bluuebunny/crossref_metadata_2025_split huggingface dataset:
Follow-up Study of Morbidity in Patients with Angina Pectoris and Normal Coronary Angiograms and the Value of Investigation for Esophageal Dysfunction
Authors: Schofield Peter M. 
Published: November 2007

A postal questionnaire was used to assess the symptoms, use of medical facilities, and employment status of patients with angina pectoris and normal coronary angiograms following cardiac catheterization. In a retrospective study of 187 patients, 66 had left ventricular dysfunction demonstrated by abnormal regional wall motion and 121 had normal left ventricular function. At follow-up twelve to forty-six months following catheterization, 89% with left ventricular dysfunction and 82% with normal ventricular function had continued to experience chest pain. There was no significant change in the admission rate to hospital because of chest pain or the proportion of patients who were working, after catheterization as compared with before, in either group. Some patients with left ventricular regional wall motion abnormalities appeared to have progressive left ventricular dysfunction. In a prospective study of 63 patients, detailed investigation of esophageal function was performed. Twenty-two patients had left ventricular wall motion abnormalities. The majority of the 41 patients with normal left ventricular wall motion had esophageal abnormalities that were treated appropriately. At follow-up six to twenty-four months following catheterization significantly fewer patients with normal left ventricular function continued to experience chest pain compared with those with left ventricular dysfunction. Following catheterization the hospital admission rate fell significantly and the proportion of patients working increased significantly in the group with normal left ventricular function. The hospital admission rate and employment status of patients with left ventricular dysfunction did not change significantly following angiography. These findings suggest, therefore, that investigation for and treatment of esophageal dysfunction should be performed in patients with angina pectoris, normal coronary angiograms, and normal left ventricular function.
Clinical Study of Late-Stage Postthrombotic Lower Extremities
Authors: Sun Jian-Min , Zhang Pei-Hua 
Published: November 2007

Through clinical and venographic study of 353 diseased limbs, the authors advocate a new classification for the postthrombotic syndrome of the deep veins of the lower extremity. The postthrombotic lower extremities may be divided into two types: (1) lesions of the whole lower extremity, consisting of the completely obstructed, partially recanalized, and completely recanalized types; (2) local lesions, such as segmental obstruction of the iliac, iliofemoral, superficial femoral, femoropopliteal veins, and the tibioperoneal venous trunk and the venous plexus in calf muscles. Each type has its characteristics related to the duration of symptoms and clinical features, and their management is not the same at all. The authors suggest that clinically this new classification may be of great help in estimating the status of the diseased limb and in selecting proper method of treatment.
Objectifying Exercise Ischemia in Peripheral Vascular Disease: A Study in 120 Patients
Authors: Caillard Philippe , Mouren Xavier , Pujade Bertrand , Blanchemaison Philippe , Elbeze Yves , Pr Cloarec Maurice 
Published: November 2007

This study presents the results of transcutaneous oxygen pressure (TcPO2) monitoring during a treadmill test walk performed in the early stages of peripheral obliterative vascular disease. The study population consisted of a first group of 50 known arteriopathic patients presenting, on questioning, with intermittent claudication; a second group of 50 known arteriopathic patients void of any symptoms of intermittent claudication; and a third group, which was a control cohort of 20 nonarteriopathic, nonclaudicating patients. Though resting TcPO 2 cannot be used to aid the clinical diagnosis of exercise ischemia it may be useful in revealing asymptomatic chronic resting ischemia (9% of cases in this series). On the other hand, a posteffort (recovery phase) fall in TcPO2 had a predictive positive diagnostic accuracy for ischemia on exercise in 99% of the cases reported here versus 87% for clinical appraisal. In the light of these results, TcPO2 measurements coupled to a treadmill test walk perfectly ascertain exercise ischemia in arteriopathic patients, whether asymptomatic or not, and avoid the false-positive results obtained by clinical evaluation.
Dipyridamole Radionuclide Ventriculography in Patients with Coronary Artery Disease: Comparison with Ergometer Exercise
Authors: Konishi Tokuji , Koyama Takao , Aoki Toshikazu , Futagami Yasuo , Nakano Takeshi 
Published: November 2007

