bluuebunny/crossref_metadata_2025_split huggingface dataset:
Measurement of Blood Pressure in All Toes in Arterial Occlusive Disease of the Leg
Authors: Hirai Masafumi , Kawai Seiichi , Ohta Takashi , Seko Toshiyuki , Shionoya Shigehiko 
Published: November 2007

In the present study, systolic blood pressure in all toes was measured by using a bladder-free cuff in 20 normal limbs and 106 limbs with arterial occlusive disease, and the clinical significance of blood pressure measurement in all toes was studied. In 97 of 106 limbs with arterial occlusion, all 5 toes showed a significantly decreased blood pressure, indicating that any toe can be used for the purpose of diagnosis of arterial occlusions. However, 41% of cases showed the differ ence in blood pressure of more than 15 mm Hg between any 2 toes. Great variations of blood pressure among 5 toes were observed especially in limbs with gangrene or with other skin ischemic symptoms such as cold sensitivity, numbness, or history of gangrene in the toes. In these cases, evaluation of hemodynamics in each toe is considered to be of use for prognostic study of gangrene, selection and evaluation of treatments, and follow-up study. In limbs with intermittent claudication, however, blood pressure measurement in all toes may have little value in clinical practice because of small variation among blood pressure values of 5 toes. In comparison of blood pressure values in each toe from limbs with gangrene, toes with gangrene showed a significantly lower blood pressure than toes without gangrene. However, even in these toes without gangrene, a significantly lower blood pressure was observed than in toes from limbs without gangrene. These findings indicate that severe damage to digital circulation due to an occlusive process proximal to the toes is a primarily indispensable condition for development of gangrene in arterial occlusive disease.
Systemic Arterial Compliance in Patients with Non Obstructive Cardiomyopathy (NOCM), and Coronary Artery Disease (CAD)
Authors: Levy Bernard I. , Babalis Dimitri , Masquet Christianne , Slama Robert 
Published: November 2007

Arterial compliance had been estimated in three groups of patients: control, NOCM, and CAD, from analysis of the arterial pressure curve. In the three groups, a simple first order Winkessel model had been validated during normal and post extrasystolic beats. The measured arterial compliance depends mainly on i the diastolic pressure, ii, the mechanical properties of the aorta and major arteries. For the same range of age and diastolic pressure, the arterial compliance was not significantly different in the three groups of patients. Because of the significant variations of the arterial compliance during slight modifications of the diastolic pressure, the lack of difference in the compliance of control, NOCM, and CAD patients may be attributed to similar arterial mechanical properties.
Noninvasive Quantification of Ambulatory Venous Hemodynamics During Elastic Compressive Therapy
Authors: Norris C. Scott , Turley Glenn , Barnes Robert W. 
Published: November 2007

Quantifying the hemodynamic results of elastic compression requires inva sive and cumbersome techniques. Twenty lower extremities (normal, primary, acute and chronic post-thrombotic varicosities) were evaluated with quantita tive photoplethysmography (PPG) prior and subsequent to initiating graded compression. The PPG transducer is placed against the stockings and the in vivo method of calibration is used to predict the results of compressive therapy on ambulatory venous pressure (AVP). Noninvasive evaluation of patients with quantitative PPG techniques follow ing compressive therapy may provide a better understanding of venous hemo dynamics and a rational approach to selection of therapy.
Influence of Intravenous Infusions of Hydroxyethylstarch (HES) (MW 40,000 and 450,000) on the Blood Flow Properties of Healthy Volunteers
Authors: Ehrly Albrecht M. , Landgraf Helmut 
Published: November 2007

Infusions of hydroxyethylstarch (HES) solutions as plasma substitutes and flow improvers play an increasing role in the treatment of various diseases. Little is known about the effect of HES solutions of different molecular weights on the flow properties of blood i. e. blood viscosity, plasma viscosity, erythrocyte aggregation and erythrocyte deformability (filtrability). In the present study the influence of 500 ml-infusions of a 6% solution of HES (MW 450,000) has been compared to that of 6% solutions of HES 40,000. Infusions of 500 ml of HES 450,000 into healthy persons induced a hemodilution with a subsequent decrease in whole blood viscosity whereas the plasma viscosity increased. Red cell aggregation increased as well, red cell deformability was slightly impaired. Infusions of 500 ml of HES 40,000 into healthy persons were followed by a hemodilution with a decrease in blood and plasma viscosity, a decrease in erythrocyte aggregation and a slight improvement of red cell deformability. The reason for this difference in behaviour and its therapeutical consequences are discussed.
Biochemical Analysis of Dermal Connective Tissue in Subjects Affected by Primary Uncomplicated Varicose Veins
Authors: Andreotti Lupo , Cammelli Daniele , Sampognaro Salvatore , Allori Andrea , Baldoni Daniele , Bussotti Alessandro , Cortini Paolo , Di Giovine Francesco , Sterrantino Gaetana 
Published: November 2007

