bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Exercise Training on Multiple Respiratory Variables in Patients with Coronary Artery Disease: Correlation with Change in Exercise Capacity
Authors: Stratmann Henry 
Published: November 2007

Multiple measurements of pulmonary function were performed during exer cise testing in 29 patients with coronary artery disease (CAD) before and after exercise training. Following training, significant increases in oxygen consump tion (VO 2), carbon dioxide production (VCO2), and peak flow at maximal exer cise were seen as compared with pretraining values (p < .01), but not in any other respiratory variables. Only the peak respiratory exchange ratio (RER) achieved during pretraining exercise testing and peak values of minute ventilation (VT), respiratory rate, and VCO2 during a posttraining exercise test showed signifi cant correlations with the change in maximum VO2 following exercise training (p<.05). Significant correlations were also found among VT, VCO2, and peak flow at peak exercise following exercise training and the change in exercise du ration between pretraining and posttraining stress tests. Of 22 patients evaluat ed with thallium 201 scintigraphy during their pretraining exercise test, 11 developed ischemic ST depression or a reversible perfusion defect. No signifi cant differences in pulmonary function measurements during exercise testing were seen between patients who developed ischemia and those who did not. However, the change in peak metabolic equivalents (METS) achieved between pretraining and posttraining exercise was significantly greater in patients who developed ische mia (.836±1.003 versus .091±.481, p<.05). These results indicate that exercise training in patients with CAD is not as sociated with significant changes in most measurements of pulmonary function and, with the exception of RER at peak exercise, pretraining measurements do no show a significant correlation with changes in exercise capacity.
Internal Carotid Artery Occlusion: Diagnostic Inaccuracy of the Ocular Pneumoplethysmography
Authors: Smith S. Wayne , Angie Billie , Cheek Rosa , Stiglbauer Nancy 
Published: November 2007

The diagnosis of internal carotid artery (ICA) occlusion has serious manage ment and prognostic consequences. The accuracy of noninvasive techniques in this setting remains questionable, with the result that contrast arteriography re mains the diagnostic method of choice in patients in whom ICA occlusion is suspected. Ocular pneuoplethysmography-Gee (OPG-Gee) is one of the nonin vasive methods that is still utilized extensively in the evaluation of carotid artery disease. In order to determine the real utility of OPG-Gee, the authors conduct ed a retrospective comparison of the results of OPG-Gee and arteriography in 26 patients (52 internal carotid arteries) who had undergone both examinations. With the angiography results as the standard of comparison, 4 incorrect di agnoses were obtained by OPG-Gee, thus yielding an overall accuracy of 92 for this method. However, duplex ultrasonography, also performed in the same 26 patients, correctly identified the 2 ICA occlusions defined by angiography and further demonstrated patency in the 48 arteries so shown by angiography. The authors conclude from this experience that OPG-Gee is less reliable than duplex ultrasonography in the diagnosis of ICA occlusion. Furthermore, despite the 92% overall accuracy of their results with OPG-Gee, the occurrence of both false-positive and false-negative results renders this examination modality sus pect in the diagnosis of ICA occlusion.
Peripheral and Renal Vein Renin Activity in Patients with Renovascular Hypertension Due to Nonspecific Aortoarteritis
Authors: Lall S.B. , Dave V. , Dash S.C. , Bhargava S. 
Published: November 2007

