bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Improved Noninvasive Method for Measurement of Cardiac Output and Evaluation of Left-Sided Cardiac Valve Incompetence
Authors: Kelbaek Henning 
Published: July 2008

A time-saving method was devel oped to label red blood cells in vitro with 99mTc while avoiding centrifuga tion. After tin incubation, extracellu lar tin was oxidized by sodium hypochlorite, and EDTA was added for stabilizing the complex prior to 99mTc incubation. Labeling yields were 95%, and in vivo decay showed a high stability with a mean biologic half-life of eleven hours. The first-passage radionuclide technique for determination of car diac output using the above-men tioned tracer was evaluated by using the left ventricle as area-of-interest with individual background correc tion after complete mixing of the tracer. This technique showed a high level of agreement with invasive methods. By combining this method for measurement of the forward stroke volume with the multigated equilib rium principle for determination of the total left ventricular stroke vol ume using similar background cor rections, an exact evaluation of re gurgitation fractions was obtained. In patients with aortic and mitral valve disease the noninvasive radio nuclide technique gave similar but probably more accurate results as compared with contrast aortography and ventriculography. The radionu clide technique may be suitable for monitoring and selecting patients for surgical treatment.
Real-Time Ultrasound for Diagnosis of Symptomatic Venous Thrombosis and for Screening of Patients at Risk: Correlation with Ascending Conventional Venography
Authors: Monreal Manuel , Montserrat Enric , Salvador Rafael , Bechini Jordi , Donoso Lluis , MaCallejas Jose , Foz Marius 
Published: July 2008

This is a prospective study of 108 patients in two distinct groups undergoing real-time ultrasonography (US) and ascending conventional venography within the same day. The two patient groups consisted of the following: Those patients evaluated because of suspicion of deep venous thrombosis of lower limbs (69 patients) and those at high risk for venous thrombosis (19 patients with a recent hip fracture, 20 with a suspected pulmonary embolism). In the diagnosis group 48 patients had venographic evidence of thrombosis. The predictive value of abnormal findings from real-time US was 97%, and that of a negative study was 75%. Thus, real-time US may have a role as a diagnostic procedure, to be fol lowed by x-ray venography in patients with negative US results. By contrast, real-time US is far less sensitive as a screening test in patients without clinical evidence of thrombosis. Only 3 of 9 patients with thrombosis were detected, with a 50% sensitivity for proximal vein thrombosis. Therefore, the use of real-time US for screening high-risk patients must be limited to very high risk patients in whom other tests are ineffective (as in hip surgery).
Percutaneous Subclavian Vein Catheterization for Hemodialysis: A Report of 57 Insertions
Authors: Al-Mohaya Sulieman , Sadat-Ali Mir , Al-Muhanna Fahd , Ibrahim-Saeed Abdulrahman 
Published: July 2008

The authors report an analysis of 57 subclavian vein catheterizations for hemodialysis. A total of 51 pa tients (34 men, 17 women) kept the Cobe single- and double-lumen cathe ters for 1,726 days. The youngest pa tient was eighteen and the oldest sev enty-two years of age. There were no catheter-related deaths. Complica tions were encountered in 9 patients. The only life-threatening complica tion was cardiac arrest, which oc curred during flushing of the catheter. The patient was successfully revived. The other complications were pneumothorax and hydrothorax in 1 patient, catheter site infection in 5 patients, and arrhythmias in 2 pa tients, which stopped after readjust ment of the catheter tips. Their experience indicates that percutaneous subclavian vein cathe terization is safe and provides quick access for hemodialysis with no mor bidity and mortality if done correctly, patiently, and meticulously. The au thors believe that this should be the first choice in patients with reversible renal failure and in patients with chronic renal failure, who are usually elderly and medically compromised, till a permanent vascular access is ready for use.
Immunoscintigraphic Detection of Venous Thrombosis of the Lower Extremities by Means of Human Antifibrin Monoclonal Antibodies Labeled with 111In
Authors: Lusiani Luigi , Zanco Pierluigi , Visonà Adriana , Breggion Giovanni , Pagnan Antonio , Ferlin Giorgio 
Published: July 2008

