bluuebunny/crossref_metadata_2025_split huggingface dataset:
Equine Laminitis: A Potential Model of Raynaud's Phenomenon
Authors: Hood David M. , Amoss Max S. , Grosenbaugh Deborah A. 
Published: November 2007

Raynaud's phenomenon (RP) and equine laminitis in the horse are medical enigmas. Clinical and scientific data were compared to evaluate the degree of similarity that exists between these two peripheral vascular diseases. Data indicate that certain pathologic and pharmacologic aspects seem to have common features. Some of the correlations maybe due simply to both diseases having ischemia of the distal digits as a pathologic component. The exact etiology of the ischemia is not known for either disease. The results of this study suggest the hypothesis that RP and laminitis are the same disease in different species. This hypothesis can be tested more efficiently when the pathophysiology of both conditions is better documented. It is possible that comparative studies will promote advances in the understanding of both RP and laminitis. The fact that equine laminitis can be experimentally induced is of potential value in such future studies.
Effects of Insulin on Vasoconstrictor Responses to Alpha Agonist and Tilting
Authors: Yamamoto Masakazu , Asayama Kunio , Kanai Masanobu , Sugimoto Tatsuho , Yagi Shinji , Takata Shigeo , Ikeda Takayuki , Hattori Nobu 
Published: November 2007

The effects of insulin on vasoconstrictor response were studied in diabetics without autonomic neuropathy. Vasoconstrictor response to phenylephrine was measured before and after insulin injection in 10 diabetics. Mean blood pressure, forearm blood flow, and forearm vascular resistance remained unchanged after insulin administration. But the increase in forearm vascular resistance to phenylephrine decreased significantly and heart rate increased significantly after insulin injection. In 9 diabetics, vasoconstrictor response to tilting was measured before and after insulin injection. Mean blood pressure, cardiac index, and the total peripheral resistance index remained unchanged after insulin administration. However, the increase in the total peripheral resistance index to tilting decreased significantly and heart rate increased significantly after insulin injection. Furthermore, a significant fall in mean blood pressure following tilting was observed only after insulin administration. Although blood glucose levels decreased significantly, no hypoglycemic symptoms occurred. The present study suggests that insulin inhibits vasoconstrictor responses to both alpha agonist and tilting in diabetics.
Characteristics of the Limb Circulation in Hypertension
Authors: Solti Francis , Váradi Andrew , Iskum Nicholas 
Published: November 2007

The aim of this study was to investigate the effect of hypertension on the regulation of limb circulation. The study group consisted of 50 patients suffering from hypertension; in 21 cases the peripheral circulation was intact, while 29 patients had peripheral obliterative arterial disease (POAD) (clinical symptoms: intermittent claudication or rest pain). The control group consisted of 67 nor motensive patients. In 33 subjects of the control group the peripheral circulation was intact, while 34 patients suffered from POAD (clinical symptoms: intermit tent claudication or rest pain). The total limb blood flow (LBF) was measured by using venous isotope dilution technique. In hypertensive patients the limb vascular resistance (LVR) was markedly elevated, but the LBF remained in the normal range. In patients suffering from both hypertension and POAD the LVR was pathologically elevated and the LBF markedly diminished. After acute vasodilator therapy the LBF significantly increased, despite the drop in blood pressure owing to the extensive decrease of the LVR. It appears that in hypertension the elevation of the LVR is the most characteristic change of the limb circulation. The elevation of the arterial blood pressure has no favorable effect on the limb circulation, and the LBF compared with the blood pressure is relatively low.
Real-Time Ultrasound in the Diagnosis of Acute Deep Venous Thrombosis of the Lower Extremity
Authors: Habscheid Wolfgang , Höhmann Margarethe , Wilhelm Thomas , Epping Johannes 
Published: November 2007