Biochemical analysis of dermal connective tissue was carried out in 14 sub jects affected by primary uncomplicated varicose veins and 14 controls. Skin samples were taken, according to fixed criteria, from operation pieces of total mastectomy for breast cancer. The results suggest that the dermal tissue in these subjects is just thinner than that of controls, confirming previous similar clinical findings. The elective reduction of the collagen content observed, unassociated with changes of other components of the dermal connective tissue, brings evidence for a systemic biochemical defect of the extracellular matrix i.e. a collagen de fect affecting the entire body structure and not only the varicose or pre-varicose veins of the lower limbs.
A Non-Invasive Index of Leg Arterial Perfusion Pressure During Walking, Derived From Cutaneous Toe Temperature
Authors: Baccelli Giorgio , Corbellini Ezio , Walsh J Timothy , Busca Stefano , Boccaccini Ugo , Zanchetti Alberto 
Published: November 2007

This article describes and evaluates a non-invasive technique for continuous monitoring of hemodynamic changes in the legs during walking. The method involves monitoring of cutaneous toe temperature. In six normal subjects we have shown that, during exercise under carefully controlled conditions, a unique steady-state toe temperature exists for any given leg arterial perfusion pressure, when perfusion pressure is varied by means of an external occluding ankle cuff. Further, we have demonstrated a strong correlation between this external ankle cuff pressure and the time rate of changes of toe temperature during the test-period following occlusion. Correlation coefficients, r1, were be tween -1 and -0.88 (mean -0.95; standard deviation±0.03) for big toe and between -1 and -0.87 (mean -0.94; standard deviation ±0.03) for third toe. We conclude that during walking the time profile of toe temperature changes is a useful index of changes in leg perfusion pressure. Therefore, toe tempera ture may be used to study the dynamics of leg arterial circulation in atheroscler otic occlusive diseases.
Instrumental Evaluation of the Venous Circulation in the Arteriopathic Subjects
Authors: Bartolo M. , Antignani P.L. , Pittorino L. , Todini A.R. , DiFolca A. 
Published: November 2007

In peripheric arteriopathies, alterations occur to the venous system with a particular swelling of the veins of the foot-top, in the subjects (sclerotic or dia betic) at the 2nd and 3rd Fontaine stage, which gradually decreases until the collapse in the most advanced levels of the arterious affection (4th stage). In order to verify all that, we examined 40 artheriopathic subjects at the different Fontaine stages through a c.w. doppler apparatus and an impedence plethysmograph. Together with the modification of the arterious doppler velocitogram and the reduction of the Winsor index, we noticed that the velocity of the venous flow increases together with a venous hypertension that reaching the highest values at the 3rd stage, while at the 4th stage they are reduced because of the progress of the sclerosis. The impedence plethysmogram shows a reduction of the systo diastolic sphygmic excursion with a variation of the basic line, depending on the respiration, proportional at the clinic stage. In diabetic subjects the progress of the disease is more precocious because of the quicker implication of the microcirculation.
Evaluation of the Effects of Vasoactive Drugs on Cutaneous Microcirculation by Laser Doppler Velocimetry
Authors: Leonardo Giuseppe , Arpaia Maria Rosaria , Del Guercio Raffaele 
Published: November 2007

The effects provoked in different points of skin circulation by a vasoactive drug injected in the femoral artery of patients affected by chronic obliterative arterial disease at clinical stage 2, were evaluated using the laser Doppler velocimeter. At the same time, by means of strain gauge plethysmography, measurements were taken of the relative variations of volume and amplitude of the pulse waves in the hallux and of blood flow in the calf. After administration of the drug, a number of phenomena were observed, the most notable of which was a rapid and intense shift of blood from skin to muscle, followed by an increase in the global perfusion of the limb. Considering the physio-pathological importance of regional blood redistribution between skin and muscle and the high frequency rate of skin lesions in vascular diseases of the limbs, the possibility of evaluating, with a practical, non-invasive technique, the effects of drugs at the skin level is of great interest.
An Uncommon Systemic Arteritis — A Case Report
Authors: Di Giacomo V. , Meloni F. , Transi M.G. , Mastroberardino G. , Iannucci G. , Sciacca V. 
Published: November 2007