A new monoclonal antibody spe cific for the beta-chain of human fi brin (C22A) and labeled with 111In has been obtained and successfully used in rabbits and dogs for the in vivo de tection of venous thrombosis. Studies in humans are currently ongoing. In order to assess the diagnostic value of 111In-antifibrin for the detection of ve nous thrombosis of the lower extrem ities, the authors investigated 25 consecutive patients. Ten patients had clinical and instrumental (con trast phlebography and duplex scan ning) evidence of acute deep venous thrombosis (DVT), 3 had a long standing DVT with relapsing epi sodes of swelling and pain, 5 had superficial venous thrombosis, and the remaining 7 had no signs of thrombosis at all. Twenty patients were being treated with heparin. All patients received 111In-antifibrin at the dose of 74 MBq IV and were scanned with a large field of view gamma camera coupled with a high- energy, parallel-hole collimator at 30 minutes and three, six, and twenty- four hours postinjection. Only the persistence of an abnormal uptake at twenty-four hours confirmed by two observers at visual inspection was considered as positive. A positive result was obtained in 9 of 10 DVT patients (90% sensitivity) and in all SVT patients. The single DVT patient with a negative 111 In- antifibrin test had the longest inter val between scintigraphy and onset of symptoms (fifty-five days). Thus, the age of thrombi represented a sub stantial limitation for the test. A false-positive result was obtained in a single SVT patient, in whom also a deep involvement, unconfirmed by phlebography, was suspected (91.6% specificity). The authors conclude that 111In- antifibrin is a new diagnostic tool for studying deep venous thrombosis, which allows direct imaging of thrombi during their relatively early phase, with a high degree of sensitiv ity and specificity.
A SPECT Study in Internal Carotid Artery Occlusion: Discrepancies Between Flow Image and Neurologic Deficits
Authors: Moriwaki Hiroshi , Hougaku Hidetaka , Matsuda Isato , Kusunoki Masahito , Shirai Jun 
Published: July 2008

A SPECT (single photon emission computed tomography) study in internal carotid artery (ICA) occlusion was performed in 6 patients. The validity of iodoamphetamine (IMP) SPECT study in the evaluation of cerebral blood flow (CBF) or neurologic function is still controversial. In this study, the authors showed several cases in whom SPECT images of brain were not compatible with their neurologic deficits. In 2 typical cases, a large low-density area was observed in the non-dominant hemisphere in computed tomography (CT) scan, but no apparent motor-sensory deficits in left limbs were present. In these patients, SPECT study also revealed flow reduction in the affected side of the brain. So there was a possibility that an IMP brain image could not always reflect CBF, which maintains neurologic function of the brain.
The Role of Lasers in the Management of Peripheral Vascular Disease
Authors: Sanfelippo Peter M. 
Published: July 2008

Although it has been almost twenty-five years since the first studies of McGuff et al, who employed the laser for atheroablation, problems still require resolution. The various laser wavelengths from ultraviolet through visible to in frared have been employed for athero ablation. The laser's greatest appeal and the most spectacular results have been in reopening channels in totally occluded vessels. The laser's greatest problem has been damage of the arte rial wall and even perforation. The purpose of this presentation is to clarify the present status of avail able lasers for the treatment of pe ripheral vascular disease of the lower extremities. To this end, the initial experience with angioscopically guided laser-assisted angioplasty with a new hybrid laser probe is reported.
Ketanserin in the Treatment of Systemic Hypertension During and Following Coronary Artery Bypass Surgery
Authors: van der Starre Peter J. A. , Reneman Robert S. , Scheijgrond Henk W. 
Published: July 2008

One of the most important prob lems during cardiac surgery is the prevention and treatment of hyper tension, occurring in 40-60% of the patients following coronary artery bypass surgery (CABS). Hyperten sion should be avoided to prevent myocardial damage, neurologic com plications, increased blood loss, and premature graft closure due to inti mal damage. During and following cardiac surgery hypertension is rou tinely treated with vasodilating agents, which generally induce reflex tachycardia and increased intrapul monary shunting. The results obtained with ketan serin, a specific S 2-serotonergic re ceptor blocker with alpha1-adrener gic receptor blocking properties, in the prevention and treatment of hy pertension in patients undergoing cardiac surgery, are presented. Ke tanserin effectively lowers blood pressure by decreasing systemic vas cular resistance but does not com pletely prevent perioperative and postoperative hypertension when ad ministered as a continuous infusion from the start of anesthesia. In con trast to sodium nitroprusside, ketan serin does not induce reflex tachycar dia in the treatment of postoperative systemic hypertension following CABS. The compound improves di uresis and perfusion of the skin pe rioperatively. Ketanserin is devoid of rebound phenomena after its admin istration is stopped. It is postulated that the antihypertensive effect of ke tanserin can be explained by its prop erty of simultaneously blocking al pha 1-adrenergic and S2-serotonergic receptors.
Ephedrine Improves Microcirculation in the Diabetic Neuropathic Foot
Authors: Wollersheim H. , Netten P.M. , Lutterman J.A. , Lenders J.W.M. 
Published: July 2008

