bluuebunny/crossref_metadata_2025_split huggingface dataset:
Three-Month Therapy with Calcium-Heparin in Comparison with Ticlopidine in Patients with Peripheral Arterial Occlusive Disease at Leriche-Fontaine IIb Class
Authors: Andreozzi Giuseppe Maria , Signorelli Salvatore Santo , Cacciaguerra Giuseppe , Di Pino Luigi , Martini Romeo , Monaco Sergio , Butto' Giuseppe , Sardina Marco 
Published: July 2008

Forty patients with a mean age of 62.6 ± 6 years, 36 men and 4 women, with peripheral arterial occlusive disease (PAOD) at Leriche-Fontaine IIb class, were randomly allocated to one of two treatment groups, receiving either 12,500 IU/ day of subcutaneous (sc) calcium-heparin (CAE) or 250 mg/day of oral ticlopi dine, each given for ninety days. The following parameters were evaluated be fore the start of the active treatment period and after thirty and ninety days of treatment: pain-free walking distance (PWD), maximum walking distance (WDmax), systolic and diastolic blood pressure (BP), posterior tibial arterial pressure and Winsor index at rest and after exercise (treadmill), transcutaneous oxygen and carbon dioxide pressures at rest (TcPO2 and TcPCO2 respectively), and time to 50% TcPo2 recovery after three-minute ischemia. Both treatments induced an improvement in PWD/WDmax, which, at the end of the study, were increased by 50.7/58.7% and 31.7/36.2%, respectively, for CAE and ticlopidine treatments, respectively. Statistical analysis did not show any difference between treatments, al though a statistically significant difference was found in comparison with basal measurements for both CAE and ticlopidine treatments (p < 0.01). Neverthe less, the effects determined by ticlopidine were, on the whole, less impressive than those of CAE. In fact, interestingly, although not in a statistically significant way, the CAE group walked longer in comparison with the ticlopidine group irrespective of the more critical baseline clinical conditions. Moreover, TcPo2 was favorably modified by CAE (p < 0.01) but not by ticlopidine treatment while the other parameters remained unchanged. In conclusion, CAE, given at the daily dose of 12,500 IU in patients with PAOD at the Leriche-Fontaine IIb class, showed beneficial clinical effects, which, in turn, could be due both to the removal of the thrombophilic im balance and to the restoration of the fibrinolytic-coagulatory hemostasis in the involved microvascular circulation.
Results of Directional Peripheral Atherectomy with Reference to Histology, Histochemistry, and Ultrastructure
Authors: Gonschior Peter , Höfling Berthold , Mack Brigitte , Simpson Lindi , Gerheuser Florian , Nerlich Andeas , Bauriedel Gerhard , Welsch Ulrich 
Published: July 2008

One hundred patients with symptomatic peripheral vascular disease were treated with a directional atherectomy catheter; 153 lesions comprising 98 stenoses and 55 occlusions were located in the iliac (n=22), superficial femoral (n = 114), popliteal (n = 16), and anterior tibial (n=1) arteries. The majority of these patients were poor candidates for balloon angioplasty because of the com plexity of lesions. There were 70 eccentric and 28 concentric lesions and 55 occlusions (mean length 4.2 ± 2.9 cm). Acute success rate was 94% for both stenoses and occlusions. Four patients were treated in both lower extremities. The stenoses were reduced from 85 ± 12% to 12 ± 10% acutely (occlusions 100% to 9 ± 9%). Six-month angiographic follow-ups were performed in 81% of treated patients, the others refusing angiography. Mean stenosis after six months was 33 ± 25% (occlusions 44 ± 28%). Restenosis (> 50%) was found in 20% of treated lesions: 26% in concentric lesions, 8% in eccentric lesions, and 32% in occluded vessels. Treatment of peripheral vascular disease with the atherectomy device is safe and effective therapy with good long-term results. These results were obtained in complex lesions with 55 occlusions. Atherectomy seems to be particularly beneficial in the treatment of eccentric and complex stenoses and is not limited by occlusion or calcification. Furthermore, insight into the pathogenesis of arte riosclerosis and the development of restenosis is enabled by analysis of removed plaque material.
Light-Reflection Rheography and Acute Deep Vein Thrombosis
Authors: Antignani Pier Luigi , Pillon Sergio , Grassi Flavio , Paiella Maria Laura , Bartolo Mauro 
Published: July 2008

