bluuebunny/crossref_metadata_2025_split huggingface dataset:
Selective agonists revealα1A‐ andα1B‐adrenoceptor subtypes in caudal artery of the young rat
Authors: Parés‐Hipólito J. , Gómez‐Zamudio J. H. , Gallardo‐Ortiz I. A. , López‐Guerrero J. J. , Santamaría‐Ortiz J. , Ibarra M. , Villalobos‐Molina R. 
Published: September 2006

Summary1 Multipleα1‐adrenoceptors were evaluated in caudal artery of the young Wistar rat using selective agonists and antagonists.2 Arteries were exposed to the selectiveα1A‐adrenoceptor agonist, A‐61603 (N‐[5‐(4,5‐dihydro‐1H‐imidazol‐2‐yl)‐2‐hydroxy‐5,6,7,8‐tetrahydronaphthalen‐1‐yl] methanesulfonamide) or to phenylephrine and to prazosin (α1‐adrenoceptor antagonist), or the selectiveα1A‐adrenoceptor antagonists 5‐methylurapidil, RS 100329 (5‐methyl‐3‐[3‐[4‐[2‐(2,2,2,‐trifluoroethoxy)phenyl]‐1‐piperazinyl]propyl]‐2,4‐(1H)‐pyrimidinedione), RS 17053 (N‐[2(2‐cyclopropylmethoxy) ethyl]‐5‐chloro‐α,α‐dimethyl‐1H‐indole‐3‐ethanamide), and the selectiveα1D‐adrenoceptor antagonist BMY 7378 (8‐[2‐[4‐(2‐methoxyphenyl)‐1‐piperazinyl]ethyl]‐8‐azaspiro[4.5] decane‐7,9‐dione).3 Results showed a 100‐fold higher potency of A‐61603 for theα1‐adrenoceptor present in the artery, compared with phenylephrine. Prazosin displaced both agonists with high affinity, whereas 5‐methylurapidil, RS 100329 and RS 17053 displaced A‐61603 with high affinity, indicating the presence ofα1A‐adrenoceptors.4 The selectiveα1A‐adrenoceptor antagonists blocked phenylephrine responses with low affinity, suggesting that phenylephrine activated a second receptor population in caudal artery.5 BMY 7378 antagonized with low affinity both A‐61603 and phenylephrine‐induced contractions, indicating absence ofα1D‐adrenoceptors in the vessel.6 The results suggest that functionalα1B‐adrenoceptors are present in caudal arteries of the young Wistar rat.
Pulmonary blood volume and transit time in cirrhosis: relation to lung function
Authors: Møller Søren , Burchardt Hans , Øgard Christina G. , Schiødt Frank V. , Lund Jens O. 
Published: September 2006

Abstract: Background/Aims: In cirrhosis a systemic vasodilatation leads to an abnormal distribution of the blood volume with a contracted central blood volume. In addition, the patients have a ventilation/perfusion imbalance with a low diffusing capacity. As the size of the pulmonary blood volume (PBV) has not been determined separately we assessed PBV and pulmonary transit time (PTT) in relation to lung function in patients with cirrhosis and in controls.Methods: Pulmonary and cardiac haemodynamics and transit times were determined by radionuclide techniques in 22 patients with alcoholic cirrhosis and in 12 controls. The lung function including diffusing capacity for carbon monoxide (DL, CO) was determined by conventional single breath technique.Results: In the patients, PTT was shorter, 3.9±1.2 vs 5.7±1.0 s in the controls, P<0.001, and the PBV was lower, 362±151 vs 587±263 ml, in the controls, P<0.005. Both PTT and PBV were lowest in patients with advanced disease. DL, CO was reduced in the patients and correlated significantly with PTT (r=0.58, P=0.007) and PBV (r=0.49, P<0.03).Conclusions: The results suggest that the reduced PBV contributes to the reduced effective blood volume in cirrhosis. The relation between PBV and PTT and the low diffusing capacity suggests the pulmonary vascular compartment as an important element in the pathophysiology of the lung dysfunction in cirrhosis.
Reviews: Altered Laboratory Findings Associated with End‐Stage Renal Disease
Authors: Robitaille Robert , Lafrance Jean‐Philippe , Leblanc Martine 
Published: September 2006