The diagnostic utility of peripheral and renal vein renin estimations in rela tion to angiographic findings was evaluated in 13 patients with renovascular hyper tension and non-specific aortoarteritis (NSAA, Gr I), in comparison with 10 patients with renal artery stenosis due to other causes (Gr II). Plasma renin ac tivity (PRA) was measured by radioimmunoassay. Blood samples were collect ed after angiography from the femoral vein and renal vein on the affected side followed by sampling from the less affected or unaffected side. Renal vein renin ratio (RVRR) was calculated from renal vein renin values. The effect of cap topril (25 mg oral) on blood pressure, PRA, and RVRR was examined in 8 pa tients from each group. Normotensive volunteers (8) with moderately low salt intake were also included in the study for comparison of twenty-four-hour uri nary sodium output, peripheral PRA, and response to captopril.The mean peripheral PRA was high in both groups as compared with normo tensive controls; however, the values were lower in patients with NSAA. The rise in PRA in response to captopril was insignificant in Gr I (p >0.05) and RVRR > 1.5 was observed in 5 of 13 patients in contrast to 9 of 10 in Gr II (p < 0.05). A paradoxical ratio, ie, (high renal vein renin levels on the less stenotic side) was noticed in 3 patients of Gr I, whereas none of the patients of GR II showed such a ratio. An improvement in RVRR after captopril was observed in 50% of patients of Gr I as compared with a marked response in all patients of Gr II.The predictive value of RVRR for positive outcome of surgery or angioplasty could be assessed in only 5 patients owing to extensive bilateral involvement and poor general condition of patients with NSAA. Two patients with RVRR > 1.5 and 1 with a false-negative ratio were cured after unilateral nephrectomy/ angioplasty, whereas 2 with RVRR < 1.5 did not show any improvement; prob ably bilateral intervention in these was required. On the other hand, all the 8 patients of Gr II were benefited after unilateral intervention. It is concluded that peripheral PRA and RVRR are useful indices in patients with NSAA for diag nosis and planning surgery/angioplasty and also in avoiding unnecessary surgi cal intervention in patients with paradoxical ratio.
Interaction between Histidine-Rich Glycoprotein and Platelet Factor 4 with Dermatan Sulfate and Low-Molecular-Weight Dermatan Sulfate
Authors: Cella Giuseppe , Boeri Giuseppe , Saggiorato Graziella , Paolini Rossella , Luzzatto Guido , Terribile Vittorio Ilario 
Published: November 2007

There is a controversy about whether or not histidine-rich glycoprotein (HRG), the most abundant plasma protein with glycosaminoglycans-neutralizing capacity, is able to prevent the inhibition of human thrombin by heparin cofactor II (HC II) in the presence of dermatan sulfate (DS). The authors studied the interaction of DS and low molecular weight DS, in a purified system with HRG, platelet factor 4 (PF 4), and with HC II. Their results show that HRG, like PF 4, has an affinity, not only for heparin, but also for DS. However, this affinity seems very weak. In fact, HRG is 10 times less effective than PF 4 in neutralizing the 50% antithrombin activity of HC II in the presence of DS.
Effect of Intensive Walking Exercise on Skeletal Muscle Blood Flow in Intermittent Claudication
Authors: Weiss Th. , Fujita Y. , Kreimeier U. , Messmer K. 
Published: November 2007

Walking exercise is generally accepted as a valid therapeutic regimen in the treatment of peripheral arterial occlusive disease (PAOD) of Fontaine stage II. In order to quantify the effect of walking exercise and/or drug therapy on regional muscular blood flow, PAOD Fontaine stage II was induced by multiple ligations of the femoral artery and of all side branches in one hindlimb of mongrel dogs; the contralateral extremity served as control. The animals underwent walking exercise with increasing intensities on a treadmill five days per week over one year; one group received 600 mg buflomedil (BF) per day orally in addition. At the end of the training period, the regional blood flow in all skeletal muscles of both hindlimbs was quantified by means of 15 μm radioactively labeled microspheres at resting conditions, after treadmill exercise (ten minutes) with or without preinjection of BF (3 mg/kg body weight) into the abdominal aorta. At resting condition and at the end of treadmill exercise the regional muscular blood flow did not differ significantly between the diseased and control extremity. Supplementary oral treatment with BF over one year had no significant effect; the increase in muscular blood flow during treadmill exercise was not enhanced after intra-aortic injection of BF. Consequently walking exercise has the potential to increase the functional capacity of collaterals in intermittent claudication and to restore blood supply to skeletal muscle.
Blood Flow Asymmetry in Carotid Occlusive Disease
Authors: Levine Ross L. , Rozental Jack M. , Nickles Robert J. 
Published: November 2007

