bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is Heparin-Induced Platelet Activation an Unrecognized Cause of Thrombosis in Chronic Dialysis Patients?
Authors: Brent Kerns D. , Frymoyer Paul A. , Kopecky Richard T. , Tice Diane , Fillinger Mark F. , Bruch David , Schwartz Robert A. 
Published: August 2008

Despite an increase in vaso-occlusive disorders and routine exposures to large quantities of heparin, chronic dialysis (CD) patients have not been studied for the presence of heparin-induced platelet activation (HIPA). Measurement of platelet aggregation and adenosine triphosphate release was performed at hepa rin concentrations of 0.1 U/mL and 100 U/mL using platelet-poor plasma (PPP) from 90 nonthrombocytopenic CD patients; 72 patients received heparin over prolonged periods (108 ±15 weeks); 18 patients received no heparin for two months prior to study. Results: PPP from 1 hemodialysis (HD) patient stimulated strong ( > 19%) platelet activation at both 0.1 and 100 U/mL heparin concentrations. Four pa tients (4.4%) demonstrated intermediate (10-19%) platelet activation in the presence of 0.1 U/mL but not 100 U/mL heparin concentrations. Eighty-five patients demonstrated no platelet activation ( < 10%) at either heparin concen tration. Conclusion: (1) None of the 90 dialysis patients met the strict laboratory criteria for HIPA. (2) Despite long-term exposure to large quantities of heparin, the prevalence of HIPA in CD patients appears to be no greater than that of the general patient population receiving heparin. (3) Nonthrombocytopenic HIPA is not a major factor contributing to thrombotic disorders in dialysis patients.
Vascular Complications After Total Knee Replacement —
Authors: McKellar Daniel P. , Dutro John A. , Mesghali Homayoun 
Published: August 2008

Despite the close association of the popliteal artery to the knee joint, rela tively few cases of arterial injury following total knee replacement have been reported. The authors report 2 patients with total knee prostheses who devel oped hemarthrosis due to pseudoaneurysm formation originating from the ge niculate branches of the popliteal artery. In 1 patient, early arteriography led to a prompt diagnosis and treatment with subsequent good outcome. In the second patient the diagnosis was delayed, for an arteriogram was performed only after recurrent bleeding. This patient had a prolonged course eventually necessitating removal of the total knee prosthesis. These cases emphasize the need for a high index of suspicion for arterial injury in patients who undergo total knee replacement with subsequent develop ment of hemarthrosis or persistent bleeding. Early arteriography to establish the diagnosis is advocated.
Intramyocardial Coronary Arteries: Dissection During Coronary Artery Bypass Surgery in 70 Patients
Authors: Olearchyk Andrew S. 
Published: August 2008

Between October, 1983, and January, 1991, of a total of 395 patients who underwent coronary artery bypass (CAB) surgery, 70 (17.7%) had dissection and vein (65.7%) or internal thoracic artery (ITA; 34.3%) grafting of intramyocardial (IM) coronary arteries for significant proximal coronary artery disease (CAD). The IM left anterior descending (LAD) artery was dissected and grafted in 58.6%, the IM branches of the circumflex artery (CFA) in 31.4%, the IM posterior descending artery (PDA) in 1.4%, and multiple IM arteries in 8.6% of the patients. The LAD artery was usually dissected distally at the site of reemergence, and then, the myocardium was transected cephalad, as were the CFA branches, by cutting the overlying myocardium over them. The intracavitary or subendocardial LAD arteries were dissected, grafted, and elevated to permit closure of the opened left ventricle (LV) beneath. There were no complications related to the dissection of the IM arteries. The IM arteries are usually of a larger diameter and more often free of atherosclerosis. Therefore, they should be dissected and grafted in patients suffering from significant proximal atherosclerotic disease.
Recanalization of Coronary Artery Occlusion in Patients with Acute Myocardial Infarction by Use of Brushing Wire—Case Reports
Authors: Hachida Mitsuhiro , Hirai Masaya , Ihashi Kenji , Koyanagi Hitoshi , Chong Young Shi  
Published: August 2008

