclose a synergistic antiplatelet effect of PGI2 and pentoxifylline, which increases the antithrombotic potential and sheds light on the beneficial effects of pentoxifylline in the treatment of occlusive vascular disease.
Thermography as a Predictor of the More Involved Side in Bilateral Carotid Disease: Case History
Authors: Soria Emilio , Paroski Margaret W. 
Published: November 2007

Contact thermography using liquid crystals provides a simple, inexpensive method of evaluating carotid disease. It does not duplicate information provided by other noninvasive methods, because, whereas Dopplers give an indication of flow and degree of stenosis in the artery, thermography measures the actual hypoperfusion as demonstrated by diminished temperature in areas of the forehead supplied by branches of the ophthalmic artery. A 74-year-old man presented with bilateral carotid distribution TIAs. Carotid Dopplers and angiography revealed 99% occlusion of both internal carotid arteries. Contact thermography showed diminished temperature in the right supraorbital artery territory. The patient subsequently underwent carotid endarterectomy. Following induction of anesthesia but prior to carotid clamping, the patient became transiently hypotensive. Intraoperative EEG monitoring showed marked attenuation of the background rhythm on the right with preservation of background on the left. Normal rhythm was quickly restored with pharmocologic restoration of the blood pressure. This case illustrates the usefulness of thermography, which predicted the hemisphere in jeopardy when Dopplers and angiography showed equal bilateral disease.
Adrenal Cortical Adenoma and Adrenal Medullary Hyperplasia of the Right Adrenal Gland—A Case Report
Authors: Borrero Edgar , Katz Paul , Lipper Stanley , Chang John B. 
Published: November 2007

The normal adrenal gland contains two types of tissue, the adrenal cortical tissue and the adrenal medullary tissue. The cortex is divided into three portions: the outermost "zona glomerulosa," the central "zona fasciculata," and the innermost "zona recticularis." The adrenal medulla is a developmentally separate organ, derived from neuroectoderm, and is the site of epinephrine and norepinephrine production. Adrenal cortical adenoma is commonly the result of a basophilic tumor of the anterior pituitary that secretes excessive amounts of ACTH. Adrenal medullary hyperplasia (or pheochromocytoma) are clinically hazardous tumors because of their excessive secretion of catecholamines. Combined adrenal cortical adenoma and adrenal medullary hyperplasia of the right adrenal gland has never been described previously.
Thallium 201 Muscle Scintigraphy: Application to the Management of Patients with Arterial Occlusive Disease
Authors: Chevreaud C. , Thouvenot P. , Lapeyre G. , Laurens M-H. , Renard C. 
Published: November 2007

Skull (S), thigh (T), and calf (C) scintigraphies were performed by using 2 mCi thallium 201 IV in 30 patients suffering from stages II, III, and IV arterial occlusive disease (Fontaine's classification). Two indexes were calculated: P=T/C-C/S (T/C and C/S were the absolute values of radioactivity ratios measured before medical treatment) and R=Δ(C/S)-Δ(T/C) (where Δ expressed the relative variation of the ratios measured after treatment and compared with initial values). Angiography was performed on all patients prior to treatment, and the results were quantified as 1 in the case of obliteration and 0.5 in case of stenosis of major arterial axes. Clinical improvement was demonstrated by a 100% increase in walking distance for stage II disease, abolition of pain at rest for stage III disease, and reepithelialization of trophic lesions for stage IV disease. Paraclinical effectiveness was evaluated by measuring ankle systolic pressure (SP) and index (SI) before and after treatment. The correlation observed between the values of P and angiography results was p < 0.025 (Student t-test). The mean of P (measured before treatment) was 1.75 for the improved patients and 0.56 for the others (p < 0.005). After treatment, R was + 58% for improved patients versus —13% in those in whom the treatment was inefficient (p < 0.025). P expresses the microcirculatory effects of arterial lesions detected by angiography. It is a prognostic index: satisfactory proximal perfusion (high T/C), associated with lesions that are essentially peripheral (low C/S), predicting a positive effect of medical treatment. R measures the increase in peripheral circulation (increase in C/S) at the expense of the proximal region (decrease in T/C) and quantifies the results of treatment. SI gives the same information, but the correlation is less precise.
Prognostic Implications of Left Ventricular Function During Exercise in Asymptomatic Patients with Aortic Regurgitation
Authors: Lindsay Joseph , Silverman Angela , Van Voorhees Lucy B. , Nolan Nicholas G. 
Published: November 2007

Few data are available that address the prognostic implications of the response of the left ventricle (LV) to exercise in asymptomatic patients with aortic regurgitation (AR) who have normal resting LV function. Thirty-one such patients were contacted two to seven years after rest and exercise radionuclide ventriculography. Eleven had had significant cardiovascular events. Event-free survival at forty-eight months was 64%. Ten of eleven events occurred in 21 patients with decline in ejection fraction (EF), but the magnitude of decline did not further separate the group with regard to prognosis. Eight events (73% of total events) occurred in the 11 patients (35% of total patients) with an EF during exercise of 0.55 or less. The short and intermediate outlook for asymptomatic patients with AR and normal resting LV function is good regardless of the response of the EF to exercise, but an exercise EF ≤ 0.55 does identify a relatively high-risk subset for deterioration beyond twenty-four months.
Effect of Pindolol and Propranolol on Sinus Node Recovery Time and Atrioventricular Conduction Intervals
Authors: Kostis John B. , Binenbaum Steve Z. , Oliveri Philip , Sclar Craig , Hosler Maryhelen 
Published: November 2007

In a randomized, observer-blind study, the effect of incremental doses of pindolol 0.001, 0.002, 0.003, and 0.004 mg/kg IV and propranolol 0.01, 0.02, 0.03, and 0.04 mg/kg IV on SA nodal recovery time (SNRT) and atrioventricu lar conduction interval (AH) was assessed in 20 patients (15 men and 5 women age range thirty to seventy-two, mean age fifty-three). AH and His bundle-to- ventricle (HV) intervals and SNRT were measured at spontaneous heart rate and at incremental atrial pacing rates (80, 100, 120, 140 bpm). Both drugs caused significant beta blockade as estimated by the percentage suppression of heart rate increment induced by 3 mcg isoproterenol administered intraven ously (pindolol 67.6±5.3%, P < 0.007; propranolol 38.6±10.6%, P < 0.001). Propranolol significantly prolonged SNRT (P < 0.05) and AH interval (P < 0.05). Pindolol did not significantly affect either SNRT (P=0.25) or AH intervals (P=0.78). Significant effects on HV interval were not seen. Thus, in the doses tested that resulted in significant beta blockade, pro pranolol prolonged SA nodal recovery times and depressed AV nodal conduc tion while pindolol did not affect these variables.