bluuebunny/crossref_metadata_2025_split huggingface dataset:
Day to day reproducibility of doppler sonographic measurements in patients with valvular aortic stenosis
Authors: Siostrzonek P. , Kronik G. , Jung M. , GöSSINGER H. , Schmoliner R. , Zangeneh M. , MöSSLACHER H. 
Published: February 2009

AbstractHigh reproducibility of Doppler gradient measurements is necessary for both the reliable noninvasive assessment of the severity of aortic stenosis and for repeated follow‐up examinations in individual patients. We therefore studied day to day reproducibility of Doppler sonographically measured peak pressure drops in 46 patients with valvular aortic stenosis. Clinically stable patients were examined twice within 29 ± 18.2 days by the same examiner. Peak pressure drop (PPD) and peak flow velocity differed between the two examinations by 8.6±7.0 (range 0‐29) mmHg and by 0.25±0.18 (range 0‐0.7) m/s, respectively. Reproducibility was comparable in patients with excellent, good, and moderate quality examinations, but was lower in the 6 patients with poor quality examination. Variability of PPD, but not of peak flow velocity was higher (p<0.05) in patients with severe (PPD >60mmHg) stenosis. Reproducibility was comparable in patients with or without concomitant aortic incompetence and in patients with normal or reduced left ventricular function. Similar reproducibility was obtained in patients with heart rate changes below or above 10 beats/min between the two examinations. It is concluded that good reproducibility of Doppler measurements in patients with aortic stenosis allows reliable noninvasive assessment of the severity of the stenosis. In follow‐up studies of patients with mild to moderate aortic stenosis increases in peak flow velocity in excess of 15% (mean day to day variability+2 SD) are highly indicative of the true progress of the stenosis.
Partial anomalous pulmonary venous drainage and intact atrial septum with mitral stenosis: the paradox of a small shunt
Authors: Dev V. , Narula J. , Tandon R. , Shrivastava S. 
Published: February 2009

AbstractClinical, hemodynamic, and angiographic features of 10 patients with partial anomalous pulmonary venous drainage, intact atrial septum, and rheumatic mitral stenosis have been presented. Seventeen patients with this combination of anomalies reported in the literature have also been reviewed. The clinical diagnosis of mitral stenosis was possible in each of our 10 cases. Partial anomalous pulmonary venous drainage and intact atrial septum in addition to mitral stenosis was clinically suspected in only four patients. The findings suggesting additional presence of partial anomalous pulmonary venous drainage and intact atrial septum in a patient with mitral stenosis include: wide variable splitting of the second sound, pulmonary ejection systolic murmur with or without a thrill, and radiological evidence of unilateral increase in pulmonary vascularity or unilateral hilar pulsations. Hemodynamic findings were characterized by a relatively modest left to right shunt (Qp/Qs:2.2±1.4). Elevated pulmonary vascular resistance was found in the anomalously draining as well as the normally draining lung segments (9.1 ±4.9 and 6.5±3.4 units, respectively, t=1.32;NS). The mechanism of the unexpected high resistance in the anomalously draining lung segments permitting only a small left to right shunt is discussed.
Infection risk of cardiac catheterization and arterial angiography with single and multiple use disposable catheters
Authors: Frank U. , Herz L. , Daschner F. D. 
Published: February 2009

AbstractIn a prospective study from November 1986 to June 1987, a cohort of 414 patients underwent cardiac catheterization or angiography with either multiple use or single use disposable catheters: 161 patients were studied with 426 single use catheters, 152 patients with 384 multiple use catheters which were resterilized once or twice, and 101 patients with 325 multiple use catheters reprocessed several times. Postcatheterization temperature did not exceed 38.2°C in any patient, but was greater than 37.4°C in 4‐6% of the patients studied. No significant differences between the three groups with respect to fever could be observed. Infectious complications associated with cardiac catheterization or angiography did not occur in any case. Of 414 patients, 38 (9.2%) developed hematoma at the puncture site. It is concluded that careful cleaning, disinfection, and resterilization of intravascular catheters with ethylene oxide does not increase the risk of infection. With the rising pressure for containment of health care costs, it is likely that the practice of reprocessing and reuse of expensive intravascular catheters will expand further.
Swallowing‐induced arrhythmia
Authors: Matsubara K. , Inoue D. , Morikawa Y. , Shirayama T. , Omori I. , Katsume H. , Nakagawa M. 
Published: February 2009

