bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Management of Valvular Heart Disease in Children
Authors: Folger Gordon M. 
Published: November 2007

The child with significant valvular heart disease may present in any single instance both the most difficult of management decisions or a surprisingly simple one. Thus, if a direct surgical approach on the valve is feasible, the problems may very well be quite simple and straightforward; conversely, if valve replacement is indicated such may not be the case. We have recently reported our experience with one type of valvular heart condition, congenital aortic stenosis, in respect to determination of surgical approach based upon the ability to predict the orifice area and valvular anatomy.1,2 This report reviews our current experience with this technique. As well, the experience concerning the approach to each of the valvular conditions will also be reviewed with emphasis in respect to the left heart valves and particularly their long term postoperative management.
Trental® 400 in the Treatment of Intermittent Claudication: Results of Long-Term, Placebo-Controlled Administration
Authors: Roekaerts F. , Deleers L. 
Published: November 2007

A double-blind, randomized, placebo-controlled long-term clinical study of Trental® 400 was carried out, partly under cross-over design, partly as a parallel-group study, in 36 patients suffering from chronic arterial obstructive disorders in the lower limbs, associated with intermittent claudication, in order to evaluate the effectiveness and the safety of this drug administered t.i.d. over a period of 6 months. This controlled period was preceded by a placebo run-in period of 3 months. The clinical results under Trental 400 showed a statistically significant within group improvement of painfree and maximum walking parameters (p < 0.05) corresponding to an increase to baseline by + 96% to + 139% respectively and also in comparison to placebo (p < 0.05). The alterations of walking parameters within the placebo groups, ranging between -25% and +28% were not significant. The subjective parameters (rest pain, paraesthesias, muscular cramps and sensation of heaviness in the legs) paralleled the course of the walking parameters. Under Trental 400, 24 out of 36 patients reported an improvement of these symptoms compared to 7 under placebo. Trental 400 was well tolerated. Minor side effects were mentioned by 7 out of 36 patients. One patient had to stop the drug treatment because of persisting prickling sensation and subsequent insomnia. Drug-related changes in the laboratory findings could not be detected; vital signs varied in function of age, concomitant drug treatments and seasonal factors. The results obtained in these studies suggest Trental 400 as a drug of choice for treating patients with intermittent claudication due to peripheral arterial obstruction according to stage II or III after Fontaine.
Non-Invasive Predictors of Short and Long-Term Survival in Dilated Cardiomyopathy
Authors: Missri Jose C. 
Published: November 2007

Dilated cardiomyopathy (DCM) carries a poor prognosis. This study exam ined the non-invasive parameters that may be predictive of survival in two groups of patients, short-term survivors who died within one year of onset of symptoms (Group I, 6 patients) and long-term survivors who survived greater than one year of presentation (Group II, 16 patients). The M-mode echocardio gram (E), resting radionuclide ventricular function study (RNA) and electro cardiogram (ECG) were reviewed for factors that would differentiate between Group I and II. The E mean ventricular wall thickness in Group I was 0.6 cm and Group II 0.9 cm (p < 0.05), a hypertrophy-dilation index (mean thick ness/LVDd) was 0.09 for Group I and 0.12 for Group II (p < 0.05). There was no significant difference between Groups I and II in LVDd by E, RNA, LV ejection fraction, ECG (LVH, ventricular ectopy, conduction abnormalities). Thus, the finding of a mean ventricular wall thickness of 0.9 cm and a hyper trophy-dilation index of greater than 0.10 by E was predictive of survival longer than one year. The ECG and RNA LV ejection fraction did not predict outcome.
Age-Dependent Changes of Collagen and Elastin Content in Human Aorta and Pulmonary Artery
Authors: Hosoda Yasuhiro , Kawano Koichi , Yamasawa Fumihiro , Ishii Toshiharu , Shibata Tetsuichi , Inayama Seiichi 
Published: November 2007

Collagen and elastin in the arterial wall are thought to show some age-dependent changes, and to relate with development of the arteriosclerotic lesion. Both aortas and the pulmonary trunks were collected from 137 autopsy cases. Biochemical determination of collagen and elastin content was carried out. Collagen and elastin of the aorta and the pulmonary artery showed no significant age-dependent changes. Elastin content of the pulmonary artery increases with age in the adult. This paper seems to be the first report of simultaneous estimation of collagen and elastin content of both the aorta and the pulmonary artery.
The Effectiveness of Isoxsuprine in Patients With Intermittent Claudication
Authors: Skotnicki S.H. , van Gaal G. , Wijn P.F.F. 
Published: November 2007