One hundred twenty-six patients with clinically suspected acute deep venous thrombosis of the lower extremity (DVT) were examined comparatively with ultrasound and venography. In total, 174 lower extremity venograms were obtained. Ultrasonic examinations were performed on patients in the supine position. The venous segments were evaluated almost exclusively with transversal scanning. In the thigh, the only criterion for DVT was the reduced or absent compressibility of the venous lumen when gently compressed with the transducer. In the calf, normal unobstructed veins can usually not be viewed in the supine patient, whereas thrombotic veins appear as sonolucent, incompressible channels. Eight-three of the 174 lower extremity venograms were positive for DVT. In the majority of cases (53 of 83) the thrombotic process had involved two or more segments in combination. The sites of involvement of the different venous segments were distributed as follows: 24 occlusions of the common femoral vein, 52 of the superficial femoral vein, 56 of the popliteal vein, and 71 of the calf veins. Ultrasound had a sensitivity of 100% for thrombosis of the common femoral vein, 96% for the superficial femoral veins, 98% for the popliteal vein, and 93% for the calf veins. For the entire lower extremity, in regard to the diagnosis of thrombosis, the overall sensitivity was 95%. In 90% the extension of the occlusion was foreseen correctly. In no cases were false-positive results reported. Thus the overall specificity was 100%. The authors conclude that real-time ultrasound is a highly accurate method for the diagnosis of DVT of the lower extremity. It is the only indirect method capable of evaluating the venous system of the thigh, as well as that of the calf, with high accuracy. It should be the first choice of diagnostic imaging method in the diagnosis of deep venous thrombosis of the lower extremity.
Does the Decrease in Heart Rate Prevent a Detrimental Decrease of the End-Systolic Volume during Central Hypovolemia in Man?
Authors: Sander-Jensen KÅre , Marving Jens , Secher Niels H. , Hansen Inge-Lis K. , Giese Jørn , Warberg Jørgen , Bie Peter 
Published: November 2007

Central hypovolemia occurring with epidural anesthesia was investigated by measurement of hemodynamic and endocrine variables in 10 patients. Responses fell into two categories. Four patients experienced a hypotensive bradycardic episode after seventeen ± four minutes. In this group epidural anesthesia initially induced a tendency toward an increase in heart rate from 65 ± 4 to 73 ± 5 beats/min concomitantly with decreases in end-diastolic (172 ± 22 to 138 ± 16 mL), end-systolic (67 ± 12 to 51 ± 9 mL), and stroke (105 ± 10 to 85 ± 7 mL) volumes (radionuclide cardiography). A subsequent decrease in mean arterial pressure from 76 ± 3 to 67 ± 4 mmHg was associated with a decrease in venous return as reflected by the decrease in cardiac output from 6.1 ± 0.4 to 4.7 ± 0.7 L/min. In this situation when the venous return was critically reduced, the heart rate was 49 ± 4 beats/min and no further reduction in end-diastolic and end-systolic volumes was observed. The observed endocrine changes were compatible with a response to central hypovolemia. In the other 6 patients the reaction to epidural anesthesia did not induce statistically signif icant changes in hemodynamic and endocrine variables. It is concluded (1) that the decrease in heart rate associated with central hypovolemia during epidural anesthesia seems to be elicited when the left ven tricular end-systolic volume is decreased by about 25% and (2) that a further decrease in end-systolic volume during progressive central hypovolemia is avoided possibly as a direct consequence of the slowing of the heart.
Coronary Artery Calcification Detected by CT: Clinical Significance and Angiographic Correlates
Authors: Masuda Yoshiaki , Naito Shigenori , Aoyagi Yutaka , Yamada Zenjyu , Uda Takehiko , Morooka Nobuhiro , Watanabe Shigeru , Inagaki Yoshiaki 
Published: November 2007

Cardiac computed tomography (CT) to detect coronary calcification was performed on 161 patients undergoing coronary angiography for proven or suspected coronary artery disease. Among 108 patients in whom coronary calci fications was identified, 90% had significant coronary stenosis angiographically (>75% stenosis), and 80% of 121 patients with significant coronary stenosis showed calcification by CT. The relationship between the calcification site and the significance in stenosis of each vessel was determined. Calcification was present in 133 arteries among 205 stenotic coronary arteries (sensitivity = 65%) as compared with 59 of 439 entire arteries with normal coronary angiograms (specificity = 87%). In the younger age group the sensitivity of calcification for stenosis of each coronary artery was lower and the specificity and predictive value were generally higher than those in the elderly group. These results demonstrate that CT is a valuable procedure for detecting coronary arterial disease, since this examination is easy to conduct, noninvasive, and widely applicable for screeening a large population.
Microcirculation and Hemorheology in NIDDM Patients
Authors: Catalano Maria , Tomasini Maurizio , Annoni Massimo , Gherardi Elia , Scandale Giovanni , Galimberti Paolo , Porro Tomaso , Milanese Franco , Libretti Arnaldo 
Published: November 2007