AbstractDeglutition tachyarrhythmia, first reported in 1926 by Sakai and Mori, is a rare clinical entity. Vagal reflex has been supposed to be responsible for the induction of the arrhythmia. We have recently studied a patient with swallowing‐induced premature atrial contractions. Atropine sulfate and catecholamine infusion increased the frequency of the arrhythmia, while beta blockade suppressed it. It is suggested that the mechanism of the swallowing‐induced arrhythmia might be related to a sympathetic reflex. As far as we know, there have been few reports in which the sympathetic reflex was proposed to be responsible for the arrhythmia.
Effects of transient increase in intrathoracic pressure on hemodynamic determinants of myocardial oxygen supply and demand
Authors: Pepine C. J. , Nichols W. W. 
Published: February 2009

AbstractEffects of transient increases in intrathoracic pressure on hemodynamic indexes of myocardial oxygen supply and demand were evaluated in 21 patients with ischemic heart disease. Left ventricular, ascending aortic, and right atrial pressures and electrocardiogram (ECG) were recorded while a Valsalva maneuver was performed during ischemia. Myocardial oxygen demand was assessed from the tension time index (TTI) and cardiac size and potential myocardial oxygen supply were assessed from a diastolic pressure time index (DPTI) and relative changes in supply/demand ratio from DPTI/TTI. During an asymptomatic interval an abrupt but small transient decrease in TTI and cardiac size occurred during phase II (p <0.05) of the Valsalva maneuver. DPTI did not change significantly and DPTI/TTI increased (p<0.05). When Valsalva maneuver was initiated during angina, 16 patients reported prompt and complete relief of angina, and left ventricular end‐diastolic pressure declined following the maneuver. Relief of ischemia occurred uniformly during the latter part of straining (phase II) coincident with the peak reduction in TTI, cardiac size, and increase in DPTI/TTI. These data indicate that a transient increase in intrathoracic pressure results in a decrease in hemodynamic determinants of myocardial oxygen demand and an increase in the myocardial oxygen supply: Demand ratio.
Detection of impaired left ventricular function in coronary artery disease with acceleration index in the first derivative of the transthoracic impedance change
Authors: Feng S. , Okuda N. , Fujinami T. , Takada K. , Nakano S. , Ohte N. 
Published: February 2009

AbstractIn order to detect impaired left ventricular (LV) function in coronary artery disease (CAD) patients using acceleration index (Ac) of impedance cardiography (ICG), exercise ICG was performed in 29 patients with chest pain but without CAD (Group 1) and 21 patients with CAD (Group 2), and their resting values were compared with 30 healthy controls (Group 3). The acceleration index, which reflects indirectly aortic blood flow acceleration, was calculated as the ratio of dZ/dtmax to its accelerating time (AT). At rest, the values for Ac in Groups 1, 2, and 3 were 23±10, 15±6, and 36±13 Ω/s2, respectively. There were significant differences between Group 1 versus 3, 2 versus 3, and 1 versus 2 (all p<0.001). At maximal exercise, Ac showed the largest percent change among the various indices used in this study. An increase of 198% for Group 2 was markedly lower than that of 250% in Group 1 (40±14 vs. 68±24 Ω/s2, p<0.001). With a value of ≤40 Ω/s2, Ac can detect the CAD patients, with a sensitivity of 62% and specificity of 90%, superior to stress ECG using CM5 lead. It is concluded that: (1) Ac is the sole index capable of distinguishing not only between the normals and diseased groups, but also between CAD patients and suspected CAD cases at rest. (2) Ac is a remarkably sensitive index for detecting impaired LV function at maximal exercise. (3) Exercise ICG is useful for predicting CAD from the population predisposing to CAD. As an indicator of acceleration, Ac is the most valuable of its kind in exercise ICG.
Plasma level changes of fibrinopeptide a after uncomplicated coronary angioplasty
Authors: Manolis Antonis S. , Melita‐Manolis Helen , Stefanadis Christodoulos , Toutouzas Pavlos 
Published: February 2009