A new coronary intervention using a brushing wire was performed in 11 patients at emergency. All patients were found to have a total obstruction in a coronary artery or a coronary bypass graft. In all patients, thrombolytic ther apy had been performed, without achieving coronary recanalization. Infarct- related arteries on which this technique was used were the left descending artery in 8 patients, right coronary artery in 2 patients, and a bypass graft in 1 patient. The mean ischemic time was 4.18 ±2.59 hours. Coronary recanalization was obtained in all patients (100%). The residual diameter stenosis was less than 50% in 3 patients, between 50% and 95% in 5 patients, and more than 95% in 3 patients. Preserved left ventricular ejection function was 57.0±12.8%. Ventricular fibrillation occurred in 2 cases owing to thrombolytic therapy. Additional intervention was performed with percuta neous transluminal angioplasty in 3 patients and with coronary artery bypass grafting in 7 patients. One patient underwent CABG following PTCA. Addi tional intervention was not required in 2 patients.
Therapy of Peripheral Arterial Disease: Laser-Assisted Angioplasty Combined with Intravascular Endoprosthetic Stents
Authors: Hundt Cornelia , Berger Hermann , Schmand Jochen , Lauterjung Lutz 
Published: August 2008

Percutaneous transluminal laser-assisted angioplasty (PTLA) was combined with percutaneous implantation of vascular endoprostheses to reduce the reoc clusion rate after recanalization of iliac and femoropopliteal occlusions. PTLA (laser recanalization and following balloon dilation) was performed in 56 complete occlusions of iliac (n=9), femoral (n=31), and popliteal (n=16) arteries. Success or failure was defined by clinical criteria (Fontaine's classifica tion), ankle-arm Doppler systolic pressure index, and (if necessary) arteriog raphy. Cumulative long-term patency (mean follow-up time sixteen months) was estimated by the Kaplan-Meier method. The success was also analyzed in corre lation with a couple of variables (localization, length of occlusion, vessel runoff, and the medical treatment). The initial success rate of PTLA was 83.9%. Reocclusions (4 immediate and 5 at follow-up) occurred only in patients with initially insufficient morphologic result after balloon dilation. In 17 of such cases with residual stenosis after PTLA, stents were implanted. Stent implantation was completed in 88.2%. The overall cumulative success was 68.4%. No difference was observed in this study between the long-term patency rates of treated iliac and femoropopliteal vessels. The combination of laser recanalization and implantation of vascular stents is a promising method in the management of peripheral arterial occlusive dis ease. It can prevent reocclusions after PTLA and avoids bypass surgery.
Long-Term Follow-up of Laser-Assisted Angioplasty: Analysis of Factors Influencing Restenosis and Patency
Authors: Odink Henk F. 
Published: August 2008

In a prospective study 24 successful laser recanalizations of femoropopliteal occlusions (mean length, 10.4 cm ± 6.6) were followed up. Before recanaliza tion all patients were classified according to the Rutherford classification and after one year grouped as a clinical success or failure. From the present, the Rutherford classification appears to be useful in predicting long-term patency. The patients classified in the Rutherford categories 1 and 2 showed a long-term patency of 86%. The patients classified in the categories 3, 4, and 5 had a mean patency of only 30%. This difference was statistically significant. The length of the occlusion influenced neither the patency nor the restenosis rate. The mean occlusion length in the vessels that remained patent was 10.3 cm ± 6.6, compared with a mean occlusion length of 10.5 cm ± 6.7 for the vessels that showed a restenosis. Directly after the procedure, the mean patency of the successes was 83% and that of the failures was 63%. It is postulated that the influence of the laser and 20% overdilation can contribute to a better long-term patency.
Lipid Peroxides in the Mechanism of Ischemia/Reperfusion Injury in Skeletal Muscle—Experimental Studies
Authors: Ikezawa T. , Nishikimi N. , Oba Y. 
Published: August 2008