The authors studied 10 patients with non-insulin-dependent diabetes mellitus and 5 controls matched for age, sex, blood lipids, and smoking habit. The two groups were also comparable for hemorheologic characteristics as evaluated by viscosimetry on whole blood, plasma and serum, erythrocyte filtration and aggregation. The microcirculation was studied in the subjects of both groups by microalbuminuria determination, retinal fluorangiography, and capillaroscopic examination of the bulbar conjunctive and nail folds. None of the patients presented microalbuminuria values higher than the upper limit of normal (20mg/24h). Fluorangiographic alterations were observed in 4 patients, and all 10 pre sented capillaroscopic alterations at the bulbar conjunctiva (microaneurysms, erythrocyte aggregates) and nail folds (more frequently of the fingers than toes). Similar alterations were detected in controls. Thus these abnormalities seem independent of hemorheologic values.
Efficacy of Low-Molecular-Weight Heparin in the Management of Intermittent Claudication
Authors: Mannarino Elmo , Pasqualini Leonella , Innocente Salvatore , Orlandi Ugo , Scricciolo Vito , Lombardini Rita , Ciuffetti Giovanni 
Published: November 2007

Treating chronic arterial occlu sive disease with heparin is contro versial because of the risks associated with long-term anticoagulant ther apy. Low molecular weight (LMW) heparin (mw about 5000 Dalton), which selectively inhibits the Xa fac tor with minimal risk of hemorrhage, seems to offer new possibilities in the prevention and treatment of both ve nous and acute arterial thromboem bolism. Therefore, 44 patients with inter mittent claudication were recruited to a randomized, double-blind, con trolled study. Twenty-two were treated for six months with a single daily subcutaneous dose (15,000 UaXa) of LMW heparin and 22 with placebo administered in the same way over the same period of time. After six months, LMW heparin treatment not only improved walking capacity (by lengthening the pain- free walking time by 25 %) but also significantly modified the hemor rheologic pattern (by reducing fibrin ogen concentrations and whole blood viscosity at low shear rates). LMW heparin also exerted an anti thrombotic and profibrinolytic effect by significantly increasing both the anti-Xa factor and plasminogen ac tivity without markedly modifying activated partial thromboplastin time ( + 20 %). No LMW heparin- treated patient hemorrhaged or re ported other noteworthy side effects. These results suggest LMW hepa rin might be a useful drug in the long- term treatment of chronic arterial occlusive disease of the limbs.
Neuropeptide Y- and Vasoactive Intestinal Polypeptide-Containing Nerve Fibers in the Human Cerebral Arteries: Characteristics of Distribution
Authors: Kawamura Koji , Sakata Noriyuki , Takebayashi Shigeo 
Published: November 2007

Perivascular innervation in cerebral arteries from 28 human fetuses at twelve to twenty-eight weeks' gestational age was studied histochemically. Neuropeptide Y (NPY)- and vasoactive intestinal polypeptide (VIP)- containing nerve fibers were densely distributed along with adrenergic and cholinergic nerve fibers in the major pial arteries at the base of the brain, an area that forms the circle of Willis, and in the lenticulostriate arteries. In contrast, distribution was sparse in the cortical circumflex branches of the middle cerebral artery, as compared with findings in the lenticulostriate artery of the same diameter. Densely distributed perivascular nerve fibers in the lenticulostriate arteries may play an important role in the pathogenesis of intracerebral hemorrhage.
The Role of Intracaval Filters in Patients with COPD and DVT
Authors: Pomper Stuart R. , Lutchman Gordon 
Published: November 2007