Patterns of anterior border zone (ABZ) and middle cerebral artery (MCA) cerebral blood flow (CBF) asymmetry were readily seen during both normocap nic room air (RA) and induced hypercapnic (CO2) inhalation using fluoromethane and a multislice, high-resolution positron scanner. Wilcoxon two-sample rank testing showed symptomatic-over-nonsymptomatic CBF ratios for unilateral greater than 75 % carotid stenosis patients (n = 8) to be 1.05 ± 0.07 (p < 0.008 as compared with control of 0.97 ± 0.02) ABZ RA, 0.98 ± 0.11 ABZ Co2, 0.98 ± 0.04 MCA RA, and 0.98 ± 0.06 MCA CO2. Unilateral carotid occlusion pa tients (n = 8) had ratios of 0.90 ± 0.16 ABZ RA, 0.81 ± 0.19 (p < 0. 002) ABZ CO2, 0.90 ± 0.12 and 0.89 ± 0.13 for MCA RA and CO2, respectively (both p < 0.008 as compared with control 0.99). These preliminary results suggest an upgrade of autoregulation (ie, very high ratio) in the ABZ of high-grade stenosis patients during normocapnia. CBF was preferentially higher on the symptomatic side and then either did not increase or paradoxically fell in response to hypercapnia. In comparison, carotid occlu sion patients had low ABZ and MCA ratios during normocapnia, also unable to increase with hypercapnia. The fall in ratios from normocapnia to hypercap nia indicates that these areas, already subject to maximal vasodilation, fail to increase CBF or actually become hypoperfused following induced hypercapnia. These results aid in understanding the concept of "hemodynamic significance."
Evaluation of the Metabolic Compensation After Treadmill Test in Patients with Peripheral Occlusive Arterial Disease
Authors: Duprez Daniel , De Buyzere Marc , Van Wassenhove Annie , Clement Denis 
Published: November 2007

Patterns of release of lactate, hypoxanthine, and arginine into the bloodstream after a standardized treadmill test (twelve minutes, 1.6-2.8 mph, inclination 0,5,10,15%) were recorded in 21 consecutive patients with stage II peripheral arterial occlusive disease. Heart rate, systolic blood pressure, ankle blood pres sure, and ankle/brachial systolic blood pressure ratio (A/B ratio), as well as plas ma lactate, plasma hypoxanthine and serum arginine were recorded before and at fifteen to thirty-minute intervals for up to two hours after the treadmill test. Immediately after the treadmill test, lactate levels (36.6 ± 3.7 mg/L) and hypoxanthine levels (2.73 ± 0.19 mmol/L) were significantly (p < 0.001) increased but returned to preexercise levels after thirty and sixty minutes, respectively. Ar ginine levels did not change significantly. Ankle blood pressure (57 ± 5 mm Hg) and A/B ratio (0.40 ± 0.04) were significantly (p < 0.001) decreased after exercise, while heart rate and systolic blood pressure were increased. These parameters returned to normal as well within a half hour after exercise. Abso lute walking distance correlated significantly (p < 0.01) with the postexercise sys tolic blood pressure (r = - 0.62), ankle pressure (r = 0.63) and A/B ratio (r = 0.72). Induced hypoxanthine and lactate production intercorrelated signifi cantly positively (r = 0.57, p = 0.007) but were independent of the absolute walking distance. In contrast with lactate, hypoxanthine production correlated significantly with postexercise ankle pressure (r = 0.49, p = 0.02) and exercise- induced fall in A/B ratio (r = 0.66, p = 0.001). Initial preexercise venous hypox anthine, but not lactate levels were correlated with postexercise A/B ratio (r = - 0.49, p = 0.02) but not with the patients' walking distance. These results indicate that hypoxanthine determination may reflect more close ly than lactate the degree of metabolic compensation after exercise in peripheral arterial occlusive disease.
Exercise Strain-Gauge Venous Plethysmography: Evaluation of a "New" Device for Assessing Lower Limb Venous Incompetence
Authors: Rooke Thom W. , Heser J.L. , Osmundson P.J. 
Published: November 2007

Plethysmography can be used to detect and assess venous incompetence in the lower extremities. The authors recently evaluated a new device designed for this purpose that uses strain gauges to determine changes in lower extremity cir cumference occurring with (and immediately after) exercise. The device plots a curve of volume against time for each limb and automatically calculates key values such as the volume of blood expelled from the lower limb veins during exercise and the time required for the veins to refill following exercise. The ap paratus was incorporated into their noninvasive vascular laboratory and used (along with other standard tests) to study patients referred for suspected venous incompetence. They observed the following: (1) A shortened postexercise refilling time ac curately identified limbs with venous incompetence. (2) The clinical severity of venous incompetence was inversely related to the refilling time. (3) Exercise- induced changes in lower extremity volume correlated well with simultaneously determined changes in venous pressure. (4) Valvular incompetence could be local ized to the deep or superficial veins based upon the improvement in refilling times seen following placement of elastic tourniquets around the lower limb. (5) The type of exercise performed (knee bends while the patient was standing versus ankle reflexes while sitting) had little effect on results. The authors conclude that exercise venous plethysmography is a useful noninvasive tool for assessing low er limb venous incompetence.
Is Sublingual Nifedipine Administration Superior to Oral Administration in the Active Treatment of Hypertension?
Authors: Diker Erdem , Ertürk Sehsuvar , Akgün Günes 
Published: November 2007