ABSTRACTSeveral laboratory parameters can be altered in advanced renal failure. Results may be difficult to interpret and may become misleading and unreliable in such a context. On the other hand, some of the alterations may reflect real abnormalities. Thus sufficient knowledge and careful judgment are required by the clinician. We reviewed different publications related to biochemical anomalies in renal failure and report some of the main findings. The sections are divided as follows: cardiovascular risk factors and markers, inflammation markers, pancreatic and liver function tests, hormones, bone turnover indices and parathyroid hormone assays, tumor markers, carbohydrate metabolism indicators, and others. The information provided should be useful to clinicians involved in the care of renal failure patients.
The Role of Continuous Renal Replacement Therapy in the Treatment of Poisoning
Authors: Goodman Jeffrey W. , Goldfarb David S. 
Published: September 2006

AbstractExtracorporeal elimination of drugs and toxins is a critical component in the management of poisonings, though specific techniques and indications remain a matter of debate. Conventional hemodialysis is frequently the treatment of choice because of its widespread availability and proven effectiveness for certain drugs and toxins. With the increased availability of continuous renal replacement therapy (CRRT) modalities, there is yet another therapeutic option, but one that has yet to find a definitive role in this field. The continuous nature of these therapies is attractive for the management of acute renal failure, but the relatively slower clearance rates as compared to conventional hemodialysis is a distinct drawback in patients with acute xenobiotic‐induced toxicity. There are abundant case reports as well as a few small case series in the medical literature documenting the use of CRRT, but specific techniques and the clinical outcomes vary considerably. Therefore one cannot draw definitive conclusions regarding benefit. Some patients, particularly those who are hemodynamically unstable and are not candidates for conventional hemodialysis, may warrant a trial of CRRT. However, at the present time, routine use for the treatment of poisoning is not supported. Controlled trials to better clarify its role would be beneficial, though such studies would be extremely difficult to conduct in this field. We believe that the intelligent application of extracorporeal modalities requires a thorough knowledge of drug pharmacokinetics, of the techniques utilized, and a skeptical analysis of the available literature.
Interventional Nephrology in a Federal Hospital: Economics of Health Care
Authors: Vachharajani Tushar J. , Atray Naveen K. 
Published: September 2006

AbstractInterventional nephrology is now an accepted subspecialty of nephrology that is revolutionizing the standard of care for renal failure patients. Interventional nephrology deals with the placement of tunneled cuffed catheters (TCCs) and maintenance of permanent vascular accesses, thus assisting in timely care. Prior to 2000 most end‐stage renal disease (ESRD) patients from the Overton Brooks Veterans Affairs Medical Center (OBVAMC) were referred to an outlying hospital for TCC placement and endovascular procedures (EVPs) of permanent dialysis access. The referral process was cumbersome for the patients and expensive to the Medicine Service. OBVAMC started an interventional nephrology service in 2000. The current study reports the financial benefits of starting an interventional nephrology service at our institution. All procedures performed during the period from April 2000 to April 2004 were analyzed. The procedures were performed in the cardiac catheterization laboratory. The total payment (physician's and hospital fees) to the referral hospital for procedures prior to April 2000 was used to estimate the average savings to the Medicine Service over the last 4 years. A total of 129 TCCs and 43 EVPs were performed during this period. The estimated expense to OBVAMC would have been $603,978 for TCCs and $288,100 for EVPs based on charges prior to April 2000. The actual expense to the hospital, including facility fees and disposables, was $156,013. The net savings to OBVAMC over the last 4 years was $736,065. Interventional nephrology provided to a small population of renal failure patients in a tertiary federal health care facility has resulted in huge savings for the hospital. Increasing awareness of this procedural aspect of nephrology benefits not only the patients, but also helps ease the financial burden of ever‐escalating health care costs.
ASDIN Clinical Case Focus: Optimal Timing for Secondary Arteriovenous Fistula Creation: Devastating Effects of Delaying Conversion
Authors: Asif Arif , Leon Carlos , Merrill Donna , Ellis Renee , Bhimani Bhagwan , Pennell Phillip 
Published: September 2006

