bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Different Amounts of Blood Transfusion Given at Different Speeds on Left Ventricular Filling Pressure in Cases of Chronic Severe Anemia
Authors: Nand Nitya , Gupta M.S. , Sharma Manju 
Published: November 2007

Pulmonary capillary 'wedge' pressure (PCWP) was measured before and after transfusion of 1 and 2 units of blood @ 5 and 10 ml/min. in 40 adult cases of chronic severe anemia (CSA). The cases were randomly divided into 4 sub groups of 10 cases each. Following blood transfusion (BT), PCWP increased significantly in all the 4 subgroups (p < 0.001). The highest rise in PCWP was recorded when 2 units of blood were transfused at a rate of 10 ml/min, and the rise was minimum when 1 unit of blood was transfused @ 5 ml/min. Out of the two variables—speed and amount of BT—the amount was more important. It is, therefore, concluded that administration of 2 units of blood in case of CSA at a rate of 5 or 10 ml/min is not desirable and that transfusion of 1 unit of blood @ 5 ml/min is quite safe.
Interstitial Vasculitis—Interstitial Lung Disease: Case Studies
Authors: Demeter Stephen L. 
Published: November 2007

Six patients with interstitial lung disease were tested in a serial fashion to determine response to medications. All patients had biopsy-proven interstitial lung disease. Exercise testing with measurements of PaO2, PaCO2, and DLCO (the diffusing capacity to carbon monoxide) were made before and after exer cise to determine the response to medications. Three patients were treated with corticosteroids and three patients with cy totoxic medications. Results of serial testing of gas transfer correlated with im provement of interstitial lung disease as characterized by resting Pa02, symptoms, and maximal duration of exercise. The value of serial exercise test ing is of great help in some, but not all patients. The value of serial testing of patients with interstitial lung disease is discussed.
Effects of Alcohol on the Heart: Current Views
Authors: Kouvaras George , Cokkinos Dionisios 
Published: November 2007

Chronic and heavy alcohol consumption has deleterious effects upon the car diovascular system and may cause congestive cardiomyopathy. Evidence of car diac malfunction has been found in chronic alcoholics without overt heart fail ure by invasive and noninvasive methods. Ethanol is the incriminated factor having a direct cardiotoxic effect. Elec tron microscopy and cardiac muscle biopsies show that ethanol may cause changes on plasmalemmal, mitochondrial, and sarcoplasmic membranes. The clinical picture and general management of alcoholic cardiomyopathy do not differ substantially from those of congestive cardiomyopathies of any type. It has, however, been demonstrated that cessation of alcohol consumption may lead to an improved prognosis, even to restoration of normal cardiac func tion, in individuals with preclinical and mild manifestations of cardiac dysfunc tion. The literature on the possible association of coronary heart disease with alco hol seems to be ambiguous. It has, however, been postulated recently that mod erate alcohol intake may have a protective role against coronary heart disease, in contrast to alcoholic intemperance, which may be a factor favoring coronary heart disease.
Prevention and Treatment of Supraventricular Tachycardia Shortly After Coronary Artery Bypass Grafting: A Randomized Open Trial
Authors: Janssen Johan , Loomans Leonie , Harink Joukje , Taams Meindert , Brunninkhuis Leo , van der Starre Peter , Kootstra Gert 
Published: November 2007

Supraventricular arrhythmias continue to complicate the postoperative course of patients following coronary artery bypass grafting. In a randomized, open, controlled trial we assessed the value of two different beta-blocking agents in the prevention and treatment of these arrhythmias. Of 151 consecutive pa tients undergoing coronary artery surgery, 39 were treated with metoprolol and 41 were treated with sotalol (a beta blocker with class III antiarrhythmic prop erties). Fifty patients served as a control group and received no prophylactic therapy. Twenty-one patients were eliminated from the study for various rea sons, making a final total of 130 in the study group. In the metoprolol group 15.3% of patients developed supraventricular tachycardia SVT after coronary artery surgery, which was significantly less (p < 0.05) than the incidence observed in the control group. However, in the group of patients receiving sotalol, 2.4% developed SVT (p < 0.01 compared with the control group). Of 18 patients in the control group who developed SVT after randomization, 10 received sotalol and 4 metoprolol to terminate the arrhythmia. The mean time of termination of SVT after drug administration was 2.4±1.8 hours for treatment with sotalol and 13.6±9.8 hours for treatment with metoprolol. We conclude that sotalol significantly reduces the incidence of supraventric ular tachycardia in the early period after coronary artery bypass surgery.
Central Inhibition of Sympathetic Overdrive by Clonidine in Acute Myocardial Infarction with Systolic Hypertension. Haemodynamic Study
Authors: Renard Marc , Liebens Isabelle , Waterschoot Patrick , Bernard Roland 
Published: November 2007