Intravenous administration of dipyridamole during radionuclide ventriculog raphy (RNV) was performed in 26 consecutive patients with symptomatic coro nary artery disease. The authors compared the results of dipyridamole-RNV with those of ergometer exercise-RNV in detecting myocardial ischemia. During exercise, ST depression, regional wall motion (RWM) abnormalities, and de creased left ventricular ejection fraction (LVEF) were observed in 21 (81%), 23 (88%), and 20 (77%) patients, respectively. However, after intravenous di pyridamole, ST depression, RWM abnormalities, and decreased LVEF were observed in 14 (54%), 15 (58%), and 2 (8%) patients, respectively. Although LVEF usually decreases during myocardial ischemia, LVEF did not decrease (57 ± 11% to 58 ± 10%), even in patients with ST depression, after intravenous dipyridamole. Maintained left ventricular ejection fraction is considered to be a hemodynamic effect of the potent arterial vasodilatation induced by di pyridamole. These results from dipyridamole-RNV in myocardial ischemia seem to con flict with the results from dipyridamole-thallium studies carried out to deter mine the capacity to detect coronary artery disease. Unknown mechanisms of dipyridamole other than the coronary steal phenomenon may be operative in the genesis of myocardial ischemia.
Intimal Thickening of Jugular and Femoral Veins vs Arteries in the Rabbit Following Investment
Authors: Funaki Chiaki , Naito Michitaka , Hayashi Toshio , Kuzuya Masafumi , Asai Kanichi , Kuzuya Fumio 
Published: November 2007

The authors induced intimal thickening in the jugular and femoral veins and in the common carotid and femoral arteries of rabbits by placement of a poly ethylene tube cuff. The comparative effects on the intima were studied by light and electron microscopy. Even in the veins, thickening resulted from the migration of medial smooth muscle cells into the intima with subsequent proliferation. Thickening in the arteries consisted of tightly packed smooth muscle cells and a few elastic fibers, whereas that in the veins was characterized by an abundance of collagen fibers, layers of smooth muscle cells, and a few elastic fibers. Capillaries were often observed in the thickened intima of the veins but not of the arteries.
Comparison of Standard One-Minute Treadmill Exercise and Strandness Test (Absolute Walking Distance) in Relation to Site of Lesion, Walking Distance, and Diastolic Blood Flow Velocity (Doppler Curves)
Authors: Fabry Regine , Dubost Jean-Jacques , Pochon Philippe , Duchene-Marullaz Pierre 
Published: November 2007

In 215 outpatients suffering from occlusive arterial disease of the lower limbs the authors compared the decrease in the ratio of ankle systolic pressure to brachial systolic pressure according to whether the treadmill exercise was limited to one minute or extended until pain forced the patient to stop. After a one-minute walk the pressure index always decreased significantly, especially when walking was restricted. The decrease in the pressure index was generally greater when the exercise was continued until the absolute walking distance, and the recovery time was usually twice as long. The fall in the pressure index was significantly greater for patients with single and multiple iliac stenoses than for those with stenoses at lower levels. In patients having a diastolic blood flow velocity on Doppler curves at rest, not modified by walking, a maximum drop in peripheral pressure was recorded after walking for one minute. In this instance there was no intensification of the decrease in peripheral pressure, unlike in patients without a diastolic blood flow velocity at rest. This one-minute test is not a maximal hemodynamic response, but it is suf ficient for the appreciation of ischemia during exercise, according to the differ ent parameters measured.
Doppler Diagnostics, Indications, and Control of Surgical Treatment in Patients with Carotid Pathology
Authors: Grosdinsky L. , Rankov S.T. , Petrov V. , Drenovsky V. 
Published: November 2007

Major stroke is a relatively common cause of death or disabling invalidism in patients with atherosclerosis. In a large percentage of cases it is caused by stenotic/thrombotic processes in carotid arteries and this emphasizes the impor tance of the problem of early diagnosis and treatment of carotid pathology. Recently Doppler sonography has become a leading non-invasive method of early screening of stenotic processes in carotid arteries. The aim of the present study was to ascertain the diiagnostic abilities of Doppler sonography for screening of carotid pathology, assessment of extra-cra nial and intracranial hemodynamics, defining of indications, and control of vascular reconstructions of carotids.
Active Drainage of Cardiac Lymph in Relation to Reduction in Size of Myocardial Infarction: - An Experimental Study
Authors: Taira Akira , Uehara Kagemitsu , Fukuda Shigeru , Takenaka Koji , Koga Masaaki 
Published: November 2007