A retrospective study of the Coney Island Hospital experience with Greenfield filters over a five-year period was undertaken. During this period, a total of 78 intracaval filters were placed in 76 patients. The patients' charts were reviewed for (1) indication for Greenfield filter placement, (2) complications of the proce dure, (3) associated medical problems, and (4) follow-up information. The data revealed one statistically significant subpopulation within the group that had particularly poor survival statistics after intracaval filter insertion. These were patients who had a pulmonary embolism and also had chronic obstructive pulmonary disease (COPD). Considering the low morbidity associ ated with this procedure, it is the author's feeling that prophylactic intracaval filters in patients with deep vein thrombosis and COPD may be warranted.
Diabetes Mellitus and Localizations of Obliterating Arterial Disease of the Lower Limbs
Authors: Rubba Paolo , Leccia Giovanni , Faccenda Fulvio , De Simone Biagio , Carbone Luciano , Pauciullo Paolo , Vaccaro Olga , Mancini Mario 
Published: November 2007

Thirty patients with intermittent claudication (IC) and treated diabetes melllitus and 30 age- and gender-matched nondiabetic claudicants underwent a vascular examination by noninvasive ultrasound methods (continuous-wave Doppler, duplex scanner). The ankle/arm systolic pressure index did not differ in the two groups. Diabetic patients with IC had more (p < .001) non-flow-reducing stenoses (lumen reduction < 50%) and fewer (p <.002) flow-reducing obstructions (lumen reduc tion > 50 % ) of the iliac arteries than nondiabetics had. These data are consistent with a preferentially distal (below the inguinal ligament) localization of arterial stenoses in diabetic patients, whereas iliac artery diseases are relatively more severe in nondiabetics.
Physical Training and Antiplatelet Treatment in Stage II Peripheral Arterial Occlusive Disease: Alone or Combined?
Authors: Mannarino Elmo , Pasqualini Leonella , Innocente Salvatore , Scricciolo Vito , Rignanese Antonio , Ciuffetti Giovanni 
Published: November 2007

The efficacy of physical training alone or combined with antiplatelet thera py (dipyridamole and aspirin) was studied in 30 patients with stage II peripheral arterial occlusive disease (PAOD). Patients were randomly allocated to one of the following groups: Group A— dipyridamole 75 mg three times daily and aspirin 330 mg once daily: Group B— physical exercise; Group C—physical exercise and dipyridamole 75 mg three time daily and aspirin 330 mg once daily. After six months' treatment the pain-free walking time (PFWT) and the max imum walking time (MWT) improved significantly (p < 0.05) in all three groups. In group A the PFWT lengthened by 35% (from 101.00 ± 34.56 to 137.32 ± 40.50 s) and the MWT by 38% (from 150.34 ± 55.60 to 207.26 ± 60.67 s); in group B the PFWT lengthened by 90% (from 90.65 ± 40.54 to 171.45 ± 55.60 s) and the MWT by 86% (from 145.39 ± 60.50 to 270.63 ± 63.61 s). When physical exer cise was associated with drugs as in group C, the PFWT lengthened by 120% (from 89.51 ± 43.89 to 196.72 ±51.73 s) and the MWT by 105% (from 160.43 ± 59.84 to 329.05 ± 63.96 s). No significant variations were observed at any stage of the study in the ankle/arm pressure ratio at rest and after standard treadmill exercise, in the plethysmographic rest and peak flows, or in the trans cutaneous oxygen pressure in basal conditions and in its half recovery time after an induced ischemia. The results confirm the benefits of regular exercise in stage II PAOD pa tients but suggest they may be enhanced by antiplatelet therapy.
Quantitation of Early Myocardial Ischemia Using Acridine Orange Fluorescence — an Experimental Study
Authors: Sabherwal U. , Chopra P. 
Published: November 2007

It has been observed in the present investigation that ischemic myocardium consistently produces bright green fluorescence after Acridine Orange (AO) staining. The area of ischemia in the left ventricular myocardium at different time intervals after onset of experimental ischemia has been calculated by us of this AO fluorescence technique. Zonal distribution of ischemia in the epicardial, middle, and endocardial zones has also been evaluated quantitatively from ten minutes to six hours after ligation of the anterior descending branch of the left coronary artery in the Wistar strain of albino rats. No similar study was available for comparison from the literature reviewed. The total area of left ventricular ischemia showed an increase with the prolongation of duration of coronary ligation from 13.39 ± 2.69 mm2 at ten to twenty-five minutes to 32.99 ± 5.69 mm2 at six hours after ligation. Statistical analysis of the zonal area of ischemia has shown that ischemia in the middle and endocardial zones was greater than that in the epicardial zone at all time intervals recorded. Middle zone ischemia extended over a larger area than that over the endocardial zone at all intervals except at intervals II (30-45 min), IV (2-2½ hrs) and V (3-4 hrs). The results of this experimental investigation are significant for these point to the value of Acridine Orange fluorescence in detecting early myocardial ischemia and in demarcating zonal differences in ischemia. The authors have successfully utilized the method in a few human cases of clinically suspected myocardial infarction and recommend the technique for routine use to detect early human myocardial ischemia.
Ventricular Tachycardia as a First Manifestation of Right Ventricular Myxoma—A Case Presentation
Authors: Badui Elias , Cruz Humberto , Almazan Arturo , Enciso Roberto , Soberanis Napoleon , Garcia Romeo 
Published: November 2007