Nifedipine, a calcium-channel-blocking agent, was administered orally to 44 untreated patients (Group A) and sublingually to 51 untreated patients (Group B) who had a diastolic blood pressure more than 90 mm Hg and systolic blood pressure more than 140 mm Hg. The mean pretreatment systolic and diastolic blood pressure values were 185.3 ± 26.0 and 115.1 ± 13.4 mm Hg in Group A patients and 193.6 ± 23.1 and 118.1 ± 14.1 mm Hg in Group B patients respectively (p >0.05). The hypotensive activity of nifedipine was observed at the tenth minute in both groups. Mean systolic and diastolic pressures were 168.9 ± 23.7 and 101.9 ± 14.2 mm Hg in Group A and 170.6 ± 26.2 and 103.0 ± 15.8 mm Hg in Group B, (p < 0.001) Diastolic blood pressures dropped under 100 mm Hg at the twentieth minute in both groups. Maximal reduction of blood pressure was observed at the fortieth minute in both groups and the degree of reduction in blood pressure was also the same (mean systolic and diastolic blood pressures: 143.7 ± 22.1 and 86.9 ± 11.7 in Group A and 148.7 ± 21.4 and 91.7 ± 17.0 in Group B (p >0.05) The authors conclude that sublingual nifedipine administration is not supe rior to oral nifedipine administration (in capsular form) in the acute treatment of hypertension.
Measurement of Lymphatic Flow Variation by Noninvasive Method Cases of Lymphedema
Authors: Thibaut G. , Durand A. , Follignoni P. , Bertrand A. 
Published: November 2007

The purpose of this study was to measure the variations of lymphatic flow. A noninvasive isotopic method was used to achieve a functional exploration of lymphatic circulation. Fifteen subjects were used in the study: 10 healthy subjects and 5 patients with lower extremity lymphedema. A first subcutaneous injection of technetium 99m rhenium sulfate (99mTc) was performed in the first interdigital space of both feet. The radioactivity was re corded in two places: the first one on the inguinal site by a gamma camera; the second, below the first, on the precordial site by a multichannel analyzer. With the two types of recording procedures, it was possible to obtain a curve that showed the amount of radioactivity in relation to time. In order to obtain a muscular activity fifty-five minutes after the injection, each subject or patient spent ten minutes on an ergometric bike. A second subcutaneous injection was performed one week later, but prior to the injection, the subject or patient took orally 1800 mg of heptaminol adeno sine phosphate (HAP) per day for three days. The radioactivity recording was made under the same conditions as with the muscular activity. The statistical results of the experiment without treatment on the two types of recording show that in the healthy subjects the amount of radioactivity in creased during muscular activity. Moreover, the treatment indicated higher ra dioactivity values, which remained at a higher level. However, the muscular activity performed by a patient was unable to increase the radioactivity. On the other hand, the drug gave radioactivity values that were higher than the previous values of the first curve. Then, because of the increase of the pre cordial recording in all cases, it is possible to say that the lymphatic flow rose; the drug was able in each case to obtain an increase in the lymphatic flow. This method permits recognition of an increase in the lymphatic flow; more over, it shows that muscular activity improved the flow only in healthy subjects, whereas HAP in all cases constantly gave a higher flow.
Comparison of Three Progressive Exercise Protocols in Peripheral Vascular Occlusive Disease
Authors: Gardner Andrew W. , Skinner James S. , Vaughan Natalie R. , Bryant Cedric X. , Smith L. Kent 
Published: November 2007