Two sets of experiments were conducted to investigate whether oxygen-de rived free radicals are involved in the mechanism of ischemia/reperfusion (I/R) injury of skeletal muscle and vitamin E is effective in alleviating the injury. In the first set of experiments, twenty adult mongrel dogs were divided into three groups: group 1 (n=7) control, group 2 (n = 6) I/R, and group 3 (n=7) I/R with 500 mg of vitamin E. Serum creatine phosphokinase (CPK) and lipid per oxides (LPO) were measured as markers of rhabdomyolysis and biomembrane injury due to oxygen-derived free radicals, respectively. CPK increased signifi cantly after reperfusion with a peak value of 38,000 ± 9,800 mU/mL in group 2, when compared with a peak value of 1,060 ± 290 mU/mL in group 3 (p < 0.02). LPO also significantly increased with a peak value of 20.4 ±3.7 nmol/mL in group 2, when compared with a peak value of 9.2 ± 2.2 nmol/mL in group 3 (p < 0.04). In the second sets of experiments, 13 dogs were divided into two groups: group A (n=5) control and group B (n=8) I/R. Tissue LPO was measured eighteen hours after reperfusion in the gracilis muscle and gastrocnemius mus cle. The mean value of LPO in the gracilis muscle was 0.94 ± 0.46 nmol/mg protein in group A, compared with 1.13 ± 0.67 nmol/mg protein in group B. It was higher in group B, but there was no significant difference. Mean LPO in the gastrocnemius muscle was 0.85 ± 0.34 nmol/mg protein in group A, and 1.83 ± 0.71 nmol/mg protein in group B. There was a significant difference (p < 0.02). Serum CPK and LPO were significantly higher in group 2 than in groups 1 and 3, and tissue LPO was also high in skeletal muscle after reperfusion. Serum CPK and LPO were effectively suppressed by administration of vitamin E be fore reperfusion. These results show that oxygen-derived free radicals are involved in the mechanism of I/R injury in skeletal muscle and suggest that vitamin E is effec tive in alleviating the injury.
Lactobacillus Endocarditis Necessitating Combined Mitral and Aortic Valve Replacement—A Case Report
Authors: Olearchyk Andrew S. 
Published: August 2008

A sixty-nine-year-old man with previous exposure to radiation and with Heyde's syndrome developed endocarditis caused by Lactobacillus acidophilus, involving the mitral and aortic valves, and resistant to antibiotic treatment. He underwent mitral and aortic valve replacement (MVR and AVR) with mechanical valves, followed by six weeks of antibiotic therapy with excellent results.
Overwhelming Postsplenectomy Infection Presenting as Acute Lower Limb Ischemia—A Case Report
Authors: Hersch M. , Olsha O. 
Published: August 2008

This report describes acute ischemia of the right lower extremity as the first sign of overwhelming postsplenectomy infection (OPSI) in a sixty-five-year-old man with known peripheral vascular disease two months after gastrectomy and splenectomy for gastric cancer. While emergency arterial bypass was being con sidered, the patient developed generalized peripheral vasoconstriction together with clinical and laboratory evidence of consumption coagulopathy and meta bolic acidosis. The possibility of OPSI was suggested and he was accordingly managed in the intensive care unit. A blood culture grew Streptococcus pneumo niae. The patient died of overwhelming pneumococcal sepsis with marked hemodynamic instability and multiorgan dysfunction four days after admission. The onset of acute lower limb ischemia was an early sign of OPSI in this patient with preexisting peripheral vascular disease. This sign has not been pre viously reported.
Interval Gangrene After Femorodistal Bypass: Case Report
Authors: de Nie A.J. , Yo T.I. 
Published: August 2008

Interval gangrene is a rare but devastating complication after a successful peripheral revascularization procedure. It represents ischemic necrosis in a seg ment proximal to a functioning distal anastomosis and may develop when a bypassed segment is deprived of good perfusion. The patient here described underwent a femoroperoneal bypass because of severe atherosclerosis, with is chemia in the left lower extremity. Despite a good functioning bypass and a warm foot, she postoperatively developed ischemia of an area in the lower limb proximal to the distal anastomosis and eventually required above-knee amputa tion. This case emphasizes the need for maintaining good perfusion of the entire lower limb after successful distal extremity bypass, which may require adjunc tive procedures. The authors recommend, therefore, that intraoperative angi ography be performed routinely, not only to judge the anastomosis and the distal perfusion, but also to assess the adequacy of antegrade and retrograde perfusion of the bypassed segment. Thus measures can be taken in time for optimal prevention of interval gangrene.
Cardiac and Hemodynamic Effects of Infrarenal Aortic Clamping During Repair of Abdominal Aortic Aneurysms. A Reason for Combined Coronary Bypass and Aneurysm Repair in Patients with Severe Coronary Artery Disease
Authors: Carrel T. , Pasic M. , Schmid E.R. , Turina M. 
Published: August 2008