The authors examined 47 subjects affected by acute phlebothrombosis of the lower limbs by means of light-reflection-rheography (LRR). The diagnosis was based on the results of clinical, Doppler, and duplex scanner evaluations. The results were compared with those obtained in 30 healthy subjects (control group). The LRR examinations were performed by two methods: the one consisting of a passive execution of postural movements of the limb, the other using the technique of plethysmographic venous occlusion. The pathological LRR curves were characteristic for each type of disease and for the site of thrombosis and were different from the normal ones. The results obtained show the usefulness of the method and it potential in studying the collateral circulation and the effects of different therapies.
Budd-Chiari Syndrome: Analysis of 30 Cases
Authors: Bayraktar Yusuf , Balkanci Ferhun , Kansu Emin , Kayhan Burhan , Arslan Serap , Eryilmaz Muzaffer , Telatar Hasan 
Published: July 2008

The authors report their experience with 30 adult patients with Budd-Chiari syndrome (BCS), which is a rare and serious disorder, characterized by hepatic outflow obstruction caused by many different conditions. The diagnosis was based on the clinical data, ultrasonography (US), vena cavography and hepatic venography, computed tomography (CT), and liver bi opsy. Behçet's disease (BD) was found in 10 patients with BCS as an underlying disease. Two patients used oral contraceptive drugs, 2 had liver tumor hepato cellular carcinoma and liver lymphoma, and 1 patient had chronic lymphocytic leukemia. Despite full investigation, the authors could not find any obvious un derlying cause in the other 15 patients. The results suggest that (1) BCS must be considered as a possible complica tion in patients with Behçet's disease when they have hepatomegaly even if there were no cardinal manifestations of the disease at the time of admission, and BD is the most common etiologic factor in BCS (33%) in Turkey, where the inci dence of Behçet's disease is relatively high. (2) Anti-aggregant treatment seems to be effective in many instances. (3) There were space-occupying lesion-like appearances in the liver of 7 cases by CT and US examination in the acute stage, and these disappeared on the follow-up CT and US in 5 patients but continued in 2. BCS should thus be differentiated from other liver lesions. (4) There were other great-vessel involvements in 43% of the cases, mostly venous, but only 1 pulmonary arterial occlusion.
Features of Coronary Artery Lesions Related to Left Ventricular Aneurysm Formation in Anterior Myocardial Infarction
Authors: Inoue Teruo , Morooka Shigenori , Hayashi Terumi , Takayanagi Kan , Sakai Yoshihiko , Fujito Tsuneo , Takabatake Yutaka 
Published: July 2008

To determine the factors of left ventricular aneurysm formation in acute myocardial infarction, the authors studied the distribution of coronary artery lesions and the left ventricular wall motion of 43 patients with anterior myocar dial infarction. Of 15 patients with aneurysm, 9 (60%) showed a single-vessel disease with severe stenosis of the proximal left anterior descending artery. Of 9 patients with triple-vessel disease, 8 (89%) had no aneurysm. In patients with the aneu rysm, the Gensini score of the culprit lesion was significantly higher (p<0.05) and the score except for the culprit lesion was less (χ 2=5.7, p<0.05). In 23 patients with single-vessel disease, the collateral score was significantly less (p < 0.05) in patients with the aneurysm. The systolic wall motion on the ventriculogram appeared more impaired in the anterior infarct area but well maintained in the posterior noninfarct area in patients with the aneurysm. In conclusion, the important factors of left ventricular aneurysm formation were as follows: (1) A culprit lesion of the myocardial infarction was severe, but other coronary artery lesions were mild. (2) Collateral vessels were poor. (3) The left ventricular wall motion of the infarct area was impaired, but that of the noninfarct area was relatively good.
Carotid Ultrasonographic Findings in Intracranial Internal Carotid Artery Occlusion
Authors: Lee Tsong-Hai , Ryu Shan-Jin , Chen Sien-Tsong , Chan Jin-Lieh 
Published: July 2008