AbstractFibrinopeptide A (FPA) is a small polypeptide cleaved from fibrinogen by thrombin, has a short half‐life, and is considered a sensitive biochemical marker of thrombin activity, fibrin generation, and ongoing thrombosis. Increased plasma levels of FPA have been reported in various procoagulable and thrombotic medical and cardiovascular disorders, including acute myocardial infarction, unstable angina, and sudden cardiac death. However, activation of thrombosis by the arterial injury incurred during coronary angioplasty has not been systematically examined with use of plasma FPA measurements.To detect and monitor activation of thrombosis by coronary angioplasty, plasma levels of FPA were obtained by venipuncture and measured by radioimmunoassay before, immediately after, 24 to 48 h later, and 1 and 3 months after uncomplicated coronary angioplasty. From December 1990 through June 1991, FPA was measured in 30 patients (28 men and 2 women, aged 54 ± 9 years) with coronary artery disease who were undergoing coronary angioplasty. The mean left ventricular ejection fraction was 55 ± 7%. The dilated vessel was the left anterior descending coronary artery in 20 patients (together with a second vessel in 2), the right coronary artery in 9, and the left circumflex in 1. The procedure was successful and free of major complications in all patients. Before angioplasty the FPA levels averaged 6.50 ± 1.18 ng/ml. Shortly after angioplasty they rose to 20.20 ± 7.91 ng/ml (p = 0.08) despite intravenous heparin. At 24 to 48 h and after heparin had been discontinued for at least 4 h, the mean FPA levels were significantly higher (32.33 ± 10.86 ng/ml) compared with baseline values (p = 0.025 ). At 1 month after the procedure, the FPA levels measured in 22 patients were lower but still elevated (20.25 ± 9.29 ng/ml), albeit nonsignificantly, compared with baseline values, and at 3 months they had fallen to baseline values (4.84 ± 2.20 ng/ml, n = 11). No patient developed restenosis during the study period of 1 to 3 months, during which all patients were receiving aspirin. We conclude that, as reflected by increased FPA levels, angioplasty, most likely due to arterial injury incurred, activates thrombin and generates ongoing coronary thrombosis, which is not suppressed by heparin or aspirin and appears to extend at least through the first month after the procedure.
C‐reactive protein as a risk factor for left ventricular thrombus in patients with acute myocardial infarction
Authors: Çlelik Şüukrü , Baykan Merih , Erdöul Cevdet , Kilinçl Kaǧan , ÖREM Asim , Rem Cihan Ö , Durmus Idotu Smet 
Published: February 2009