A 26-year-old male shortly after an acute respiratory disease was affected by a thrombophlebitis of the left leg. After a few days he had two syncopal attacks. Later on, a myocardial ischemia was diagnosed. Subsequently the patient began to complain of a bilateral claudication of the calves; after an attack of fever, the ischemia of the lower limbs worsened with recurring pain at rest. At the same time, in absence of any symptom, a myocardial ischemia occurred again and the presence of a thrombus was observed in the right atrium. After surgical removal of it, the ischemic troubles of the lower limbs once again began to worsen with the occurrence of bilateral gangrene of the feet. An amputation of both the legs was promptly performed at the level of the thighs. The histological examination of the arteries of the amputated legs showed segmental arteritis with partially recanalized thrombi of the popliteal, left femoral and tibioperoneal arteries. In the meantime, the titres for Coxsackie virus B2 and B6 were found slightly increased. One month later, the left radial pulse disappeared for a few days. The histopathological findings may relate this arteritis to a form of Buerger's disease even if a systemic thromboangioitis obliterans is not commonly accepted. In case that the acute respiratory infection represented the true onset of the sickness, it seems conceivable that the hypothesis of a viral infection gave raise to arteritis with morphological features recalling those of Buerger's disease.
The Use of Beta-Adrenergic Blockers in the Treatment of Angina and Hypertension
Authors: Caris Timothy N. 
Published: November 2007

During the past decade, beta-adrenoreceptor blocking agents have proved to be valuable assets in our therapeutic armamentarium for management of both angina pectoris and essential hypertension. In ischemic heart disease, these agents reduce myocardial oxygen require ments by decreasing the force of myocardial contraction and by reducing heart rate. Consequently, decreased blood supply to portions of the myocardium is tolerated better.1 The beta-blockers are effective in reducing the frequency and severity of episodes of angina pectoris and in extending exercise tolerance. If needed, additional benefit may be gained by adding long-acting nitrates, or calcium-channel blockers or both.2
Vascular Manifestations of Systemic Lupus Erythematosus
Authors: Ansari Azam , Larson Paul H. , Bates Henry D. 
Published: November 2007

Systemic lupus erythematosus (SLE) is a well-known acute and/or chronic multisystem disease of complex autoimmune nature, having predilection for cardiovascular system. While its cardiac manifestations have been adequately studied, there is paucity of information on its vascular manifestations. Accord ingly, we studied the incidence of vascular manifestations in 50 consecutive SLE patients seen at our institutions and in private practice during the past 12 years. Systemic hypertension (44%) was the most common vascular manifestation followed by vasculitis (30%), Raynaud's phenomenon (26%), telangiectasis (20%), premature coronary atherosclerosis (6%), digital ulceration (6%), thrombophlebitis (6%), pulmonary hypertension (4%) and portal hypertension (4%). Diffuse systemic vasculitis similar to polyarteritis nodosa was rare (2%). Often more than one lesion was found in the same patient. The clinical diagnosis of these vascular manifestations in the context of the primary disease (SLE) usually does not pose any difficulty except when they antedate it. We also studied the pathology and pathogenesis of some of these vascular lesions in both autopsy and biopsy specimens by both light microscopy and immunofluorescent techniques. Our results as well as those of others who also studied these lesions indicate that immune complex deposition and subsequent complement activation play an important role in the pathogenesis of vasculitis, coronary arteritis and premature coronary atherosclerosis. Corticosteroids and vasodilators remain the drugs of choice for the manage ment of the majority of the symptoms arising from the vascular lesions of SLE.
Cardiovascular Effects of Polycyclic Antidepressants
Authors: Mahapatra Rajat K. , Paul Subir K. , Mahapatra Dipta , Winter Scott 
Published: November 2007