Coronary disease is the leading cause of early and late death after any type of vascular operation, but its immediate implications are more serious in patients who require abdominal aortic reconstruction. Infrarenal cross-clamping required during aortic replacement is generally well tolerated but may occasionally lead to severe hemodynamic disturbances in patients suffering from coronary artery disease (CAD). The authors performed prospective registration of hemodynamic and cardiac effects of infrarenal aortic clamping in three groups of 25 patients each who underwent infrarenal aortic aneurysm repair. Group I included patients without CAD, group II patients had manifest signs of CAD, whereas patients in group III underwent aortic repair immediately after coronary revascularization, as part of a combined approach. Patients with CAD demonstrated significant increase of central venous pressure, pulmonary arterial pressure, and pulmonary capillary wedge pressure after aortic clamping. Cardiac output measurements showed a significant decrease while systemic vascular resistance increased. A majority of patients presented ischemic ECG alterations and/or arrhythmia. Patients of group III presented an intermediate response to aortic clamping as compared with cardiac-healthy patients of group I and coronary patients from group II. However, there were no signs of ischemia after cross-clamping in this group of patients. The study demonstrates clearly the different tolerances to the stress of aortic cross-clamping in patients with and without CAD. Intraoperative transesophageal echocardiography allowed the authors to detect dilatation of the cardiac cavities following cross-clamping in patients with severe CAD; when this is not available, left ventricular filling pressure should be monitored in patients with CAD undergoing abdominal aortic repair. Registration of left ventricular pressure is a prerequisite for proper intraoperative application of vasodilators.
Predictive Value of Manual ECG-Monitored Exercise Test Before Abdominal Aortic or Peripheral Vascular Surgery
Authors: Kaaja Risto , Sell Henrik , Erkola Olli , Harjula Ari 
Published: August 2008

The value of manual ECG-monitored exercise test was studied in 58 patients (39 men and 19 women) with intermittent claudication scheduled for abdominal or peripheral vascular surgery. There was a high incidence of well-known risk factors (hypercholesterolemia, smoking, and hypertension) in men and women. History of coronary artery disease (CAD) was present in 29.3% of the patients. No correlation was found between patients with single or multiple stenoses in lower extremity arteries (angiography) and CAD. Ischemic response (ECG) to manual exercise testing was positive in 14 patients (24.1%), of whom 2 (14.3%) had major cardiovascular postoperative complications. Both died of acute myocardial infarction within fourteen days. They had slow recovery (thirty to sixty minutes) of the ST segment (0.3-0.6 mV). The authors conclude that manual exercise testing might reveal serious CAD in patients with severe occlusive peripheral arterial disease of the lower extremi ties. In cases with slow recovery of ischemic response to exercise, coronary by pass or angioplasty could be advantageous before major vascular surgery.
Adventitial Cystic Disease of the Popliteal Artery: Successful Surgical Treatment of 8 Cases
Authors: Yorulmaz Fatih , Çetingök Ugur , Doğan Orhan , Yücel Ertan 
Published: August 2008

Adventitial cystic disease is a rare condition with an unknown etiology predominently seen in young men. The clinical presentation is of a sudden onset of unilateral calf claudication with a progressive course. Between May, 1988, and April, 1992, 8 patients have been operated on with the diagnosis of adventitial cystic disease of the popliteal artery in the authors' clinic. In 1 of the patients the lesion was bilaterally present in both of the popliteal arteries. Early diagnosis and surgical treatment are of utmost importance to the success of treatment. The preferred treatment is arterial resection with venous bypass. This is highly effective and has good long-term results.
Kinking of Aortobifemoral Graft as a Rare Complication: Case Report
Authors: Zengin Mustafa , Mavioglu Ilhan , Dogan Orhan Veli , Yücel Ertan 
Published: August 2008

Aortobifemoral arterial bypass grafting (Y-graft) is an important operation in vascular surgery. Early complications of Y-graft implantation are generally technical and infrequent. These are postoperative hemorrhage, acute occlusion of graft limb, distal atheroembolism (trash foot), and early thrombosis of the graft. Early occlusion of the graft is attributable to twisting or kinking of the graft in the retroperitoneal tunnel. In this patient, who was operated on at another center, the symptoms were seen six months after the operation. At the reoperation, both limbs of the Y-graft were found to be kinked in the retroperitoneal tunnel. The kink was solved and excised, and profundoplasty was applied to both of the deep femoral arteries.
The Effect of whole-Blood Transfusion on Survival of Patients with Breast Cancer: Why the Controversies?
Authors: Salsali Morteza 
Published: August 2008