Sixty male patients with intermittent claudication were investigated in a ran domized, double-blind, placebo-controlled study in order to determine the ef fectiveness of Isoxsuprine. The analysis of the results was made on the basis of subjective assessment of symptoms by the patients themselves and also on the results of segmental blood- pressure measurements and ankle/arm indices at rest and after standardised exercise. Significant differences were demonstrated between the active and placebo groups as regards pain-free walking distance although arterial pressure mea surements did not show statistically significant differences between the two groups. Isoxsuprine appears to be significantly beneficial only for patients with ob structions at the femoro-popliteal level.
Treatment of Hypertension in Mild Asthmatic Patients With Atenolol
Authors: Krauss Shimon , Spitz Edward , Krauss Agota , Grizotzki Bronja , Clement Sinai 
Published: November 2007

Fourteen patients with uncomplicated essential hypertension and mild asthma were treated with Atenolol 50-125 mg/day for up to 8 months. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), rate pressure index (RPI), stress testing time (STT) and peak expiratory flow rate (PEFR) were measured before, during and after stress testing (ST) before and during treatment. Atenolol significantly lowered HR, SBP, DBP and RPI. It prolonged STT and had no effect on PEFR. Furthermore, Atenolol did not worsen the patient's asthma except for one patient. The drug did not interfere with the bronchodilatation effect of salbutamol. Atenolol can be used cautiously to treat hypertension in asthmatic patients under certain conditions.
Hemodynamic Factors Changing Blood Flow Velocity Waveform and Profile in Normal Human Brachial Artery
Authors: Baccelli Giorgio , Pignoli Paolo , Corbellini Ezio , Pizzolati Pier Luigi , Bassini Mario , Longo Tito , Zanchetti Alberto 
Published: November 2007

We have investigated the influence of changes of perfusion pressure and local peripheral resistance on blood flow velocity waveform and profile in normal human peripheral arteries. Blood flow velocity and profile were recorded from the distal end of the left brachial artery in ten normal subjects by means of an ultrasonic device. The records were obtained in basal conditions and after blood pressure in the brachial artery and local peripheral vascular resistance were changed, separately or together, by progressive inflation of two arm cuffs, one encircling the proximal half of the left arm and the other the middle part of the left forearm. Both blood flow velocity waveform and profile were shown to be markedly modified by changes in perfusion pressure and local peripheral vascular resistance. Reduction of perfusion pressure decreased both forward and reverse peak velocities, but had the largest effect upon reverse velocity. The upslope and the downslope of the forward velocity wave were left unchanged. Increase in local peripheral vascular resistance markedly augmented reverse peak velocity, whether perfusion pressure was normal or reduced. Increased resistance only slightly influenced peak forward velocity.
Clinical-Instrumental Relationships in Post-Phlebitic Syndrome
Authors: Bartolo M. , Antignani P.L. , Nicosia P.M. , Raffi S. 
Published: November 2007

981 lower limbs belonging to 829 subjects, 67.6% of which were females, have been examined. The average venous pressure at the tibial posterior vein was 101 ± 12 mmHg and 102 ± 13 mmHg on the internal saphenous vein. In 311 lower limbs with femoro-iliac thrombosis, venous pressures are slightly higher than in 670 lower limbs with calf veins occlusion. In the 44.4% of cases the phlebothrombosis was clearly dependent on traumas, deliveries, surgical operations or other conditions. The relationships between the supposed aetiopathogenesis of the affection and the pressure values have been examined. The 6.7% refers to phlebitis, which caused pulmonary embolism during their acute phase. The different objective and subjective symptoms have, furthermore, been taken into consideration. It has been noticed by the analysis of the diagrams of the pressure values in the time that the same values which are considerably high at the initial phase of the iliac postphlebitic syndrome, are always high in the following years. On the other hand, in postphlebitic syndrome of the leg those pressures whose value are not remarkably high in the initial phase, increase from the second to the fourth year after the arising of phlebitis and, finally become stable at fairly high values, but still lower than those of iliac syndrome. The venous orthostatic pressure of internal saphenous vein in the iliac postphlebitic syndrome was also found to exceed the deep pressures, likely because of the altered saphenous discharge at the cross level.
Peripheral Circulatory Effects of Insulin in Diabetes
Authors: Takata Shigeo , Yamamoto Masakazu , Yagi Shinji , Noto Yutaka , Ikeda Takayuki , Hattori Nobu 
Published: November 2007