AbstractA chronic hemodialysis patient was referred to interventional nephrology for evaluation of arteriovenous access dysfunction. The patient had been receiving hemodialysis using a left forearm brachiobasilic loop graft for the past 3 years. Physical examination revealed a hyperpulsatile graft. Angiography documented a critical stenosis at the vein–graft anastomosis and a well‐developed basilic vein from the elbow to the axillary region. Central veins were patent all the way to the right atrium. All attempts to navigate the wire across the stenosis failed. The patient was educated and counseled regarding the possibility of surgical creation of a secondary arteriovenous fistula (AVF). The images obtained were shared and discussed with the surgeon. A plan to create a secondary AVF using the basilic vein in the arm was made. A few months later the patient was referred to interventional nephrology, this time for thrombectomy of the same left arm loop graft. Thrombectomy could not be performed and a right internal jugular tunneled catheter was inserted. The patient again was referred to the surgeon for AVF creation. Six weeks later the patient was seen in the interventional laboratory for removal of the right internal jugular tunneled catheter. It was noted that instead of a fistula, the patient had received a right forearm brachiocephalic loop graft. Devastating consequences, such as the lost opportunity to create a fistula, insertion of a tunneled dialysis catheter, arteriovenous graft placement, exhaustion of available sites for fistula creation, and exposure to increased morbidity and mortality associated with grafts and catheters, can result if the opportunity to create a secondary AVF is not availed in a timely manner. This concept must be understood by every member of the vascular access team.
Decision‐Making Deficits in Alcohol‐Dependent Patients With and Without Comorbid Personality Disorder
Authors: Dom Geert , De Wilde Bieke , Hulstijn Wouter , Van Den Brink Wim , Sabbe Bernard 
Published: September 2006

Background: Impairments in decision making are a consistent finding in substance use disorder (SUD) populations. However, decision‐making deficits are not specific for SUDs and are also reported in the context of other psychiatric disorders such as antisocial and borderline personality disorders (PDs). Given the frequent comorbidity between SUD and cluster B PD, it might be questioned whether the decision‐making impairments typically reported in SUD populations reflect the addictive disorder, the cluster B PD, or a combination of the 2.Methods: In the current study, we compare the decision‐making performance of non–substance‐abusing controls (n=53) on the Iowa Gambling Task (IGT) with the decision‐making performance of 3 abstinent alcohol‐dependent samples, i.e., alcoholic patients without any PD (n=38), alcoholic patients with a cluster A or C PD (n=19), and alcoholic patients with a cluster B PD (n=23).Results: Overall, all 3 alcohol‐dependent subsamples performed inferior compared with controls. Between alcoholic subsamples, the alcoholic patients with a cluster A or C PD had the highest IGT score, followed by the alcoholic patients without a PD, while the cluster B alcoholic patients were the most impaired.Conclusion: These findings suggest that impairments in decision making underlie both alcohol dependence and cluster B PD, and alcoholic patients with a comorbid cluster B PD are particularly impaired in their decision making. These deficits may underlie the severe problems that characterize cluster B alcoholic patients specifically in inappropriate behaviors (e.g., poly substance abuse, legal, and professional dysfunction).
Individual Differences in Ethanol Self‐Administration Following Withdrawal Are Associated With Asymmetric Changes in Dopamine and Serotonin in the Medial Prefrontal Cortex and Amygdala
Authors: Carlson Jeffrey N. , Drew Stevens K. 
Published: September 2006

Background: Ethanol withdrawal alters brain neurochemistry, causes asymmetric activation of neurons in the medial prefrontal cortex (mPFC) and amygdala (AMY), and increases ethanol craving and drinking. Rats with intrinsic rightward‐turning preferences drink more ethanol than those with left or no preferences; they also exhibit an ethanol‐induced neurochemical activation that favors the right side of the mPFC. Our experiments used rats with different turning preferences to assess differences in withdrawal effects on mPFC and AMY neurochemistry as well as ethanol self‐administration.Methods and Results: Rats with left‐turning, right‐turning, and nonturning preferences were fed a 6% ethanol‐containing liquid diet (WD) or a pair‐fed control diet for 14 days. Differences in dopamine (DA), serotonin (5HT), norepinephrine (NE), and metabolite [3,4‐dihydroxphenylacetic acid, homovanillic acid (HVA), and 5‐hydroxyindoleacetic acid) concentrations were assessed in each side of the mPFC and AMY during acute withdrawal. Similar groups were fed the same diets and tested for consumption of 10% ethanol versus water and 1% sucrose versus water. WD increased HVA/DA in the mPFC and caused depletions of DA and 5HT in the mPFC and 5HT in the AMY. These effects were greater in the right than in the left side of these structures in rats with right‐turning preferences. WD reduced ethanol drinking but right turners drank significantly more than left turners on day 2 of testing and drank more on days 2 and 3 than on day 1. No effects were observed on sucrose drinking. Similar groups were also trained to self‐administer ethanol using a sucrose‐fade sipper tube procedure that separated measures of ethanol seeking (bar pressing) and consumption. Following 14 days of vapor chamber exposure to ethanol, rats of all turning preferences had a lower rate of bar pressing on the first postwithdrawal day and shorter latencies to begin bar pressing on the third withdrawal day versus prewithdrawal baseline. Only right‐turning‐preference rats consumed more ethanol following withdrawal.Conclusions: These studies show that individual rats differ in postwithdrawal brain neurochemistry and ethanol consumption and that these differences are associated with differences in functional brain asymmetry.
Predictors of 16‐Year Mortality Among Individuals Initiating Help‐Seeking for an Alcoholic Use Disorder
Authors: Timko Christine , DeBenedetti Anna , Moos Bernice S. , Moos Rudolf H. 
Published: September 2006