Every day, thousands of people in the United States receive polycyclic antide pressants (PCAs) prescribed by their primary care physicians. We have exam ined the cardiovascular manifestations of polycyclic antidepressants in 14 patients with primary depression receiving various antidepressant drugs for a period of six months or more. None had suffered from any systemic illness. All 14 received a commonly prescribed PCA, such as doxepin, amitriptyline, imip ramine, desipramine or amoxapine, in therapeutic doses. None developed any significant adverse reaction. Left ventricular function, as determined by M-mode echocardiogram, was within normal limit in all pa tients. A twenty-four-hour ambulatory electrocardiogram revealed rare supraven tricular ectopic beats in 8 patients and ventricular ectopic activity (Lown grade 1) in 4 patients. In 1 patient, who received additional lithium carbonate for treatment of depression, both supraventricular and ventricular ectopic activity developed on rare occasions. In 4 of the 8 patients the plasma concentration of PCA was optimal or near optimal, and in 4 of the 8 patients it was subtherapeutic (even though these 4 patients had shown clinical improvement with continued polycyclic therapy). It appears from the present data that antidepressant therapy with PCAs pre scribed in therapeutic doses was well tolerated, without any significant adverse cardiovascular reaction, in otherwise healthy young patients with primary de pression.
Catheter Separation During Cardiac Catheterization and Coronary Angiography. A Report of Four Incidents and Review of the Literature
Authors: Kyriakides Zenon S. , Bellenis Ion P. , Caralis Dennis G. 
Published: November 2007

Four incidents of catheter separation in three patients during left heart cath eterization and coronary angiography are presented. In two cases the catheters had been used before. After the second incident, we decided to use angiography catheters once only. All catheter fragments were removed under local anesthesia, and no further complications arose. In all incidents the point of catheter fracture was near the bond between the body of the catheter and its tip. We believe that catheter separation is related to polymer aging. The cathe ters in the third and fourth incidents were unused, but there was no expiration date on their packages. We recommend that (1) expiration dates be clearly stated on every catheter package, (2) catheter manufacturers issue warnings not to use catheters after expiration date, and (3) unused angiography catheters with no expiration date not be used. We also suggest that consideration be given to using catheters once only.
Monitoring of Tissue-pO2 for Invasive Diagnostics in Angiology and Vascular Surgery
Authors: Hauss J. , Spiegel H.U. , Schönleben K. , Bünte H. 
Published: November 2007

Hypoxic and ischemic states are the main problem makers in angiology and vascular surgery. It is therefore suggestive to employ the technique of tissue-pO2 measurement for the verification and support of diagnostic and therapeutic measures. Two forms of registration are possible: continuous monitoring of partial oxygen pressures in eight different places and registration in the form of pO2-histograms, which represents a kind of "representative opinion poll" held in the tissue. The effects of a surgical intervention (endarterectomy, bypass operation) and the efficacy of blood flow-promoting drugs were studied in several series. In 9 patients the effect of the blood flow-promoting agent pentoxifylline (3,7-dimethyl-1-(5-oxohexyl)-xanthine) was studied. The pO2-histograms exhibited a shift to the right by an average of 7 mmHg after administration of this drug. Moreover, findings obtained with sodium nitroprusside and nitroglycerin during induced hypotension indicate that the continuous measuring of tissuepO2 and recording of oxygen pressure distribution curves (pO2-histogram) provide the clinician with essential guidance data for the improvement of diagnostics and therapeutic control.
Kaposi's Sarcoma Following Corticosteroid Treatment for Temporal Arteritis—A Case Report
Authors: Di Giacomo Vincenzo , Nigro Daniela , Trocchi Gloria , Meloni Fortunato , Verallo Patrizia , Bottazzi Marco , Bellisario Giuseppe 
Published: November 2007

After three months of corticosteroid treatment, a sixty-nine-year-old man, suffering from temporal arteritis, developed a Kaposi's sarcoma (KS) initially located on the left ankle and subsequently spread over both feet and hands. Laboratory data showed a deficiency of both humoral and cellular immunity and constant positivity in the tests for cytomegalovirus. The onset of KS during corticosteroid treatment of temporal arteritis is an extremely rare occurrence, this case being only the second one reported in the literature. In our case the development of this neoplasm can be related to an immunodeficiency that led to a deficit in the immunological surveillance, along with an activation of oncogenic viruses.
Angiopyroplasty Using Electromagnetically Induced Focused Heat
Authors: LePage James R. , Lewis John E. , Ruiz Oscar F. , Yamanashi William S. , Padron Gustavo M. , Hood Cynthia H. 
Published: November 2007