Intravenous clonidine was used to treat systolic hypertension (systolic blood pressure greater than 160 mm Hg) in 15 patients with acute myocardial infarction and documented sympathetic overactivity (high plasma norepinephrine). Its effects on haemodynamics and blood gases were studied. After one hour, clonidine significantly reduced the systolic (195±7 to 137±7 mm Hg, p < 0.01) and diastolic (81±4 to 60±3 mm Hg, p < 0.01) blood pressures as well as the systemic vascular resistance (26±2 to 20±1 IU, p < 0.01). The cardiac index was reduced from 2.8±0.2 to 2.4±0.2 l/min.m2, p<0.01. This change was related to a reduction of the heart rate (92±4 to 81±4 beats/ min, p < 0.01) as the stroke index was unchanged. Pulmonary wedge pressure (15±3 to 10±2 mm Hg, p < 0.01) and rate pressure product (18.034±1.159 to 11.274±917 mm Hg, beats/min, p < 0.01) were also significantly decreased. The arterial oxygen tension did not change significantly but there was a significant drop in the mixed venous oxygen saturation (63±2 to 61±2%, p<0.02) and oxygen transport (433±41 to 409±36, p < 0.01). Clonidine is thus able to normalize blood pressure in acute myocardial infarction ; this is accompanied by a reduction in myocardial oxygen requirements and pulmonary wedge pressure. Oxygen transport to the tissues, however, may be decreased.
Muscular Blood Flow in Patients with Heart Failure
Authors: Bellandi Francesco , De Scalzi Maurizio , de Leonardis Vittorio , Arena Luca , Belli Brunella , Barbagli Susanna , Morace Giandomenico , Cinelli Piero , Morace Giorgio 
Published: November 2007

We studied reactive hyperemia in a group of patients with heart failure before and after therapy, since changes in the characteristics of muscular blood flow may influence the functional class of these patients. At the same time we evaluated some echocardiographic parameters too. When the patients improved clinically, they showed an increase in muscular blood flow at rest and in percent of fractional shortening and a decrease in peripheral vascular resistance. The reactive hyperemia did not change significantly. This fact probably depends on a maximal response to the postischemic hyperemia and represents the integrity of autoregulatory mechanisms.
Tissue Fibrinolytic Activity in Different Types of Varicose Veins
Authors: Hach Viola , Fink Monika , Blees Norbert , Scharrer Inge 
Published: November 2007

The fibrinolytic activity of the venous wall was investigated by using Todd's technique 1 in 92 patients with different types of varicosis. A control group consisted of 19 patients with apparently normal superficial veins who had had a saphenectomy prior to an aortocoronary bypass operation. Fibrinolytic activity was mainly localized in the adventitia of varicose and nor mal veins. It significantly decreased in the distal regions of all types of varicosis. The highest fibrinolytic activity was detected in the proximal part of the vari cose vena saphena magna and the lowest values were observed in the perforat ing and side branch veins of the calf. Fibrinolytic activity is higher (p < 0.077) in the normal vena saphena magna than in the varicose vena saphena of the calf. Older patients show a loss of fibrinolytic activity in their vena saphena magna. Obese patients have less fibrinolytic activity in varicose calf veins than patients with normal weight do.
Theory and Methods of Local Tissue-pO2 Monitoring in Experimental Angiology
Authors: Spiegel H.U. , Hauss J. , Schönleben K. , Bünte H. 
Published: November 2007