Peripheral circulatory effects of insulin were studied in the diabetic patients with and without autonomic neuropathy. Forearm blood flow, calf venous vol ume and calf venous distensibility were measured by strain gauge plethysmo graphy. In the diabetic patients with autonomic neuropathy, mean blood pres sure fell from 96±5 to 88±5 mmHg after an intravenous injection of 4 U of monocomponent insulin (p < 0.001). Forearm vascular resistance decreased from 53.99±8.29 to 45.88±7.76 mmHg•ml -1•100ml-1•min-1 after insulin (p < 0.01). Insulin increased calf venous volume from 1.20±0.19 to 2.23±0.44 ml/100ml (p < 0.05) and calf venous distensibility from 0.039±0.004 to 0.082±0.016 ml/mmHg (p < 0.05). In contrast, in the diabetic patients without autonomic neuropathy, there were no significant changes in the mean blood pressure, forearm vascular resistance, calf venous volume and calf venous dis tensibility. Symptoms of hypoglycaemia did not occur in any patient. These results suggest that insulin has a vasodilator action on both resistance and capacitance vessels, which may be one of the main factors in insulin-in duced hypotension.
Conservative Treatment of Lymphoedema of the Limbs
Authors: Földi Ethel , Földi M. , Weissleder H. 
Published: November 2007

Management of Lymphoedema is extremely variable in the medical profes sion, ranging from aggressive diagnostic procedures, which may aggravate the disease (lymphography by oily contrast mediums) in combination with thera peutic nihilism to precipitous operations. Scattered between these two con traversial extreme positions are quite a number of various conservative methods - some of which being in conflict with the anatomy and physiology of the lymph vascular system and the pathology of Lymphoedema. Lymphoedema, if left untreated, or is treated inadequately, may lead to in- validity and to death if Stewart - Treves Syndrome develops. Unnecessary sur gery may have disastrous consequences. The paper describes how Lymphoedema can be treated with success, free of any side effects, by complex physiotherapy.
Prevalence of Atherosclerotic Lesions at the Carotid Bifurcation in Patients with Asymptomatic Bruits: An Echo-Doppler (Duplex) Study
Authors: Lusiani L. , Visona A. , Castellani V. , Ronsisvalle G. , Bonanome A. , Pagnan A. 
Published: November 2007

The prevalence of atherosclerotic lesions at the carotid bifurcation with asymptomatic Meck bruits has been evaluated in 71 patients, 42 males, ages ranging from 19 to 84 yrs, referred to our non-invasive vascular laboratory for an echo-doppler (duplex) scan, associated with spectral analysis (Mark V ATL with Flow analyzer 459). Fifty-nine patients had mid-neck or high-neck bruits (30 bilateral), 12 had low-neck bruits (4 bilateral). The internal carotid arteries were classified as normal, minimal stenosis (diameter reduction 20%), moder ate stenosis (20-49%), severe stenosis ≥50%), total occlusion. Twenty-four of the internal carotid arteries homolateral to a mid- or high-neck bruit were nor mal, 84% had stenosis of various degree (16% severe), 2% were occluded. Stenoses of various degree were also present on the contralateral side of the bruit. No lesions above a diameter reduction of 20% were present in the internal carotid arteries corresponding to a low-neck bruit. The echo-doppler (duplex) system, being capable of spanning the whole spectrum of the internal carotid occlusive disease, allows us to limit the number of the invasive diagnostic procedures in asymptomatic patients.
Blood Flow Properties and Walking Performance in Chronic Arterial Occlusive Disease
Authors: Angelkort B. , Spürk P. , Habbaba A. , Mähder M. 
Published: November 2007