A diabetic patient is described who developed one-sided neuropathic ulcera tion. Noninvasive microvascular measurements during distant cooling and in spiratory gasp revealed signs of sympathetic denervation. The initially elevated total skin blood flow measured by laser Doppler equipment and decreased capil lary perfusion as determined by transcutaneous oxygen tension measurements were both partially restored after treatment with the α1-sympathicomimetic ephedrine. The improvement occurred once more after rechallenge. In conclusion this study further supports the hypothesis of a capillary steal phenomenon caused by extreme vasodilation within sympathetically denervated arteriovenous shunt vessels.
Capillary Filtration and Ankle Edema in Patients with Venous Hypertension: Effects of Daflon
Authors: Cesarone Maria Rosaria , Laurora Giuseppe , De Sanctis Maria Teresa , Belcaro Giovanni 
Published: July 2008

Capillary filtration (CF) was assessed in 43 patients with venous hypertension and in 10 normal subjects by means of strain gauge plethysmography. The patients were then divided into two treatment groups; 22 were treated with Daflon, 500 mg tid, and 21 with Daflon, 500 mg bid. The normal subjects were also treated (500 mg tid). After four weeks CF was significantly decreased in all subjects, the decrease being higher in the high-dose groups. CF did not significantly change in normal subjects. In conclusion Daflon decreases CF in subjects with venous hypertension and the CF decrease is dose related.
Echocardiographic Doppler Evaluation of Left Ventricular Diastolic Function in Athletes' Hypertrophied Hearts
Authors: Galanti Giorgio , Comeglio Marco , Vinci Marco , Cappelli Brunello , Vono Maria Concetta , Bamoshmoosh Mohamed , Galanti Giorgio 
Published: July 2008

It is well known that one of the most evident effects of prolonged and intense physical training is an increase of left ventricular mass. This increase could have a great influence on the diastolic properties of the heart, which can now be accurately evaluated by use of pulsed- and continuous-wave of Doppler echocardiography. The aim of this study was to evaluate the diastolic function of a group of auperendurance athletes (professional. bicyclists, exercising more than forty hours a week). Sixteen athletes (A), aged between twenty and thirty-one years, during the period of maximal training, and 16 age-matched controls (C) were studied. All subjects were evaluated at rest with mono-dimensional, two-dimensional, and Doppler echocardiography. Diastolic (DD) and systolic. (SD) diameter, posterior wall (PW), and interventricular septum (IVS) thickness were also measured. The ventricular mass (LVM) was calculated. Diastolic function was evaluated by calculating isovolumetric relaxation time (IVR) with continuous-wave Doppler, and deceleration time (DT), rapid filling flow peak (Ep), and atrial filling (Ap) were evaluated with pulsed Doppler echocardiography. The LVM (A: 354±47 g vs C: 170.6±33.4, p<0.05), DD (A:57.7±3.9 mm C: 50.5±2.7, p < 0.01), PW thickness (A: 11:9±0:7 mm vs C: 8.4±0.6, p<0.05), and IVS thickness (A: 12.3±1 mm vs C: 8.2±0.9, p<0.05) were significantly greater in the athletes than in the controls. The IVR (A: 69±12 msec vs C: 76±11, p<0.05) and DT (A: 171±52 msec vs C: 203±31, p<0.01) were significantly shorter in the athletes than in the controls; the Ep velocity was similar in the two groups (A: 84.3±12 cm/sec vs C: 85.1±19, p=NS), while the Ap velocity was lower in the athletes' group (A: 41.5±8 cm/sec vs C: 56±15, p<0.01). It may be concluded that prolonged and intense physical training, while causing an increase of left ventricular mass, is able to induce favorable modifications of the diastolic properties of the left ventricle.
A Case Report of Siblings with Hypertrophic Cardiomyopathy that Progressed to Dilated Cardiomyopathy-Case Reports
Authors: Okamoto Shinya , Ozaki Morihiro , Konishi Tokuji , Nakano Takeshi 
Published: July 2008