The platinum-multiwire-surface electrode after Kessler and Lübbers gives the opportunity of direct measuring of the local tissue-pO2-pressure; this 8-wire electrode with a Pt-wire-diameter of 15 μm operates on the polarographic principle. Each Pt-wire has a hemispheric collecting area of about 30 μm. Pressure ischemia by compression of capillaries is prevented by proportioning the weight (2.1 g) of the electrode. Data output is done by 1) continuous pO2 measuring; 2) pO2 histograms. During the continuous pO2 measurement the electrode stays on the tissue measuring point thus enabling the direct record of quickly proceeding reactions. The pO 2-histogram exhibits the statistical distribution of the local partial oxygen pressures in a studied organ, a quasi sample inquiry is performed in the tissue, based on minimum 100 single values that are obtained by repeated manual repositioning of the electrode. By this, values are obtained on the level and distribution of local pO2 in the tissue so that condition and function of the microcirculation can be objectively assessed. Immediate alterations in the local tissue pO2 suggest regulatory adjustment after hemodynamic changes. Technical problems connected with pO2 measurement in clinical use (sterilization, data acquisition and presentation) are described. The presented technique gives the chance to exactly assess the effects of vasoactive drugs on the microcirculation and to quantify the results of operations, for example after bypass-surgery.
Clinical Experience With a Transdermal Nitroglycerin System
Authors: Mahapatra Rajat K. , Mahapatra Dipta , Yaden Senka 
Published: November 2007

Forty-seven patients with chronic stable angina pectoris entered a thirteen-week open-label study with a transdermal therapeutic system of nitroglycerin in order to evaluate its clinical efficacy, safety, and patient acceptance. In 19 patients, a beta-blocker and in 17 patients a calcium-channel blocker were continued throughout the study period without alteration of their doses. The study consisted of a two-week run-in period and an eleven-week active drug period. Acute titration was done with nitroglycerin patches on the basis of weekly patient diaries on frequency of angina and sublingual nitroglycerin consumption. Overall, reductions in frequency of angina and in nitroglycerin consumption were statistically significant (p < 0.05). Adverse reactions were common but tolerable. The reported side effects were headache in 32, skin rash in 18, dizziness in 10, palpitation and itching in 9 each, nausea in 7, flushing in 3, and vomiting in 1 patient. In conclusion, the present study demonstrates that individual dose titration with nitroglycerin patches for obtaining significant antianginal effect is essential. The present therapeutic system is convenient to use and well tolerated and had acceptable side effects in our study population.
Immature Angiomas: The Importance of the Doppler Exam in Diagnosis and Prognosis
Authors: Salgarello G. , Rosselli D. , Salgarello M. , Pola P. , Serricchio M. , Naegeli C.D. 
Published: November 2007

Immature angiomas are vascular hamartomatous malformations but clearly different from all other vascular, capillary, venous, arteriovenous, and lymphatic malformations, which, normally present at birth and established from a cellular viewpoint, grow because of the effect of hemodynamic stimuli and present no tendency toward spontaneous regression. The difference between immature angiomas and other hemangiomas has been demonstrated by investigations into cell dynamics. To facilitate a differentiated diagnosis and prognosis, the hemodynamics of the angiomas were studied with the Doppler flowmeter. The use of noninvasive techniques, such as those introduced by the Doppler flowmeter, permit a technical alternative and/or integration, giving results of equal relevance and importance, as well as the advantages of a more accessible and less expensive methodology.
Recurrent Aneurysms of the Upper Arteries of the Lower Limb: An Atypical Manifestation of Fibromuscular Dysplasia—A Case Report
Authors: Herpels Vincent , Van de Voorde Wim , Wilms Guy , Verbeken Eric , Baert Albert , Lauweryns Jozef , Nevelsteen André 
Published: November 2007

Fibromuscular dysplasia (syn. arterial dysplasia, fibromuscular hyperplasia, medial fibroplasia) is an arteriopathy of unknown etiology, most frequently involving the renal arteries. The string-of-beads appearance of these lesions seems to be a characteristic angiographic finding. We report atypical angiographic findings at an unusual site, which proved to correspond to fibromuscular dysplasia at histological examination.
Validity of Continuous-Wave Doppler Sonography of the Vertebrobasilar System
Authors: Karnik Ronald , Stöllberger Claudia , Ammerer Hans-Peter , Perneczky Gedeon , Slany Jörg , Brenner Heinz 
Published: November 2007