Five cases of unilateral intracranial internal carotid artery (ICA) occlusion received both carotid angiographic and ultrasonographic studies. The Doppler examination showed that the resistive index (RI) of the common carotid artery (CCA) and ICA was higher but the peak systolic velocity was lower on the diseased side as compared with the normal side. Absence of the diastolic phase was found in the CCA flow in 2 cases and in the ICA flow in 3 cases on the diseased side. The mean CCA flow volume on the diseased side (271±82 mL/min) was half or less than that on the normal side (680±86 mL/min) (P < 0.01). The flow volume of the diseased ICA (49±20 mL/min) was markedly lower than that of the normal side (344±49 mL/min) (P < 0.01) and was also less than that of the ipsilateral external carotid artery (ECA) (129±43 mL/min). The Doppler ophthalmic artery flow all showed a forward direction. The authors propose that the following extracranial carotid ultrasono graphic findings may be helpful in the prediction of intracranial carotid artery occlusion: (1) diminished frequencies, increased RI, and a more than 50% re duction of flow volume in the CCA as compared with the opposite side; (2) diminished frequencies to loss of the diastolic phase, a more than 50% reduction of the flow volume, and reversed ICA/ECA flow volume in the ICA as com pared with the opposite side; and (3) a forward Doppler ophthalmic artery flow.
Arterial Mapping with Color Flow Duplex Imaging of the Lower Extremities After Excimer-Laser-Assisted Angioplasty
Authors: Visonà Adriana , Miserocchi Luigi , Lusiani Luigi , Bonanome Andrea , Mayellaro Valeria , Pesavento Raffaele , Liessi Guido , Pagnan Antonio 
Published: July 2008

The purpose of the present study was to evaluate the role of color flow du plex imaging (CFDI) in the follow-up of patients who have undergone excimer- laser-assisted angioplasty of peripheral arteries. Sixty-one patients (40 men and 21 women) were studied (mean age ± SD sixty-three ± nine years). All patients were affected by peripheral vascular dis ease and, for this reason, underwent percutaneous excimer-laser-assisted angio plasty. Digital angiography and CFDI were performed before the laser procedure. CFDI was repeated at months 1, 3, 6, 9, and 12 after the laser procedure, whereas angiography was repeated after twelve months. Common, superficial, and profunda femoral arteries and popliteal arteries were visualized in looking for the presence of lesions and occlusions, and spectral analysis of Doppler signals was recorded. After the initial success, claudication was reported again by 9 patients, 7 of whom showed total occlusions. All reocclusions were discovered by CFDI and confirmed by angiography; 3 of these 7 patients underwent a second laser pro cedure. The remaining 2 symptomatic patients showed patent vessels and did not undergo angiography. Another 9 patients redeveloped an occlusion, unsus pected from clinical history and symptoms. All the reocclusions, confirmed by angiography, were diagnosed by CFDI. The data show that CFDI provides an accurate noninvasive technique for following up patients after excimer laser angioplasty, allowing for asymptomatic reocclusions to be recognized and treated if necessary, and permitting symptoms not due to reocclusions to be properly identified, thus avoiding unnecessary angiography.
Abnormal Erythrocyte Rheology in Patients with Morbid Obesity
Authors: Levy Yishai , Elias Nizar , Cogan Uri , Yeshurun Daniel 
Published: July 2008

The objectives of this study were to investigate the rheological properties of the erythrocyte in patients with morbid obesity and to follow them up after a short-term weight loss. A fluorescent polarization method was used to assess erythrocyte membrane biorheology and to measure its fluidity. Eighteen sub jects participated in the study: 8 healthy controls and 10 patients with morbid obesity. The erythrocyte membrane fluidity was obtained in the healthy subjects and in the patients with morbid obesity prior to and after a ten-day zero-calorie diet. Fluidity was determined by steady-state fluorescence polarization after incorpo ration of the lipophilic probe 1,6-diphenyl-1,3,5 hexatriene (DPH). With this method, the anisotropy parameter at 37 ° C, which is inversely related to mem brane fluidity, was obtained. The patients with morbid obesity revealed an abnormal erythrocyte rheol ogy. They exhibited an abnormally low erythrocyte membrane fluidity as com pared with normal subjects. The anisotropy parameter at 37°C was 1.417 ± 0.093 in these obese patients compared with 1.279 ± 0.043 in normal- weight controls (p < 0.01). Upon a short-term significant weight loss from a body mass index (BMI) (weight/height2) of 39 ± 5 to 36 ± 5 kg/m2 (p < 0.05), the anisotropy parameter did not change (1.401 ±0.190). Thus, fluidity measurements permit recognition of an abnormal erythrocyte rheology in patients with morbid obesity. This abnormality may partially ex plain the excess cardiovascular and thromboembolic morbidity in morbid obe sity.
Association of Congenital Afibrinogenemia and K-Dependent Protein C Deficiency—A Case Report
Authors: De Mattia Domenico , Regina Guido , Giordano Paola , Del Vecchio Giovanni Carlo , Altomare Maria , Schettini Francesco 
Published: July 2008