Active drainage of cardiac lymph using hyaluronidase was attempted in dogs. The results were satisfactory and the ischemic myocardium was salvaged. The infract risk area (I/R) ratio decreased after drainage. Regional myocardial ischemia and infarction were provided by means of ligature of the left coronary artery for 120 and 240 minutes respectively. Cardiac lymph was collected by conventional procedures. Enzymes released from the myocardium increased significantly in the cardiac lymph. The volume of cardiac lymph gradually increased after ligature of the coronary artery. Administration of hyaluronidase further increased the cardiac lymph flow and significantly decreased the I/R ratio as determined by triphenyl tetrazolium chloride (TTC) and methylene blue staining. Drainage of the cardiac lymph salvaged the ischemic myocardium. Reduction of interstitial edema and augmentation of cardiac lymph flow with the hyaluronidase prevented the development of the infarction. This is the first documentation of the effect of active drainage of cardiac iymph on the development of infarction through observation of the I/R ratio.
Unilateral Diffuse Pulmonary Artery Involvement in Takayasu's Arteritis Associated With Coronary-Pulmonary Artery Fistula and Bronchial-Pulmonary Artery Fistula: A Case Report
Authors: Horimoto Masashi , Igarashi Keiichi , Aoi Kenichirou , Okamoto Kiyotaka , Takenaka Takashi 
Published: November 2007

Diffuse involvement of the right pulmonary artery associated with fistulas between the pulmonary artery and systemic artery is reported in a woman with Takayasu's arteritis. The most proximal portion of the abdominal aorta was pronouncedly narrowed and the aortic wall was markedly calcified. Both the celiac artery and the superior mesenteric artery were totally occluded and drained by the meandering artery arising from the inferior mesenteric artery. The proximal right pulmonary artery was focally narrowed and the middle lobe artery was occluded. All other branches of the right pulmonary artery were diffusely narrowed with sparse distributions of their distal branches. Fistulas were identified between the right coronary artery and the right pul monary artery and between the right bronchial artery and the right pulmonary artery. This is the first English report of Takayasu's arteritis presenting with a coronary-pulmonary artery fistula that is secondary to a diffuse unilateral in volvement of the pulmonary artery.
Transcranial Doppler in Reversible Migrainous Vasospasm Causing Cerebellar Infarction: Report of a Case
Authors: Gomez Camilo R. , Gomez Sandra M. , Puricelli Mark S. , Malik Maheen M. 
Published: November 2007

A young woman with a history of classic migraine suffered a large cerebellar infarction . Comprehensive evaluation did not disclose any potential causes for the stroke and she had no other risk factors. Transcranial Doppler (TCD) was useful in identifying vasospasm of the vertebral arteries. Following treatment with propranolol, angiography and repeat TCD revealed resolution of the vasospastic disorder. TCD is a useful noninvasive tool in detecting vasospasm associated with ischemic lesions in certain patients with migraine.
Investigations on the Biochemical Characteristics of Chronically Underperfused Muscle
Authors: Schweiger Hans 
Published: November 2007

During operation, biopsies from the gastrocnemius muscle and, in some cases, from the sartorius muscle were taken from 32 patients with peripheral arterial occlusive disease and from 5 subjects with normal peripheral circulation. In patients with inadequate circulation only during exercise, when compared with the control group, increased activities of enzymes involved in oxidative metabolism (malate dehydrogenase, nicotinamide adenine dinucleotide phos phate-dependent isocitrate dehydrogenase, cytochrome C oxidase, creatine ki nase), in amino acid metabolism (asparate aminotransferase, alanine aminotransferase), and in anaerobic glycoysis (lactate dehydrogenase) were found. In patients with circulatory disturbances that manifested themselves already at rest, enzyme activities were, with the exception of LDH, lower than those of patients with exclusively exercise-related insufficiency. By means of in traindividual comparisons with the corresponding enzyme activities in the sarto rius muscle, the author was able to show that the changes found were not simply the result of differences in training conditions. The diminished concentrations of energy-rich phosphate are an expression of the anaerobic metabolic state in patients with inadequate circulation at rest. It is concluded that chronic ischemia of muscle leads to changes in the energy metabolism of the cell. In the presence of more nearly adequate circulation at rest, the portion of oxidative potential of the total energy metabolism increases. In contrast, if there is an inadequate circulation at rest, the mainly anaerobic glycolysis becomes quantitatively predominant.
Double-Blind Placebo-Controlled Trial of Buflomedil in the Treatment of Raynaud's Phenomenon: Six-Month Follow-up
Authors: Le Quentrec Ph. , Lefebvre M.L. 
Published: November 2007