To assess the value of continuous-wave Doppler sonography for detection and exclusion of lesions in the vertebrobasilar system, the ultrasonic and angiographic findings were compared in a prospective study. Altogether, 200 vertebral arteries in 176 patients were evaluated by both methods. Insonation of the vertebral arteries was performed at the mastoid slope and at the origin of the vessel. Of 62 angiographically proven lesions, 45 were detected by ultrasound. Of 138 normal vertebral arteries, 129 were correctly diagnosed. Sensitivity for all lesions was 72.5%, and for hemodynamically relevant lesions it was 91%. Overall specificity was 93.5%. A positive predictive value of 83.3% and a negative predictive value of 88.4% for all lesions shown by angiography demonstrate the high reliability and accuracy of doppler ultrasound of the vertebrobasilar system.
Impact of Thromboischemic Reentry Mechanism on Coronary Thrombosis and Microembolism in Acute Myocardial Infarction1
Authors: Gasser Robert N. A. , Dienstl Franz , Henn Rainer 
Published: November 2007

It has been suggested that the thromboischemic reentry mechanism (TRM) is responsible for washing platelet aggregates out of the coronary vessels during the early phase of acute myocardial infarction (AMI). This might account for the observation of Schwartz, who reported the presence of multiple microthrombi in the subendocardial blood vessels following AMI but found only a few thrombotic occlusions in the main coronary arteries. This washing-out of the vessel (due to reperfusion waves) intermittently releases myoglobin into the serum and is responsible for the "staccato phenomenon." We examined a group of 177 patients with a mean age of 66.1 years, whose sudden death was definitely of cardiac origin. Infarction was confirmed in 84.7% of the subjects (fresh infarct: 23.7%; fresh infarct with scarring: 25.9%; scarring alone: 35.0%; no change in myocardium: 15.2%). In other words, 49.7% of all postmortem subjects (88 cases) showed fresh infarction. Opening the coronary arteries longitudinally revealed only 7 thrombi in these 88 cases, i.e., 7.9% of all fresh infarcts. These observations confirm those of Roberts (8.5%) and Friedmann (4%).
Evaluation of the Vasodilator vs Inotropic Effect of Milrinone Using an Animal Model of Left Ventricular Failure: Reversal of Disopyramide Depression of the Myocardium with Milrinone
Authors: Goldberg Emanuel , Berdoff Russell , Spivack George , Haimowitz Azriel , Tay Steven 
Published: November 2007

Milrinone (M) has been shown to improve left ventricular (LV) performance in animal and human studies. M has strong vasodilator action, and whether increased LV performance is due primarily to vasodilation or to a direct positive inotropic effect is unclear. Ten mongrel dogs were studied. Disopyramide caused a significant and sus tained decrease in LV function and was a good model for myocardial depres sion. At equal reduction in systemic vascular resistance (SVR), M reversed this LV depression to a significantly greater degree than nitroprusside (NP) did. At equal levels of vasodilation, M produced significantly greater improve ment in indices of LV function than NP did in our model of disopyramide- induced LV failure. This suggests that its effect on LV function is not due entirely to afterload reduction, or to reflex sympathetic stimulation, but has a substantial component of direct inotropic stimulation. This study also demon strated a reversal of disopyramide-induced LV dysfunction by M, which may be clinically useful since, as in many antiarrhythmics, myocardial depression may be a limiting factor in its use.
Glucose and Erythrocyte ATP: Distinctive Effects of Dipyridamole and of Ticlopidine
Authors: Solvay H. , Kahn M. , Garreyn S. , Cloarec M. , Sneppe R. , Schram E. , Fenollar J.V. 
Published: November 2007

This experiment suggests the following points: 1. Erythrocytes in control patients and in atherosclerosis patients seem to have a variable grade of affinity for adenosine and for plasma glucose. This variable grade seems to fix the level of the adenosine triphosphate (ATP) reserves and induces the erythrocytes' deformability. 2. The drop in the level of ATP reserves that induces the poor deformability of the erythrocytes in atherosclerosis patients would appear to be caused by two consecutive shortages: first a shortage that seems to be related to a deficiency of erythrocyte adenosine as the ATP shortage disappears with dipyridamole treatment and then a shortage induced by the lack of erythrocyte glucose and suppressed by the addition of ticlopidine to the dipyridamole treatment.
Interventional Radiology for Restoration of Vascular Patency in the Postoperative Patient—Case Reports
Authors: Mail John T. , Becker Gary J. , Holden Robert W. , Yune Heun Y. 
Published: November 2007