Recent investigations suggest an interdependence between blood fluidity and walking performance in patients with peripheral arterial occlusive disease (PAOD). Therefore, various blood fluidity variables (erythrocyte aggregation, erythrocyte flexibility, plasma viscosity, plasma proteins) were studied in groups of healthy subjects and claudicants with severe PAOD (exhausted perfusion re serve) receiving intravenous treatment with Trental (600 mg Pentoxifylline b.i.d., 21 days). Erythrocyte flexibility (expressed by filterability through micropore filters), red cell aggregation and plasma viscosity deteriorate with progression of disease especially in Stage IIb and III Fontaine classification, with walking distance below 150 m. Trental treatment resulted in patients with advanced POAD stages in im provement of red cell filterability, red cell aggregation, decrease of plasma vis cosity, increase in absolute walking distance and relief from rest pain, suggesting that such patients are accessible to conservative treatment with he morheologically active agents.
The Prevention of Ca2+ Overload in Vascular Smooth Muscle by Flunarizine as Detected by Laser Microprobe Mass Analysis (LAMMA)
Authors: De Nollin Sonja , Borgers Marcel , Jacob Willem , Wellens Donald 
Published: November 2007

In vitro exposure of depolarized caudal artery preparations of the rat to a high calcium concentration resulted in a strong contraction of the smooth mus cle cells. This muscle contraction was suppressed by flunarizine. It was shown cytochemically, using the combined oxalate-pyroantimonate method for the lo calization of calcium, that a considerable amount of electron-dense precipitate was seen over the depolarized muscle cells after incubation in a calcium contain ing medium. On the other hand this precipitate was not present on the smooth muscle cells when flunarizine was added to this incubation medium. The reac tion product was only present in the extracellular space. These results were controlled by Laser Microprobe Mass Analysis. By evap orating and ionizing small parts of the smooth muscle cells ( ± 1 μm), it was confirmed that the cytochemical method indeed demonstrated calcium, with negligible interference of other cations.
Essential Hypertension: A Metabolic Cause? A Hypothesis
Authors: Macieira-Coelho Eduardo , Garcia-Alves Mario , Reis-Valle Antonio 
Published: November 2007

Forty-five hypertensive patients, 28 women and 17 men, age range between 35 and 65 years (mean 50 years), with blood pressures which current therapy did not succeed to control, were submitted to several examinations in order to identify the cause of their hypertension. We found isolated or combinated ab normal values of aldosterone, renin, calcium and or potassium as the only alter ations in 19 patients. We distinguished 4 groups descretionarily classified according to biochemical alterations: renin and aldosterone increase, renin in crease, aldosterone increase, calcium and or potassium reduction. The therapy used, intentionally aimed at the correction of the biochemical alterations found. Normal blood pressure was achieved in all patients and si multaneously the biochemical alterations also became normal in patients with isolated hyperreninemia, with combined hyperreninemia and hyperaldos teronemia and in those with hypocalcemia and or hypopotassemia. In patients were only isolated hyperaldosteronemia was found, this condition returned to normal in all except one. We suggest that besides the disturbances in sodium distribution other elec trolytes or biochemical alterations may also play an equally important role in regulating, and sustaining essential hypertension.
Haemorheological Parameters in Hypertensive Nigerians With and Without Sickle-Cell Trait
Authors: Reid H.L. , Anah C.O. 
Published: November 2007

Haemorheological parameters including whole blood (WBF) and erythrocyte filterability (EF), haematocrit (H'ct), haemoglobin levels (Hb) and plasma fi brinogen concentration (PFC) were measured in 61 adult Nigerians with un complicated essential hypertension during the course of their routine anti-hypertensive treatment. Results from these patients were compared to those of 39 age and sex-matched normotensive controls. Sixteen (26.2%) of the hypertensive patients and 6 (15.4%) of the controls had the sickle-cell trait (HbAS); the rest were normal homozygotes (HbAA). Although there were no significant difference between WBF in the HbAA hypertensive and control groups, the former had a significantly lower EF than the latter (p < 0.025). Both WBF and EF were highly significantly decreased in the HbAS-hypertensives (p < 0.001). Significant differences in H'ct and Hb lev els between HbAA-hypertensives and controls were attributed to sex rather than to hypertension per se. Plasma fibrinogen concentration values were consist ently and significantly elevated in all hypertensives irrespective of sex or haemo globin genotype. In contrast to the HbAA-hypertensives, all 16 HbAS-hypertensives had a persistently raised diastolic blood pressure above 90 mm Hg, suggesting that these patients are either resistant or are less responsive to conventional anti-hypertensive therapy. A more extensive follow-up study is in progress to assess the possible rela tionship of these parameters and blood pressure, particularly in hypertensive individuals with sickle-cell trait (HbAS).
Serum Copper in Myocardial Infarction—Diagnostic and Prognostic Significance
Authors: Singh M.M. , Singh Ram , Khare Anukool , Gupta M.C. , Patney N.L. , Jain V.K. , Goyal S.P. , Prakash V. , Pandey D.N. 
Published: November 2007