The authors encountered 2 brothers with hypertrophic cardiomyopathy (HCM), both of whom were later found to have progressed to dilated cardiomyopathy (DCM). Case No. 1 (younger brother): A diagnosis of HCM without left ventricular (LV) dilatation was made at age two by cardiac catheterization and echocardiogram. However, he had been well until age thirteen when dyspnea developed. Echocardiograms showed LV wall thickening (septum 20 mm, and posterior 18 mm) and LV dilatation (left ventricular diastolic diameter [LVDd] 60 mm) accompanied by LV dysfunction (ejection fraction [EF] 18%). At autopsy, the heart weighed 875 g and showed LV dilatation with thickened walls. Case No. 2 (elder brother): At age twelve, he was found to have an increased heart size on x-ray when his family was evaluated owing to his brother's condition. Cardiac catheterization and echocardiogram showed HCM without LV dilatation. He remained asymptomatic until age twenty when dyspnea developed, at which echocardiography showed a dilatated LV. The authors speculate that the HCM with progression to DCM is an atypical type of familial HCM and that progression to DCM is genetically determined.
Evaluation of Ifenprodil Efficacy on Exercise-Induced Tissue Ischemia in Stage II Arteriopathy by Measurement of Transcutaneous Oxygen Tension During a Standard Treadmill Test: Double-Blind Study of Injectable Ifenprodil Versus Placebo
Authors: Caillard P. , Mouren X. , Bailliart O. , Cloarec M. 
Published: July 2008

Measurement of transcutaneous oxygen tension (TcPo2) is a noninvasive and easily reproducible method for objectifying and quantifying exercise ischemia in patients with stage II occlusive arterial disease. This technique is also used at rest to evaluate the therapeutic effect of vasoactive treatments. To objectively assess the effectiveness of a vasoactive treatment on the condi tions of tissue perfusion, a randomized double-blind study of ifenprodil tartrate versus placebo was performed in 20 patients, whose TCPo2 was continuously measured while they walked on a treadmill. Patients treated with ifenprodil improved significantly as compared with the placebo group, for both the half-hypoxia area, representing the overall evolu tion of the tissue ischemia (+34.9% and —16.0%, respectively, p=0.01), and the half-hypoxia recovery time, estimating the postexercise recovery time (+30.2% and —3.6%, respectively, p < 0.05). This study confirms that the continuous measurement of TcPo2 during the recovery phase after exercise represents an objective method for the evaluation and follow-up of patients with stage II intermittent claudication. The results enabled the objective assessment of ifenprodil efficacy on the evolution of tissue hypoxia.
The Effects of Orally Administered Atenolol on the Coronary Hemodynamics and Prostaglandin Metabolism in Angina Pectoris Patients
Authors: Kurita Akira , Takase Bonpei , Uehata Akimi , Nishioka Toshihiko , Satomura Kimio , Nagayoshi Hirokazu , Mizuno Kyoichi 
Published: July 2008

The effects of oral atenolol on coronary hemodynamics and prostaglandin metabolism have been investigated in 8 chronic stable angina pectoris patients who underwent the supine bicycle ergometer. At rest, atenolol taken orally reduced the pressure-rate product significantly (P < 0.05) but did not significantly affect the coronary sinus blood flow or the coronary sinus pressure. During exercise, atenolol also reduced the pressure-rate product signifi cantly (P < 0.05) but did not significantly affect the coronary sinus blood flow, the coronary sinus pressure, or the coronary vascular resistance. Atenolol also did not signif icantly affect the thromboxane B2/6-keto prostaglandin F1α ratio in the arterial blood before and after exercise but did reduce this ratio in the coronary sinus blood by 15% from 1.9 ±1.1 to 1.5 ±0.46 (P < 0.10) after exercise. These results indicate that atenolol taken orally does not significantly depress the coronary hemodynamics. However, the effects of atenolol on the prostaglandin metabo lism could not be clearly determined.
Electrical Injury in the Femoral Artery of Rabbits as a Model for Arterial Thrombosis: A Pilot Study
Authors: Kornowski Ran , Glikson Michael , Ohad Dan , Varda-Bloom Nira , Battler Alexander 
Published: July 2008

Electrical stimulation was delivered to the femoral artery of 20 rabbits to examine whether endothelial injury results in a consistent formation of arterial thrombosis. The arterial patency was monitored throughout the experiment by flowmeter and was visu alized by femoral angiography in 5/20 cases. The arterial segments remained totally occluded in 7/20 (35%), partially occluded in 9/20 (45%), and patent in 4/20 (20%) rabbits following stimulation with 200 μA anodal current for 180 minutes. The average time of electrical stimulation needed to achieve total occlusion (n = 7) was 110 ±49 minutes. Alternating occlusion and recanalization of the artery (cyclic flow variation) was observed in 12 rabbits, with total occlusion ensuing in 6/12 cases. Intravenous administration of recombinant tissue-type plasminogen activator (20 μg/kg/min for sixty minutes) resulted in femoral reflow and subsequent reocclusion in 2/5 cases. Histopathologic examination disclosed arterial thrombi composed of platelets, fibrin, and red blood cells. Thus, according to these data this technique was found to induce arterial thrombosis following electrical stimulation of the rabbit femoral artery but was inconsistent regarding the arterial patency.
Left Circumflex Coronary Artery Arising as a Terminal Extension of Right Coronary Artery
Authors: Sagkan Olcay , Ornek Ender , Yeşildağ Osman 
Published: July 2008