The efficacy of buflomedil in reducing the mean daily frequency and severity of winter ischemic attacks has been shown in a randomized, double-blind, pla cebo-controlled trial including 31 patients (16 in the buflomedil group, 15 in the placebo group) suffering from idiopathic Raynaud's phenomenon and followed up for six months. The efficacy was confirmed by nail fold capillaroscopy, which showed a significant alleviation of hemodymanic disturbances and background pallor in comparison with the placebo. Results in terms of clinical and laboratory safety parameters assessed over a six-month period were satisfactory, thus demonstrating the possibility of a long- term treatment.
Assessment of Coronary Artery Disease by Thallium Scan in Type-1 Diabetic Uremic Patients Awaiting Combined Pancreas and Renal Transplantation
Authors: Trochu Jean-Noel , Cantarovich Diego , Renaudeau Jocelyne , Patra Odile , du Roscoat Philippe , Helias Jacques 
Published: November 2007

Twenty-five type-1 diabetic uremic patients (14 men, 11 women, mean age forty ± eleven years, range, nineteen to sixty) were prospectively analyzed for coronary artery disease (CAD) by thallium scan (TLS) before syn chronus pancreas and kidney trans plantation. Duration of diabetes ranged from ten to thirty-two years (mean twenty-two ± five). Fifteen pa tients (60%) were in dialysis from two to sixty months (mean twenty ± eigh teen). Advanced diabetic degenerative complications were present in all pa tients. Twenty exercise and five phar macologic thallium scans were performed. Forty-four percent of patients (6 men, 5 women, mean age forty-two ± eleven years, range, twenty-six to sixty) had a positive (reversible or per manent defects) TLS. In 2/11 cases, se vere CAD required further cardiac investigations for therapeutic manage ment decision. A statistical correlation with resting ECG nonspecific ST-seg ment and T-wave abnormalities was observed (p<0.05) despite the absence of angor in 8 of the 11 patients. On the contrary, no statistical correlations were found regarding high blood pres sure, smoking, hypercholesterolemia, duration of diabetes, and duration of dialysis. In this particular diabetic popula tion (young age, male/female ratio = 1.2) with high incidence of silent isch emia, resting ECG repolarization ab normalities, though predictive, were not specific or prognostic of CAD severity; in these cases, exercise and pharmacologic TLS, a noninvasive and sensitive cardiovascular test, may be of great interest in diagnosis of CAD, allowing adequate cardiac man agement before, during, and after pancreas transplantation.
Renal Artery Imaging: A Prospective Comparison of Intra-Arterial Digital Subtraction Angiography with Conventional Angiography
Authors: Kim Ducksoo , Porter David H. , Brown Robert , Crivello Madeline S. , Silva Patricio , Leeming Brian W.A. 
Published: November 2007

This study describes a systematic comparison of intra-arterial digital subtraction angiography (DSA) of the main renal arteries with conventional angiography (CA), the currently accepted "gold standard" for the diagnosis of renal artery stenosis. Twenty-five patients scheduled for abdominal aortography for various indications underwent first DSA then CA. The DSA and CA images were evaluated for number of renal arteries, presence and grade of renal artery stenosis, presence of post-stenotic dilation or fibromuscular changes, and diagnostic and pictorial adequacy of the images. DSA was found to be diagnostically adequate in 92 % of cases, compared with 96 % for CA. In evaluating significant main renal artery stenosis, which the authors assumed to be any stenosis greater than 50%, there were 10 such stenoses seen by CA. DSA also detected 10 cases, but there was 1 false positive and 1 false negative, yielding a sensitivity of 90 % and a specificity of 98%. There was also close correlation of DSA and CA for the few cases of post-stenotic dilatation and fibromuscular dysplasia encountered. The authors conclude that DSA is an acceptable substitute for CA in the evaluation of patients for main renal artery stenosis.
Transient Pulsus Alternans Induced by Isosorbide Dinitrate: Echocardiographic and Hemodynamic Evidence of Reduced Venous Return—A Case Report
Authors: Matsuhashi Hironobu , Onodera Sokichi , Hasebe Naoyuki , Maruyama Jun-ichi , Honda Hajime , Yamashita Hirohisa , Tobise Katsuyuki 
Published: November 2007