Serum copper estimations were carried out in 44 cases of acute myocardial infarction, 23 cases of angina and 40 age and sex matched healthy controls. A highly significant degree of rise in serum copper levels was observed in patients with acute myocardial infarction as compared to cases of angina and controls. The levels showed a gradual rise with peak on 7th day followed by a gradual decline returning to normal on 28th day. The pattern was the same both in complicated and uncomplicated cases except that values were still higher on the 28th day in complicated cases of acute myocardial infarction. Mean peak serum copper levels were significantly higher (p < .001) in com plicated cases of acute myocardial infarction as compared to uncomplicated cases. Significant correlation was found between serial serum copper changes and creatinine phosphokinase and lactic dehydrogenase levels. The prognostic and diagnostic significance of serum copper has been dis cussed.
Therapy of Atherosclerotic Arteriopathy of Lower Limbs Aspects and Results
Authors: Tesi M. , Bronchi G.F. , Carini A. , Karavassili M. 
Published: November 2007

As far as therapy is concerned, atherosclerotic arteriopathy may be divided into acute and chronic forms. In acute embolic forms, therapy should be surgical. Only in cases of periph eral embolism or polyembolism, and in rare cases for which vascular surgery cannot be adopted, can thrombolysis be carried out with UK. In acute thrombotic forms, therapy should be medical, because a thrombus of recent formation is rich in fibrin and may be lyzed by UK. Total recanaliza tion takes place in 61% of cases treated, partial recanalization in 23%. Subse quently perviousness is maintained by adequate antithrombotic therapy. In chronic arteriopathy, the thrombus is lacking or almost lacking in fibrin and thrombolytic therapy is not indicated. Special therapeutic combinations are used containing platelet inhibitors (ticlopidine), antifibrin drugs (subcutaneous heparin), minor fibrinolytic agents (mesoglycan) and hemorheological drugs (pentoxyphylline). This therapy seems to give good results, as showed by the low percentage in amputation calculated on 2,565 patients treated and kept under observation for 5 years. Finally let us consider chronic progressive arteriopathy. This term indicates a very advanced stage, characterized by a gradual irreversible change for the worse leading towards gangrene. As a last resort, before amputating, a throm bolytic therapy with UK was tried to see if with strong fibrinolysis continued for 3 days amputation might be avoided. In a pilot study carried out on 12 patients, the angiographic data showed only partial lysis in small arteries or arterial branches. Clinical data showed reduction or disappearance of pain at rest in 80% of cases. In 70% of cases gangrene disappeared if it was initial and superfi cial, it was delimited if already in progress.
Strain Gauge Plethsymography in Ischemic Handsyndromes
Authors: van Rhede van der Kloot E.J.H. , Breslau P.J. , Jacobs M.J.H.M. , Greep J.M. 
Published: November 2007

In sixteen patients with ischemic handsyndromes, strain gauge plethysmography was used as a noninvasive diagnostic test. Contrast-arteriography was available for comparison. These patients demonstrate the role for a noninvasive test in selecting patients with Raynaud's phenomenon or asphyxia for arteriography.
The Significance of a Persistent Precordial ST Segment ≥ 0.1 mV Depression in Acute Inferior Myocardial Infarction (Coronary Angiographic and Ventriculographic Findings)
Authors: Kouvaras George , Spyropoulou Mary , Bacoulas George 
Published: November 2007

40 patients with acute inferior myocardial infarction (MI) associated with persistent precordial ST segment depression ≥ 0.1 mV underwent coronary arteriography and left ventriculography within 5-6 days of their admission. The inferior MI was the result of complete occlusion of the right coronary artery (RCA) in 38 patients and the result of complete occlusion of the posterior descending artery (PDA) coming off the cicrumflex artery (Cx) in two patients. 36 (90%) of the 40 patients showed one or more severe stenoses in the left anterior descending artery (LAD). 12 of the 36 patients had severe triple vessel disease. The 36 patients whose coronary arteriograms showed significant LAD stenosis had an emergency coronary artery by pass graft (CABG) operation. Soon afterwards the precordial leads were normal and the patients free of angina till their discharge from hospital. We conclude that a persistent precordial ST segment ≥ 0.1 mV depression in acute inferior MI is highly predictive of significant LAD disease.