Many types of coronary artery anomalies have been detected, and most of them occur in the left circumflex artery. In this report a unique circumflex artery anomaly is presented. The left circumflex artery arose as a terminal extension of the right coronary artery. The main stem and obtuse marginal branches of the circumflex artery were normal and well developed.
Effect of Magnesium Sulfate Infusion on Circulating Levels of Noradrenaline and Neuropeptide-Y-Like Immunoreactivity in Patients with Primary Raynaud's Phenomenon
Authors: Leppert Jerzy , Myrdal Urban , Hedner Thomas , Edvinsson Lars , Tracz Zofia , Ringqvist Ivar 
Published: July 2008

The effect of a short-term magnesium sulfate (MgSO4) infusion on venous plasma concen tration of noradrenaline (NA) and neuropeptide-Y-like immunoreactivity (NPY-LI) was investigated in 12 women with primary Raynaud's phenomenon (PRP) and in 12 healthy matched controls. The Raynaud's patients did not demonstrate any significant changes in mean basal plasma NA concentration (0.29 ±0.15 vs 0.37 ±0.09 ng/mL, ns) after MgSO4 infusion. However, in the controls there was more than twice the amount of circulating nora drenaline (cNA) (0.21 ±0.14 vs 0.54 ±0.22 ng/mL, P < 0.001) after MgSO4 infusion, compared with the preinfusion value. Measurements during the cold pressor test prior to the MgSO4 infusion showed a significant increase of cNA in both the PRP group and the control group (from 0.29 ±0.15 to 0.33 ±0.16 ng/mL, P < 0.05, and from 0.21 ±0.14 to 0.29 ±0.16 ng/mL, P < 0.005, respectively). After MgSO4 infusion the levels of cNA during the cold pressor test increased significantly only in the PRP group (from 0.37 ±0.09 to 0.41 ±0.11 ng/mL, P < 0.05). Circulating NPY-LI concentrations increased significantly during MgSO4 infusion in the Raynaud's patients as well as in the controls from 105 ±21 to 127 ±23 pmol/L, P<0.05, and from 107 ±17 to 132 ±27 pmol/L, P<0.01, respectively. There were no detectable changes during the cold pressor tests in either group. In healthy women short-term MgSO4 infusion induced a sympathetic response, shown by the increased concentration of cNA and NPY-LI, while in PRP patients there was only an increase in NPY-LI. The discrepancy between PRP patients and healthy controls supports the view of a so-called "local fault" in the sympathetic nerve terminal of arterial/arteriolar walls in Raynaud's patients.
Comparative Evaluation of Pentoxifylline, Buflomedil, and Nifedipine in the Treatment of Intermittent Claudication of the Lower Limbs
Authors: Chacón-Quevedo A. , Eguaras M.G. , Calleja F. , Garcia M.A. , Roman M. , Casares J. , Muñoz I. , Concha M. 
Published: July 2008

In the light of the current controversy surrounding the use of hemorheologic and vasodilator drugs in the treatment of peripheral arteriosclerosis, a comparative study was designed in order to evaluate the efficacy of pentoxifylline, buflomedil, and nifedipine in 45 patients with peripheral arterial disease (Fontaine stage II). The patients in this prospective randomized study were divided into three groups: 15 patients received pentoxifylline treatment (1,200 mg/day), 15 were treated with buflomedil (600 mg/day), and 15 with nifedipine (60 mg/day). Response to treatment was assessed at the start of the study and after forty-five and ninety days, by clinical examination, Doppler test, strain test, and digital occlusion plethysmography using a strain gauge ring. Pentoxifylline was significantly more effective (P < 0.05) than buflomedil and nifedipine at ninety days in improving walking perfor mance, resting toe pressure, resting and postexercise ankle/brachial pressure ratio, and basal/postischemic toe-pulse ratio. Significant differences within groups were also noted for initial claudication, toe peak-flow time, pulse reappearance time (PRT/2), and maximum postischemic flow time, together with significant intergroup variables. In conclusion, pentoxifylline proved more effective than the other drugs tested in: 1. improving distal pressure and resting microcirculatory blood flow; 2. increasing postexercise distal flow, ratios, and pressures and enabling faster recuper ation of basal pulse rates; 3. increasing initial claudication distance in the strain test within the test group and achieving a greater absolute subjective claudication distance than that obtained using the other treatments.