The authors describe a rare case of congenital afibrinogenemia with concom itant K-dependent protein C deficit that was brought to our observation for ischemic lesions of the foot in association with fibrinogen concentrate infusions. These lesions can be attributed to the association of various factors: fibrino gen infusion without heparin coverage, microtrauma, and protein C (PC) defi cit. In fact, thromboembolic complications during afibrinogenemia were previously reported usually in association with substitutive therapy, and it is also known that PC deficit predisposes to thrombotic complications. To the authors' knowledge, the case described by them is the first in which PC deficit is associated with afibrinogenemia. This association cannot be ex plained by a common genetic mechanism because the genes for fibrinogen and for protein C are located on different chromosomes (chromosomes 4 and 2 re spectively) .
Total Occlusion of Left Main Coronary Artery in Orientals: Profile of 4 Cases
Authors: Soo Chee-Siong , Ling Lieng-Hsi , Yeoh Joon-Kuan , Choo M. , Kannan P. 
Published: July 2008

The authors report 4 Oriental cases of total occlusion of the left core nary artery (LMCA) with differing presentations. The first patient had a twelve-year history of stable angina pectoris. The second patient had angina for a year, which became unstable two months prior to diagnosis. The third patient had myocardial infarction seven years ago and presented with a one-month history of rest angina. The fourth patient had stable effort angina for six years but presented with accelerated angina three months prior to diagnosis. The incidence of total occlusion of the LMCA is rare and survival depends on the existence of collateral circulation. In LMCA disease, is usually disease in other parts of the coronary arterial tree, and the for urgent coronary bypass surgery.
The Left Ventricular End-Systolic Pressure and Pressure-Volume Index. Comparison Between Invasive and Auscultatory Arm Pressure Measurements
Authors: Hædersdal C. , Madsen J. Kyst , Saunamäki K. 
Published: July 2008

The slope of the left ventricular (LV) end-systolic pressure-volume relation (ESPVR) has been established as a valuable clinical method to assess LV con tractile function independent of LV loading factors. The purpose of the present study was to evaluate whether the ESPVR could be reliably determined from auscultatory blood pressure (BP) measurements and from LV volume measure ment by contrast ventriculography (CVG). Twenty-four patients with suspected or known ischemic heart disease were studied by cardiac catheterization with simultaneous, blinded, intravascular and auscultatory pressure measurements. LV volume was determined by CVG. The auscultatory mean arterial blood pressure (MAP) derived from: was found to be a useful measure of the LV end-systolic pressure in this connec tion. The correlation between invasively measured LV end-systolic pressure (ESP) and MAP was highly significant (r=0.82; SEE = 6.9 mmHg; p = 0.001). The correlation between invasively and semi-invasively measured ESPVR fell close to the line of identity ( r = 0.99; SEE = 0.23 mmHg mL-1; p < 0.001). The replacement of ESP by MAP induced only a minimal error in the assess ment of the ESPVR. A complete noninvasive determination of the ESPVR and LV contractility therefore seems possible by using the MAP and by measuring the end-systolic volume by radionuclide ventriculography or by echocardiog raphy.
Platelet-Activating-Factor-Induced Changes in Cardiovascular Function and Oxyradical Status of Myocardium in Presence of the PAF Antagonist CV-6209
Authors: Gupta Jang B. , Prasad Marion , Kalra Jawahar , Prasad Kailash 
Published: July 2008

The effects of platelet-activating factor (PAF) on cardiac function and con tractility and its mechanism of action are not fully understood. The authors investigated the effects of PAF in the absence or presence of a potent PAF antag onist CV-6209 on the cardiac function and contractility; lipid peroxidation prod uct malondialdehyde (MDA), an indirect measure of oxygen free radicals; serum creatine kinase (CK); blood lactate; and pH in anesthetized dogs. CV- 6209 (1 mg/kg, IV) did not produce significant changes in the various parame ters studied. PAF (1 μg/kg, IV) produced decreases in the cardiac function (cardiac index, left ventricular work index) and indices of cardiac contractility [(+) and (-) dp/dt, dp/dt at CPIP, (dp/dt)/IP, dp/dt at CPIP/IP, Vmax] and in creases in the systemic and pulmonary vascular resistance. It also produced increases in cardiac MDA, serum CK, blood lactate, and H+ and decreases in blood pH and HCO3- . CV-6209 completely prevented the PAF-induced changes in the hemodynamic and biochemical parameters. These results suggest that PAF-induced cardiac depression may be due to PAF-induced release of oxyradicals from neutrophils and that PAF antagonist may be useful in counteracting the deleterious effects of PAF on the cardiovas cular system.
Nailfold Capillaroscopy in the Screening and Diagnosis of Raynaud's Phenomenon
Authors: Mannarino Elmo , Pasqualini Leonella , Fedeli Federico , Scricciolo Vito , Innocente Salvatore 
Published: July 2008