The authors present a case of a thirty-nine-year-old white man in good health who developed episodes of ventricular tachycardia as a first manifestation of a right ventricular myxoma, which was diagnosed by two-dimensional echocardio gram and then resected with no complications and total disappearance of the cardiac arrhythmia. After reviewing the literature they consider the present case as a rare manifesta tion of an infrequent location of an uncommon disease.
Angioscopy in Endovascular Surgery: Recent Technical Advances to Enhance Intervention Selection and Failure Analysis
Authors: Diethrich Edward B. , Yoffe Boris , Kiessling J.J. , Santiago Osvaldo , Bahadir Ilhan , Stern Larry A. , Lavine Daniel 
Published: November 2007

Recent technical and procedural modifications have greatly enhanced the usefulness of angioscopy during angioplasty. A pulsed irrigation system, proximal and distal blood flow control by pressure, and attention to sheath/vessel diameter ratio were incorporated into a study in which angioscopy was used for pretreatment assessment in 23 patients with symptomatic peripheral vascular disease presenting for initial (8 patients) evaluation or repeat treatment (15 patients) following a previous vascular procedure. Twenty-five lesions were examined with a 2.3 mm flexible angioscope equipped with an irrigating lumen; there were no complications attributable to angioscopy. The angioscope was useful in the characterization of lesions for selection of the recanalization technique. Lesions more amenable to initial atherectomy were visualized in 12 patients; 7 occlusions were successfully treated with laser/balloon angioplasty, with angioscopy assisting in probe and/or wire passage in 4 cases. Three late reocclusions were identified angioscopically as due solely to thrombosis, indicating the need for thrombolytic therapy. Angioscopy also identified 4 cases of incomplete recanalization despite a satisfactory arteriographic image. Angioscopy was also used to evaluate stenotic lesions unaccompanied by thrombus formation in patients previously treated with laser-assisted angioplasty. Histologic evaluation of the biopsied plaques identified intimal hyperplasia as the etiology, matching identically similar specimens harvested from a lesion treated with balloon dilation only.
A Serial Observation of Coronary Thrombi in Vivo by a New Percutaneous Transluminal Coronary Angioscope
Authors: Mizuno Kyoichi , Miyamoto Akira , Isojima Kazushige , Kurita Akira , Senoo Akira , Arai Tsunenori , Kikuchi Makoto , Nakamura Haruo 
Published: November 2007

This study was undertaken to observe coronary thrombus formation serially from an antegrade perspective by means of a new thin flexible angioscope that has an inflatable balloon at the distal tip and an angulation mechanism. To test its capabilities, thrombi were induced in the left anterior descending coronary artery of 11 dogs by copper coils, and the thrombi were then observed through this angioscope, which had been introduced into the coronary artery by a guide catheter. Five minutes after insertion of the copper coil, fibrin-like material and white components of the thrombi were seen massing around the copper coil. Then, thin, mixed thrombotic white and red components formed around the copper coil. At fifteen minutes after the copper coil insertion, the thrombi grew in size. Ten minutes later, the thrombi finally obstructed the coro nary lumen in most dogs. The red and white appearance of these thrombi was confirmed macroscopi cally, and the microscopic findings of these occluding thrombi revealed a fibrinous network with platelet aggregates and blood cell coagulation. Though ordinary angiography cannot reveal the precise features of the various coronary thrombi, this new angioscope was able to discern them from the antegrade perspective. The capabilities of this angioscope, which enabled these findings, should prove helpful in evaluating the stages of human coronary thrombosis. Of additional benefit, this angioscope can be used clinically for cardiac catheterization.