Transient pulsus alternans was induced by isosorbide dinitrate (ISDN) in a patient with postmyocarditis congestive heart failure under diuretic therapy. The severity and duration of pulsus alternans depended on the dose of ISDN. According to the echocardiographic and hemodynamic examinations, the superimposed preload reduction caused by ISDN combined with decreased blood volume owing to diuretic therapy most likely contributed to the development of pulsus alternans.
Thermal Effects and Histologic Changes from Nd:YAG Laser Irradiation on Normal and Diseased Aortic Tissue Using a Novel Angioplasty Catheter with a Mobile Optical Fiber: An in Vitro Assessment
Authors: Weber Helmut , Enders Susanne , Hessel Stefan 
Published: November 2007

Although various laser angioplasty devices are currently being examined, thermal damage and perforation of the vessel wall remains the major acute complication of vascular laser recanalization. Consequently, the aim of this study was to investigate the thermal effects and histologic changes from laser irradiation (Nd:YAG, 1064 nm) on normal and diseased aortic tissue using a novel angioplasty device. During laser emission the coaxially guided optical fiber tip was positioned in reference to the end hole of the metallic capped probe as follows: (1) at the end hole (metal-cap position), (2) protruding 10 mm from that end hole (bare-fiber position), (3) withdrawn 5 mm into the metal cap's lumen (hot-tip position). In total, 96 laser impacts (25 joule: 5 W, 5 s, each) were produced on normal and atherosclerotic aorta in air through a 0.2-mm-core-diameter silica quartz fiber, with direct contact on the intimal surface of the target tissue by both the fiber and the metal cap and by either the fiber or the metal cap (n = 32 each). Tissue temperature was measured by means of special sensors positioned opposite the irradiated intimal spot in direct contact with the adventitial surface. Morphohistologic evaluation of lesions was performed and injury indexes were determined. Thermal injury (on normal aorta) for the metal-cap position was 0.063 ± 0.02 versus 0.42 ± 14 and 0.13 ± 0.03 for bare-fiber and hot-tip position, respectively (p< 0.001). In the metal-cap position of the optical fiber tip the metal cap appears to act as a "heat sink" to decrease the lateral spread of thermal injury and thereby reduce the risk of perforation and enhance the safety of tissue ablation for potential vascular laser recanalization.
Influence of Sympathetic Nerve Activity on Ventricular Arrhythmogenicity in the Dog with Chronic Hypokalemia
Authors: Yano Katsusuke , Matsumoto Yoriaki , Hirata Masanobu , Hirata Tetsuya , Hano Osamu , Mitsuoka Takao , Hashiba Kunitake 
Published: November 2007

To examine the influence of sympathetic nerve activity on ventricular arrhyth mogenicity in the dog with chronic hypokalemia, an electrophysiologic study was performed before and after bilateral stellectomy (BS) in 10 dogs with chronic hypokalemia (2.8 ± 0.1 mEq/L), which was created by feeding a low-potassium diet and by administering furosemide over a four-week period, and the results were compared with those obtained from 10 dogs with normokalemia (4.7 ± 0.3 mEq/L) from being fed an ordinary diet over a four-week period. Before BS the incidence of electrically induced ventricular arrhythmias was higher in the hypokalemic than in the normokalemic dogs. After BS it was decreased considerably in the hypokalemic but not in the normokalemic dogs. Heterogeneity of effective refractory period (ΔERP), which was determined as the difference between the longest and shortest effective refractory periods in three sites of the right and left ventricles, was greater in the hypokalemic than in the normokalemic dogs before BS. The ΔERP decreased slightly in the two groups both before and after BS. There was, however, no significant difference in ΔERP in the two groups both before and after BS. Ventricular fibrillation threshold (VFT) was significantly lower in the hypokalemic dogs than in the nor mokalemic dogs before BS (p< 0.005). VFT was elevated in the two groups after BS. Percent increase in VFT after BS was significantly greater in the hypoka lemic than in the normokalemic dogs. In conclusion, sympathetic nerve activity may play an important role in the increase in ventricular arrhythmogenicity in the presence of chronic hypokalemia.