Although claudication pain and hemodynamic responses to exercise are usually clinically assessed via graded treadmill walking, measuring these responses to other commonly performed tasks may yield a more nearly complete evaluation of peripheral vascular occlusive disease. Thus, the purpose of this study was twofold: (1) to determine the reliability of claudication and hemodynamic responses to level walking and stairclimbing and (2) to compare these responses with those obtained with graded walking at similar oxygen consumption. Ten patients with stable claudication symptoms performed graded walking, level walking, and stairclimbing progressive protocols with respective increases in grade, walking speed, and stepping rate on a modified stairclimbing device every two minutes. Similar peak oxygen consumption (13.60 to 14.18 mL/kg/min) was attained with the three protocols (P = NS). Reliability coefficients for the times to onset and to maximal claudication pain during level walking (R = 0.95 and 0.95, respectively) and during stairclimbing (R = 0.92 and 0.82, respectively) were similar to those previously obtained during graded walking. Reliability coefficients for foot transcutaneous oxygen tension during and following level walking (R = 0.78 to 0.96) and stairclimbing (R = 0.65 to 0.98) and for ankle systolic blood pressure following level walking (R = 0.95 to 0.97) and stairclimbing (R = 0.90 to 0.98) were also similar to those previously found with graded walking. Additionally, claudication and hemodynamic measurements were similar among the three exercise protocols. Thus, because graded walking, level walking, and stairclimbing progressive exercise protocols yield reliable and similar information about the hemodynamic severity of peripheral vascular occlusive disease, only one is needed for evaluation.
Double-Blind Comparison of the Clinical, Hemodynamic, and Electrocardiographic Effects of Sodium Meglumine Ioxaglate or Iohexol During Diagnostic Cardiac Catheterization
Authors: Petersen Ronald , McKay Charles R. , Kawanishi David T. , Kotlewski Adam , Parise Karen , Niland Joyce C. 
Published: November 2007

The clinical effects and the maximal hemodynamic and electrocardiographic effects of two low-osmolality radiographic contrast media (ioxaglate and iohex ol) were directly compared during diagnostic cardiac catheterization in a double- blind, randomized study in 80 patients. Because small changes were expected after injection of both of these agents, sensitive ECG and intracardiac-pressure- monitoring methods were used, and maximal changes, as well as mean changes in variables, were analyzed. Symptoms were absent, mild, or moderate in 67-77% of patients after left ventriculography and in 97-100% of patients after coronary arteriography. Af ter left ventriculography, maximum and minimum left ventricular systolic pres sure and end-diastolic pressure, the first derivative of left ventricular pressure (dp/dt), heart rate, were significantly altered over the two-minute observation period but were not different from the preinjection values at two minutes after both agents. Small but significant increases in mean aortic pressure, cardiac out put, and pulmonary arterial wedge pressures were seen at two minutes after both agents. Persistent prolongation of QTc interval over two minutes after ioxaglate injec tion was not associated with ectopy or clinical events. After coronary arteriog raphy maximum and minimum aortic pressures, ST and T wave segment displacements, and QTc intervals were significantly altered after both agents, but all variables had returned to preinjection values by two minutes. Compari son of the mean changes over time showed that only QTc intervals were altered after left ventriculography. Direct comparison of the maximum changes between the two agents showed that both contrast agents caused similar hemodynamic and electrocardiographic changes except for small but significantly greater decreases in heart rate with iohexol after left ventriculography and after right coronary arteriography. These contrast agents have small differences in osmolality and significant differences in sodium content. Clinical events of nausea and heat sensation were noted more often in the ioxaglate group, but the frequency did not reach statistical significance. Analyses of maximal changes using sensitive monitoring devices showed that the two agents have substantially similar hemodynamic and elec trocardiographic effects. Analysis of mean changes over time was less sensitive in identifying small, transient changes and differences between the two agents.
Fibrinolytic Enhancement in Diabetic Microangiopathy with Defibrotide
Authors: Belcaro G. , Marelli C. , Pomante P. , Laurora G. , Cesarone M.R. , Ricci A. , Girardello R. , Barsotti A. 
Published: November 2007

Skin microcirculation was evaluated in 117 patients with diabetic microan giopathy over a period of six months. They were divided into two groups. Group 1 (64 patients) was treated with oral defibrotide, a new profibrinolytic drug, in association with diet and oral antidiabetic drugs. Group 2 (53 patients) was treated only with diet and antidiabetic agents. The microcirculation was studied by means of laser-Doppler flowmetry trans cutaneous partial pressure of oxygen and carbon dioxide pressure measurements, and evaluation of capillary filtration. After six months, patients in group 1 improved their microcirculatory parameters in association with an improvement in signs and symptoms. Moreover, 30 patients in group 1 and 36 in group 2 were followed up for eighteen months, and the authors observed that the deterioration of the microcir culatory parameters was significantly slowed in diabetics treated with defibrotide. A decrease in plasma fibrinogen during defibrotide treatment was observed in all treated patients in association with an increased fibrinolytic activity. In conclusion, it appears that defibrotide, enhancing fibrinolysis, improved the microcirculation in diabetics, preventing further, progressive deterioration.