The postoperative patient may present with one or more of a variety of prob lems amenable to management by interventional radiologic techniques, which may be curative by themselves or may, in addition, require or allow successful surgical intervention. To optimize patient care, a good working relationship between the vascular surgeon and the interventional radiologist is essential. Consideration should be given to the patient's presenting signs and symptoms, the surgical history with its alteration of anatomy, the results of available noninvasive studies, and knowledge of various therapeutic alternatives. Vascular radiologic interventions include angioplasty, thrombolytic therapy, a combination of both angioplasty and thrombolysis, and newer techniques such as percutaneous valvectomy. In this report, examples of some of the experience at Indiana University are presented. Emphasis is placed on the appropriate approach to the patient.
Effects of Blood and Crystalloid Cardioplegia on Cardiac Function at Organ and Cellular Levels During Hypothermic Cardiac Arrest
Authors: Prasad Kailash , Bharadwaj Baikunth , Card Robert T. 
Published: November 2007

The present investigation was undertaken to compare the effects of cold crystalloid and blood cardioplegia on the functional recovery of the heart; on Ca+ + binding and uptake, Ca+ + -ATPase of the sarcoplasmic reticulum (SR), and sarcolemmal (SL) ATPase; and on serum MB fraction of creatine kinase (MBCK) after one and a half hours of reperfusion following one hour of ischemic cardiac arrest in dog. This study was made also to determine if the functional changes are related to the changes in biochemistry at the molecular level. The dogs were divided into three groups: sham bypass (SB), cold crystalloid cardioplegia (CC), and pump blood cardioplegia (PB). There was a decrease in the cardiac index (CI), left ventricular work index (LVWI), and mean aortic pressure (MAP) in all three groups. The index of myocardial contractility ((dp/dt)/IIP) and CI were lower in the CC group as compared with the SB and PB groups. All the hemodynamic values for the PB group were similar to those of the SB group except total systemic vascular resistance (TSVR) and left ventricular end-diastolic pressure (LVEDP) which were lower in the PB group. The index of myocardial contractility and cardiac index appeared to be greater in the PB group than in the CC group. There was a decrease in the Ca ++ uptake by SR from both the CC and PB groups. Ca++ binding and Ca++ -ATPase of SR from the PB group were depressed. The sarcolemmal ATPase was unaffected in both groups. The serum MBCK increased in both PB and CC groups, though the increase was smaller in the PB group. These results indicate that the functional recovery of the heart was slightly better with pump blood cardioplegia than with cold crystalloid cardioplegia. The depressed myocardial contractility and cardiac function in the CC group were associated with a decrease in the Ca+ + uptake by SR. However, the decreases in the Ca+ + binding, Ca+ + uptake, and Ca+ + ATPase by SR from the pump blood cardioplegic group were not accompanied by decreases in the cardiac contractility and cardiac function. Myocardial damage as assessed by serum MBCK was smaller in the PB group than in the CC group.
Clinical Experiences Using Pneumatic Massage Therapy bfor Edematous Limbs Over the Last 10 Years
Authors: Yamazaki Zenya , Idezuki Yasuo , Nemoto Tetsu , Togawa Tatsuo 
Published: November 2007

A pneumatic massage apparatus has been developed for the treatment of peripheral lymphedema. The stag nant lymph and venous blood are dis placed toward the heart by this pneu matic massage. It has been applied to more than 650 patients with edema tous limbs in the authors' Hadomer clinic over the last ten years. Satisfac tory results were obtained, including decrease in swelling, pain, and indu ration. The authors' clinical experi ences and statistical analysis of the patients are reported here. Statistical analysis: 9 primary (4 males and 5 females) and 646 second ary (28 males and 618 females) pa tients with lymphatic edema of ex tremities have been treated. The ma jority of the patients had postmastec tomy edema of the upper extremity. Clinical studies: The circumfer ence of the edematous limb was mea sured before and after pneumatic massage treatment of forty to sixty minutes, daily or every second day. sage was effective in the treatment of edema of the limbs, and its effective ness was confirmed also by core tem perature measurement of the hand during pneumatic massage. The de creased circumference of the edema tous limb was kept constant for a long period of time by daily repeated pneumatic massage and ordinary conservative treatments. In conclusion, most lymphedema is of a secondary type. Pneumatic massage was effective in the treat ment of peripheral lymph edema, and the improvement was maintained by repeated daily pneumatic massage and ordinary conservative treatment. Therefore, before it becomes worse, lymphedema of the limb should be treated by use of conservative treat ments, including pneumatic massage continued as a long-term schedule.