Background and Methods: We examined rates and predictors of mortality in individuals (47% women) who had just initiated help‐seeking for their alcohol use disorders (AUDs) at the start of the study (n=628) and were followed for 16 years.Results: For both women and men, the observed‐to‐expected mortality ratio (1.4) was lower than rates found in samples of treated individuals with AUDs, suggesting that those initiating help‐seeking careers have better chances of long‐term survival. Of the individuals for whom cause of death was known, 68% died of alcohol‐related causes. Men were more likely to die than were women. When gender was controlled, individuals who were older and unmarried and had more alcohol dependence symptoms at baseline were more likely to die over the 16‐year period. When these baseline characteristics were controlled, better drinking outcomes at 1 year were associated with a lower likelihood of subsequent death. The combination of a shorter duration of inpatient/residential care and better drinking outcomes at 1 year was related to a lower probability of death, as was the combination of a longer duration of outpatient care or Alcoholics Anonymous attendance and better drinking outcomes at 1 year.Conclusions: Efforts should be made to help providers identify individuals who are not responding positively to inpatient or residential treatment and intervene to motivate participation in continuing outpatient care and community 12‐step self‐help groups to reduce the likelihood of a chronic and fatal AUD course.
Transthoracic Tissue Doppler Imaging of the Atria: A Novel Method to Determine the Atrial Fibrillation Cycle Length
Authors: DUYTSCHAEVER MATTIAS , HEYSE ALEX , DE SUTTER JOHAN , CRIJNS HARRY , GILLEBERT THIERRY , TAVERNIER RENE , TIELEMAN ROBERT 
Published: September 2006

Background: The atrial fibrillation cycle length (AFCL) is a critical parameter for the perpetuation and termination of AF. In the present study, we evaluated a new method to measure the AFCL based on transthoracic tissue Doppler imaging (TDI) of the right atrium (RA) and left atrium (LA). Methods: Twenty patients with AF (6 acute AF, 14 persistent or permanent AF) were studied. A quadripolar catheter was positioned at RA or LA to measure AFCL (AFCLEGM, gold standard). Transthoracic echocardiography (apical 4‐chamber view) was used to perform pulsed wave TDI at the free wall of RA or LA. AFCLTDI was defined as the time interval between two consecutive positive to negative crossings of the baseline of the atrial time velocity curves. AFCLEGM and AFCLTDI were measured at baseline and during a 10‐minute infusion of flecainide (1.5 mg/kg). Results: Measurement of AFCLTDI was feasible in all but one patient. At baseline, AFCLEGM was 170 ± 22 ms, AFCLTDI 172 ± 22 ms (difference 2 ± 5 ms). AFCLTDI correlated significantly with AFCLEGM (R = 0.91, P < 0.0001). Bland‐Altman analysis showed a bias of −2 ms with a 95% limit of agreement between −26 ms and +22 ms. During flecainide, the AFCLTDI method yielded an AFCL prolongation from 176 ± 23 ms at baseline to 279 ± 68 ms (P < 0.01) after 10 minutes of infusion (57 ± 26%). Conclusions: (1) Tissue Doppler imaging of the atria during transthoracic echocardiography can be used to reliably determine the AFCL during both acute and persistent or permanent AF. (2) Continuous measurement of AFCL with TDI can be used to monitor the effect of antiarrhythmic drugs on atrial rate during AF. (3) This novel method is attractive because of the ease of acquiring the data and its noninvasive character.
Adverse effects of fluorescein angiography in hypertensive and elderly patients
Authors: Musa Fayyaz , Muen Wisam. J. , Hancock Richard , Clark David 
Published: September 2006