AbstractBackground: Elevated C‐reactive protein (CRP) has been found to correlate with higher risk for cardiac events in patients with acute myocardial infarction (AMI). It has been suggested that CRP may be involved in initiation process of coagulation; however, the role of CRP level in the formation of left ventricular (LV) thrombus has not been studied.Hypothesis: This study investigated whether CRP is a risk factor for LV thrombus in patients with AMI.Methods: Clinical, echocardiography, and biochemical data were analyzed in 141 consecutive patients (aged 57 ± 13 years; 33 women) with first anterior AMI. Two‐dimensional and Doppler echocardiographic examinations were performed on Days 1, 3, 7, 15, and 30. Blood samples were obtained every day during hospitalization. Serum CRP concentrations were measured by an ultrasensitive immunonephelometry method.Results: Left ventricular thrombus was detected in 33 (23.4%) patients. Univariate analysis showed that patients with LV thrombus had a higher peak creatine kinase (CK) level (2879 ± 742 vs. 1693 ± 1210 I/U, p = 0.001), higher peak CRP level (14.9 ± 7.1 vs. 9.2 ± 6.8 mg/dl, p = 0.001), higher wall motion score index (1.8 ± 0.2 vs. 1.5 ± 0.3, p = 0.002), higher apical wall motion score index (2.35 ± 0.72 vs. 2.07 ± 0.70, p = 0.001), larger end‐diastolic volume (145.2 ± 43.7 vs. 116.5 ± 44.2 ml, p = 0.002), larger end‐systolic volume (85.4 ± 37.2 vs. 62.9 ± 31.6 ml, p = 0.003), and lower ejection fraction (42.1 ± 12 vs. 47.3 ± 13, p = 0.04). in multivariate analyses, only peak CK level (p = 0.0001), LV apical wall motion score index (p = 0.001), and CRP levels (p = 0.001) were independent predictors of LV thrombus formation.Conclusions: These results suggest that CRP is a risk factor for LV thrombus in patients with AMI.
Characterization of New PPARγ Agonists: Analysis of Telmisartan’s Structural Components
Authors: Goebel Matthias , Clemenz Markus , Staels Bart , Unger Thomas , Kintscher Ulrich , Gust Ronald 
Published: February 2009

AbstractTelmisartan was originally designed as an AT1 antagonist but was later also characterized as a selective PPARγ modulator. This study focused on the identification of the essential structural motifs of telmisartan for PPARγ activation activity, elucidating the individual SAR of each different component (shown).magnified imageIn addition to a proven efficacy in lowering blood pressure, the AT1 receptor blocker telmisartan has recently been shown to exert pleiotropic effects as a partial agonist of the nuclear peroxisome proliferator‐activated receptor gamma (PPARγ). Based on these findings and an excellent side‐effect profile, telmisartan may serve as a lead structure for the development of new PPARγ ligands. Therefore, we analyzed the structural components of telmisartan to identify those necessary for PPARγ activation. Synthesized compounds were tested in a differentiation assay using 3T3‐L1 preadipocytes and a luciferase assay with COS‐7 cells transiently transfected with pGal4‐hPPARγDEF, pGal5‐TK‐pGL3 and pRL‐CMV. The data obtained in this structure–activity relationship (SAR) study provide the basis for the development of new PPARγ ligands, which could lead to active compounds with a distinct, beneficial pharmacological profile compared with the existing full agonists. The basic 1‐(biphenyl‐4‐ylmethyl)‐1H‐benzimidazole scaffold of telmisartan was identified as an essential moiety with either a carboxylic acid or tetrazole group at the C‐2 position of the biphenyl. For maximum potency and activity, the alkyl chain in position 2 requires a minimum length of at least two C atoms (ethyl group), while the methyl group at position 4 of the benzimidazole core seems to contribute to partial activity. An additional benzimidazole at position 6 appears to be a further determinant of potency. Similar conclusions can be drawn for the methyl group in position 1.
Synthesis, SAR and Unanticipated Pharmacological Profiles of Analogues of the mGluR5 Ago‐potentiator ADX‐47273
Authors: Engers Darren W. , Rodriguez Alice L. , Williams Richard , Hammond Alexis S. , Venable Daryl , Oluwatola Oluwatomi , Sulikowski Gary A. , Conn P. Jeffrey , Lindsley Craig W. 
Published: February 2009

AbstractAn iterative analogue library synthesis strategy rapidly developed comprehensive SAR for the mGluR5 ago‐potentiator ADX‐47273. This effort identified key substituents in the 3‐position of oxadiazole that engendered either mGluR5 ago‐potentiation or pure mGluR5 positive allosteric modulation. The mGluR5 positive allosteric modulators identified possessed the largest fold shifts (up to 27.9‐fold) of the glutamate CRC reported to date as well as providing improved physiochemical properties.magnified image
DNA Binding Ellipticine Analogues: Synthesis, Biological Evaluation, and Structure–Activity Relationships
Authors: Ferlin Maria Grazia , Marzano Christine , Gandin Valentina , Dall'Acqua Stefano , Dalla Via Lisa 
Published: February 2009