Raynaud's phenomenon is in most cases idiopathic, but it may appear as secondary to other diseases. Since clinical evaluation is often inadequate to dis tinguish between these two forms, simple noninvasive methods are needed for an early diagnosis of the secondary form. The authors used nailfold capillaros copy to study 58 patients with Raynaud's phenomenon—44 apparently idio pathic and 14 secondary to connective tissue diseases. In all patients affected by secondary Raynaud's phenomenon nailfold capillaroscopy confirmed the pres ence of an abnormal pattern with typical systemic sclerosis alterations in 5 cases. Twenty-one (48%) of the other 44 patients presented a normal capillaro scopic pattern, 15 (34%) had alterations compatible with long-term idiopathic Raynaud's phenomenon, and 8 (18%) showed abnormal capillaroscopic pat terns, 2 of which were identified as the sclerodermic pattern. Nailfold capillaroscopy distinguishes between primary and secondary Ray naud's phenomenon and may be used to identify patients presenting no evidence of underlying disease who could be at risk of developing connective tissue dis ease.
Prevalence, Clinical Features, and Acute Course of Atypical Myocardial Infarction
Authors: Lusiani Luigi , Perrone Antonio , Pesavento Raffaele , Conte Giacomo 
Published: July 2008

Ninety-four consecutive patients (60 men and 34 women; mean age 68.5 ± 11.5 years) with acute myocardial infarction (MI) were investigated ret rospectively, in order to evaluate the prevalence, clinical features, and short- term course of the atypical forms (symptoms other than chest pain). An atypical MI was found in 30 patients, with a prevalence of 32% (95% confidence limits 27-36%). It was most prevalent in women above sixty-five years old (P < 0.05). Abdominal pain, paroxysmal dyspnea, and pulmonary edema were the most frequent symptoms (33%, 17%, 13%, respectively). No differences were ob served between typical and atypical MI in regard to risk factors (hypercholes terolemia, arterial hypertension, diabetes mellitus, cigarette smoking) and history of MI, cerebrovascular disease, peripheral vascular disease, or chronic lung disease. Significantly fewer patients with atypical MI had a history of an gina pectoris (P < 0.05). No differences were observed in regard to previous medication, except for antiarrhythmic drugs, more often used by atypical pa tients (P < 0.05). Location and severity of MI (as judged by ECG and peak levels of creatine kinase in the serum) were similar in both subgroups, as were the complications (34% typical and 50% atypical) and death rate (12.5% and 16.7%, respectively). In conclusion, atypical MI is not less severe than typical. This emphasizes the need for a high suspicion index in many different clinical settings, but particu larly (although not exclusively) in elderly females, in the presence of abdominal pain or otherwise unexplained paroxysmal dyspnea.
Evaluation of Pulmonary Arterial Pressure in Acute Pulmonary Embolism
Authors: Shimizu Hiroyuki , Tanaka Junko , Yamada Norikazu , Ohnishi Takahiro , Nakamura Mashio , Shibata Munehiro , Hiraoka Naoto , Tanaka Hideki , Fujioka Hirofumi , Konishi Tokuji , Nakano Takeshi 
Published: July 2008

Twenty-six patients with acute pulmonary embolism underwent hemody namic examination. Twenty-three of the patients were free of prior cardiopul monary diseases. The other 3 patients had prior history of cardiac disease. In the 23 patients, the mean pulmonary arterial pressure (PAm) ranged from nor mal range to 35 mmHg at the time of the embolic event and generally declined within ten days after the embolic event. However, in the 3 patients with a history of disease, reelevation of PAm was observed during the pressure monitoring. PAm was positively correlated with the extent of pulmonary vascular obstruc tion (r=0.863, p < 0.01) and also with mean right atrial pressure (RAm, r=0.830, p < 0.01). In the presence of prior cardiac disease, PAm in patients with normal preembolic PAm increased proportionally to the extent of obstruc tion. Continuous hemodynamic monitoring is valuable for estimating the degree of embolic obstruction and the speed of embolus resolution and for detecting new embolic episodes in some cases.