A metal-tipped catheter capable of inducing and withstanding extremely high temperatures suitable for angiopyroplasty has been developed. The probe utilizes external radiofrequency (RF) energy focused on the tip. A relatively inexpensive catheter and RF source make this a very plausible alternative to laser systems.
Therapeutic Efficacy of Ketanserin, a Selective Antagonist of the Serotonin (5-HT 2) Receptors, in Primary and Secondary Raynaud's Phenomenon
Authors: Meloni Fortunato , Transi Maria Grazia , Sciacca Vincenzo , De Felice Carlo , Bagarone Amedeo , Sciacca Andrea 
Published: November 2007

Fourteen ambulatory and hospitalized patients with primary and secondary Raynaud's phenomenon have been examined before and after a thirty-one-day therapeutic trial. The treatment was conducted in two cycles. The first one lasted ten days, during which placebo was administered. The second cycle lasted three weeks, during which ketanserin, a selective antagonist of 5-hydroxytryptamine (5-HT2) receptors, was administered. The therapeutic effect consisted of the complete healing of digital ulcers in 4 of 5 patients and a considerable decrease in the number, length, and severity of daily attacks. To evaluate the digital blood flow, each patient was submitted to a medical dynamic telethermographic test. This, after the cooling test, demonstrated an average decrease of twenty minutes in the time necessary to reestablish basal thermal conditions (T') at the end of an adequate period of therapy using optimal doses of the drug. The authors affirm that orally administered ketanserin has a beneficial effect and can be well tolerated in subjects with Raynaud's phenomenon.
Syndrome of Coronary Artery Spasm of Normal Coronary Arteries. Clinical and Angiographic Features
Authors: Castelló Ramón , Alegría Eduardo , Merino Alvaro , Soria Federico , Martinez-Caro Diego 
Published: November 2007

To define the clinical and angiographic features of the syndrome of spasm of angiographically normal coronary arteries, 77 patients with spasm and fixed coronary stenosis equal to or greater than 50% (group A) were compared with 35 patients with spasm and normal or minimally diseased coronary arteries (group B). Statistically significant differences between groups A and B were as follows: the incidence of rest angina (50.6% vs 85.7%; p<0.01) and mixed angina (32.5% vs 5.7%; p < 0.01); the appearance of ST segment depression (53.3% vs 16%; p < 0.01) and no electrocardiographic changes during stress test (35.6% vs 76%; p < 0.01); and the tendency for arteriographically documented spasm to be focal (87.5% vs 71.4%; p<0.05) and to affect only one vessel (76.6% vs 57.1%; p < 0.05). No differences were found between groups A and B in major coronary risk factors, history of previous myocardial infarction, electrocardiographic abnormalities at rest or during pain episodes, or arteries affected by spasm. Thus, angina appearing exclusively at rest is the main clinical feature of spasm of normal coronary arteries. The electrocardiogram, whether at rest or during pain episodes, has no value for predicting the existence of underlying coronary lesions, whereas stress testing does. Spasm of normal arteries tends to be more diffuse than that superimposed on organic lesions and to affect more than one artery, suggesting different mechanisms in the genesis of both types of spasm.
Extracranial Carotid Atherosclerosis Evaluation and Stroke Occurrence: Role of the Echotomographic Analysis
Authors: Parnetti Lucilla , Mercuri Michele , Susta Adelaide , Lupattelli Graziana , Ciuffetti Giovanni , Senin Umberto 
Published: November 2007

High-resolution real-time echotomography was used in a longitudinal study on 118 atherosclerotic plaques of the extracranial carotid tract with the aim of identifying those most likely to cause a cerebrovascular event. Seventy patients (average age 61 ± 7 years), referred to our Clinical Vascu lar Laboratory because suffering from transient cerebral ischemic attacks (TIA), coronary heart disease (CHD), peripheral artery disease (PAD), or cervi cal bruits (CB), were followed up for two years. Medical treatment remained that of the referring physician. Ten patients suffered from clinical events caused by stroke, TIA, and/or carotid occlusion during the follow-up. The echostructural profile of the lesions most often correlated with the clini cal event was characterized by a mixed or hard echogenic pattern, an irregular surface, and an initial vascular stenosis of more than 50%.