AbstractNovel angular and branched ellipticine‐correlated anticancer agents were developed. In particular, compound 24, with two basic side chains on opposite sides of the molecule, exhibits cytotoxicity in the nanomolar range, acting as a DNA intercalator and topoisomerase II inhibitor. SAR studies with pyridocarbazole derivatives in comparison with corresponding smaller pyrroloquinolines are discussed.magnified imageIn connection with our interest in the synthesis and study of the biological properties of ellipticine analogues as anticancer agents, some 7H‐pyrido[2,3‐c]carbazoles (7H‐PyC) and their corresponding tetrahydro derivatives (7H‐THPyC) were synthesized. A common multistep pathway characterized by conventional reactions involving carbazole Fischer and Conrad–Limpach quinoline syntheses yielded the tetracyclic compounds. With the aim to improve the cytotoxic activity of the new 7H‐PyC derivatives, we provided them with one or two diethylaminoethyl side chains. The new THPyCs, PyCs, and smaller pyrroloquinoline (PQ) derivatives were tested for their in vitro cytotoxic properties against several human tumor cell lines. Most of the compounds tested showed considerable cytotoxic activity, particularly compound 24, which, with two basic alkylamino chains, has IC50 values in the sub‐micromolar range, about one order of magnitude lower than those of the reference compound, ellipticine. Chemosensitivity tests on cisplatin‐, mitoxantrone‐, and multidrug‐resistant (MDR) phenotypes indicated that compound 24 shows no cross‐resistance; this suggests that, besides not being a potential MDR substrate, it might act as a mixed inhibitor of topoisomerases I and II. Flow cytometric and caspase‐3 activation analyses revealed that 24 induces a caspase‐3‐dependent apoptotic cell‐death mechanism. Linear dichroism and unwinding experiments suggested that the most active compounds act as DNA intercalators. For compound 24, an inhibitory concentration‐dependent effect on topoisomerases II and I was demonstrated. Herein we discuss interesting structure–activity relationships with respect to molecular size and planarity, as well as the substitution and position of one side chain on the PyC nucleus, in comparison with corresponding smaller PQs.
Inside Cover: Tritium‐Labeled N1‐[3‐(1H‐imidazol‐4‐yl)propyl]‐N2‐propionylguanidine ([3H]UR‐PI294), a High‐Affinity Histamine H3 and H4 Receptor Radioligand / NG‐Acylated Aminothiazolylpropylguanidines as Potent and Selective Histamine H2 Receptor Agonists (ChemMedChem 2/2009)
Authors: Igel Patrick , Schnell David , Bernhardt Günther , Seifert Roland , Buschauer Armin , Kraus Anja , Ghorai Prasanta , Birnkammer Tobias , Elz Sigurd , Dove Stefan 
Published: February 2009

AbstractThe inside cover picture shows the human histamine H2 receptor and the H2 and H3/H4 receptor‐selective ligands identified. Bioisosteric replacement of the imidazole ring of the NG‐acyl‐imidazolylpropylguanidine with 2‐aminothiazole yielded potent and selective H2 receptor agonists. In contrast, modification of the acyl group gave a high‐affinity H3/H4‐selective tritiated radioligand. For more details, see the Full Papers by A. Buschauer et al. on p. 225 ff and p. 232 ff.magnified image
Predictive value of tumor thickness for cervical lymph‐node involvement in squamous cell carcinoma of the oral cavity
Authors: Huang Shao Hui , Hwang David , Lockwood Gina , Goldstein David P. , O'Sullivan Brian 
Published: February 2009