Disputes still arise about the adverse effect of perioperative transfusion on survival of patients with malignant solid tumors. In order to find some answers to these controversies the author has studied 880 new patients with operable breast cancer, among whom 486 (55.2%) had received perioperative transfusion. In 86% of the patients the tumor size, when known, measured 3.0 cm (T2) or less. In general the ten-year actuarial survival of the 486 transfused patients has been 59.9% versus 66.7% for 394 nontransfused ones, X2 = 4.47; d.o.f. = 1, P <0.05. In multivariate analysis it was noted that only positive nodes had affected the survival significantly (P = 10-9) and blood group had produced a trend (P = 0.08). However, when the period cohort was eliminated, the adverse effect of transfusion became evident in patients with blood group A in the 1968-69 and 1970-71 cohorts but not in those with blood group O. It is concluded that the combined effect of transfusion and blood group, as a risk factor, is not as strong as positive nodes and large size of tumor. This study confirms that transfusion effect, at surgery, is a blood-group-related phenomenon.
Surgical Reconstruction and Muscular Augmentation of Ventricular Repairs: Their Impact on Compliance and Stroke Volume by Computer Simulations
Authors: Kim Francis , Yee Edward S. 
Published: August 2008

Computer simulation techniques were used to explore direct versus patch reconstructive repairs on left ventricular dynamics after damages of myocardial infarction, aneurysmal dilatation, and compensatory hypertrophy This ellipsoid geometric modeling allowed further assessment of these three pathological stages on left ventricular compliance (dV/dP) and stroke volume (SV). Primary surgical closure after any myocardium resection created a smaller ventricular cavity and, thus, decreased SV Similarly, dV/dP by direct closure is markedly in each of these three transitional stages. In comparison, for the patch repair techniques, SV after augmentation by skeletal muscle ventriculoplasty offered the most immediate recovery after acute apical infarct with relatively little change in dV/dP Synthetic patch repair after aneurysmal and/or hypertrophy formation preserved the best SV despite negative shifts in dV/dP Therefore, maintaining geometric shape and retaining functional continuity are important operative considerations for optimizing SV and minimizing the negative impact in dV/dP Computer simulation models have been extensively used to predict the impact of various operative repair on ventricular compliance and stroke volume. These techniques allow detailed evaluation of newer or experimental reconstructive surgical procedures such as skeletal muscle ventriculoplasty.
PTP1B is a negative regulator of interleukin 4–induced STAT6 signaling
Authors: Lu Xiaoqing , Malumbres Raquel , Shields Benjamin , Jiang Xiaoyu , Sarosiek Kristopher A. , Natkunam Yasodha , Tiganis Tony , Lossos Izidore S. 
Published: August 2008

AbstractProtein tyrosine phosphatase 1B (PTP1B) is a ubiquitously expressed enzyme shown to negatively regulate multiple tyrosine phosphorylation-dependent signaling pathways. PTP1B can modulate cytokine signaling pathways by dephosphorylating JAK2, TYK2, and STAT5a/b. Herein, we report that phosphorylated STAT6 may serve as a cytoplasmic substrate for PTP1B. Overexpression of PTP1B led to STAT6 dephosphorylation and the suppression of STAT6 transcriptional activity, whereas PTP1B knockdown or deficiency augmented IL-4–induced STAT6 signaling. Pretreatment of these cells with the PTK inhibitor staurosporine led to sustained STAT6 phosphorylation consistent with STAT6 serving as a direct substrate of PTP1B. Furthermore, PTP1B-D181A “substrate-trapping” mutants formed stable complexes with phosphorylated STAT6 in a cellular context and endogenous PTP1B and STAT6 interacted in an interleukin 4 (IL-4)–inducible manner. We delineate a new negative regulatory loop of IL-4–JAK-STAT6 signaling. We demonstrate that IL-4 induces PTP1B mRNA expression in a phosphatidylinositol 3-kinase–dependent manner and enhances PTP1B protein stability to suppress IL-4–induced STAT6 signaling. Finally, we show that PTP1B expression may be preferentially elevated in activated B cell–like diffuse large B-cell lymphomas. These observations identify a novel regulatory loop for the regulation of IL-4–induced STAT6 signaling that may have important implications in both neoplastic and inflammatory processes.