Abstract.Purpose:  To evaluate adverse effects in patients undergoing fundus fluorescein angiography (FA), and to assess the level of these adverse effects in hypertensive and elderly patients.Method:  We carried out a retrospective study of 358 patients undergoing FA. They were assessed for adverse effects and their relationship to medical history, pre‐ and post‐FA blood pressure and age.Results:  The overall adverse reaction rate (AR) was 11.2%, the majority (80%) of which involved nausea. There were no mortalities and no cases of anaphylaxis or cardiac arrest. Hypertension (systolic or diastolic) did not increase the AR. Interestingly, raised initial systolic blood pressure (BP) ≥ 160 showed a statistically significant decreased AR compared with that for BP < 160 (7% versus 15%, respectively; p = 0.04). There was no statistical correlation between AR and age.Conclusions:  FA is a relatively safe procedure, but serious side‐effects have been reported in the past and therefore adequate measures need to be in place to cope with such emergencies. In our study, there was no increase in the incidence of adverse effects in patients who were hypertensive or elderly. Therefore, these patients should not be denied an important diagnostic procedure that may improve their quality of life purely because of hypertension or age.
Transscleral red‐laser cyclophotocoagulation combined with limited anterior retinal cryocoagulation in neovascular glaucoma
Authors: Raivio Virpi E. , Immonen Ilkka J. R. , Puska Päivi M. 
Published: September 2006

Abstract.Purpose:  To evaluate transscleral contact red‐laser cyclophotocoagulation (CPC), using a visible red 647‐nm krypton or 670‐nm diode laser and limited transscleral anterior retinal cryocoagulation in neovascular glaucoma.Methods:  In a retrospective case series, 35 eyes of 35 consecutive patients treated during a period of 6 years were included in the study. Inclusion was dependent on follow‐up of at least 1 month. Patients who had undergone previous cyclodestructive procedures and patients who received an additional glaucoma operation in conjunction with CPC were excluded. In the combined procedure, the power per CPC application was 370–450 mW and exposure time was 10 seconds. One to two rows of cryoapplications were given to 360 degrees of the anterior retina.Results:  The success rate in terms of intraocular pressure (IOP of 8–21 mmHg or a decrease in IOP > 30%) was 89% at the last follow‐up (17 ± 15 months). Iris neovascularization regressed in 51% of eyes. Hypotonia developed in one (3%) eye (IOP of 5 mmHg). No cases of phthisis bulbi were seen. Visual acuity (VA) declined in 49% of eyes.Conclusions:  A combination of transscleral contact red‐laser CPC with limited anterior retinal cryocoagulation is efficient in lowering IOP in neovascular glaucoma and is well tolerated. During follow‐up, a decrease in VA occurs in a significant proportion of patients.
The Wnt‐signaling pathway is not implicated in tumorigenesis of Merkel cell carcinoma
Authors: Liu Shuang , Daa Tsutomu , Kashima Kenji , Kondoh Yoshiyuki , Yokoyama Shigeo 
Published: September 2006

Background:  The Wnt‐signaling pathway, involving β‐catenin, apc, and axin, plays a critical role in numerous developmental events. Alterations in the Wnt‐signaling pathway have been detected in a wide variety of neoplasms. However, similar aberrations have not been described in Merkel cell carcinoma (MCC). The aim of this study was to determine the status of the Wnt‐signaling pathway in MCC.Methods:  Twelve cases of MCC were tested for the expression of β‐catenin and mutational status of CTNNB1 (gene for β‐catenin), APC, AXIN1, and AXIN2. Genomic DNA extracted from paraffin blocks was subjected to a polymerase chain reaction/single‐strand conformation polymorphism analysis and sequencing.Results:  Nuclear accumulation of β‐catenin was observed in only one case (8.3%), as determined by immunochemistry. No mutations were found in CTNNB1, APC, and AXIN2 in all cases, although silent mutations in AXIN1 were detected in three cases.Conclusions:  We conclude that the Wnt‐signaling pathway does not play an important role in tumorigenesis in MCC.