AbstractBACKGROUND:Tumor thickness (TT) appears to be a strong predictor for cervical lymph‐node involvement in squamous cell carcinoma of the oral cavity (OSCC), but a precise clinically optimal TT cutoff point has not been established. To address this question, the authors conducted a meta‐analysis.METHODS:All relevant articles were identified from MEDLINE and EMBASE as well as from cross‐referenced publications cited in relevant articles. Lymph‐node involvement was confirmed and identified as positive lymph‐node declaration (PLND) by either pathologic positivity on immediate neck dissection or by neck recurrence identified after follow‐up ≥2 years. Odds ratios (OR) were calculated to quantify the predictive value of TT. Negative predictive values (and the percentage of patients falsely predicted to not have PLND [FN‐PLND]) were compared to determine the optimal TT cutoff point.RESULTS:Sixteen studies were selected from 72 potential studies, yielding a pooled total of 1136 patients. Data were examined for the following TT cutoff points: 3 mm (4 studies, 387 patients), 4 mm (9 studies, 778 patients), 5 mm (6 studies, 367 patients), and 6 mm (4 studies, 488 patients). The OR (95% CI) was 7.3 (5.3‐10.1) for the overall group. The proportion of FN‐PLND was 5.3% (95% CI, 2.0‐11.2), 4.5% (2.6‐7.2), 16.6% (11.5‐22.8), and 13.0% (9.7‐16.9) for TT<3, <4, <5, and <6 mm, respectively. There was a statistically significant difference between the 4‐mm and 5‐mm TT cutoff points (P = .007).CONCLUSIONS:TT was a strong predictor for cervical lymph‐node involvement. The optimal TT cutoff point was 4 mm. Cancer 2009. © 2009 American Cancer Society.
Bevacizumab for recurrent alkylator‐refractory anaplastic oligodendroglioma
Authors: Chamberlain Marc C. , Johnston Sandra 
Published: February 2009

AbstractBACKGROUND:A retrospective evaluation of single agent bevacizumab was carried out in adults with recurrent alkylator‐refractory 1p19q codeleted anaplastic oligodendrogliomas (AO) with an objective of determining progression‐free survival (PFS). There is no standard therapy for alkylator‐resistant AO, and hence a need exists for new therapies.METHODS:Twenty‐two patients aged 24 to 60 years with recurrent AO were treated. All patients had previously been treated with surgery, radiotherapy, adjuvant chemotherapy (temozolomide, 17; carmustine wafers, 4; carmustine, 1), and 1 salvage regimen (procarbazine, lomustine, and vincristine, 15; temozolomide, 6; carmustine wafers, 1). Eleven patients underwent repeat surgery. Patients were treated at second recurrence with bevacizumab, once every 2 weeks, defined as a single cycle. Neurological evaluation was performed every 2 weeks, and neuroradiographic assessment was made after the initial 2 cycles of bevacizumab and subsequently after every 4 cycles of bevacizumab.RESULTS:A total of 391 cycles of bevacizumab (median, 14.5 cycles; range, 2‐39 cycles) were administered. Bevacizumab‐related toxicity included fatigue (14 patients; 4 grade 3), leukopenia (9; 1 grade 3), anemia (5; 0 grade 3), hypertension (5; 1 grade 3), deep vein thrombosis (4; 1 grade 3), and wound dehiscence (2; 1 grade 3). Fifteen (68%) patients demonstrated a partial radiographic response, 1 (5.0%) demonstrated stable disease, and 6 (27%) demonstrated progressive disease after 2 cycles of bevacizumab. Time to tumor progression ranged from 1 to 18 months (median, 6.75 months). Survival ranged from 3 to 19 months (median, 8.5 months). Six‐month and 12‐month PFS were 68% and 23%, respectively.CONCLUSIONS:Bevacizumab demonstrated efficacy and acceptable toxicity in this cohort of adults with recurrent 1p19q codeleted alkylator‐refractory AO. Cancer 2009. © 2009 American Cancer Society.