bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sonography of Vertebral Arteries in De Kleyn's Position in Subjects and in Patients with Vertebrobasilar Transient Ischemic Attacks
Authors: Arnetoli Graziano , Amadori Andrea , Stefani Paolo , Nuzzaci Giuseppe 
Published: July 2008

Two groups of subjects, matched for age, were studied. The first group consisted of 190 healthy subjects, the second, of 60 patients with vertebrobasilar transient ischemic attacks (TIAs), 22 of whom underwent angiography. After it was ascertained that the findings from continuous-wave (cw) Doppler of carotid and vertebral arteries, performed in the standard position, were normal, the examination was then done in De Kleyn's position, the velocity signal being detected at the mastoidal slopes. The abnormal findings were classified into two groups: "loss of diastolic velocity signal" and "absence of velocity signal." In the control group, changes of flow were detected in 6.31%, whereas in the group of patients abnormal Doppler parameters were detected in 33.33%. None of the patients who were submitted to angiography showed abnormal hemodynamic findings. The authors suggest that the detection of the velocity signal of the vertebral arteries in De Kleyn's position could be of help in revealing conditions that could cause, in time, signs and/or symptoms of vertebrobasilar insufficiency in subjects with possible asymptomatic anomalies of the circle of Willis.
Stress Testing in Patients with Coronary Spasm: Comparison of Those With and Without Fixed Coronary Artery Disease
Authors: Castelló Ramón , Alegría Eduardo , Merino Alvaro , Hidalgo Ricardo , Aparici Manuel , Martínez-Caro Diego 
Published: July 2008

Stress testing is one of the preferred noninvasive methods of identifying patients with coronary artery disease (CAD). Its value in patients with coronary artery spasm (CAS) is, however, difficult to ascertain. The authors studied 91 consecutive patients with angiographically documented CAS. All patients underwent a symptom-limited bicycle exercise test before coronary angiography. Eight patients (8.8%) showed ST-segment elevation during exercise; 37 (40.7%), ST-segment depression; and 46 (50.5%), no changes. Thirty patients had normal coronary arteries; 19, one-vessel disease ; 19, two-vessel disease; and 23, three-vessel disease. Stress testing yielded abnormal results in 7 of 30 patients (23%) with no CAD and in 38 of 61 (62%) with fixed CAD (p < 0.01). ST-segment response to exercise did not correlate with most clinical findings such as age, type of angina, duration of pain episodes, or the degree of disease activity. However, a significant correlation was found with the extent and severity of CAD. Absence of ST changes or ST-segment elevation did not differentiate those patients with or without CAD, but only 4 of 37 patients with ST-segment depression had no significant fixed lesions. In conclusion, half of the patients with CAS had a normal stress test. ST-segment elevation is an uncommon finding in these patients and does not reliably differentiate those with and without fixed CAD. The only relevant finding of stress testing in CAS patients is ST-segment depression, which strongly suggests the presence of underlying CAD.
Diagnosis of Arteriosclerosis Obliterans by Impedance Technique with Special Reference to Relative Blood Flow of the Lower Extremity
Authors: Okuda Noriaki , Okuda Noriaki , Yamada Masami , Shoudao Feng  , Asai Yasushi , Fujinami Takao 
Published: July 2008

Simultaneous recordings of impedance cardiography of the chest and impe dance plethysmography of the lower extremity were performed on 105 limbs with or without arteriosclerosis obliterans (ASO) documented by angiography. The ratios of blood flow to the lower extremity—leg stroke volume/cardiac stroke volume—(LSV/CSV) were 11.2 ± 3.3% in normal male subjects, 11.1 ± 5.5% in normal female subjects, and 3.1 ± 1.2% in lower extremities with ASO, respectively. The normal value (range) for LSV/CSV calculated from the normal groups by the percentile method was between 4.9% and 17.8%, and the diagnostic accuracy of this value was 100% for sensitivity and 97.5% for specificity. LSV/CSV is a good index for the diagnosis of ASO and makes it possible to minimize error when expressed as an absolute value.
Attenuation of Reactive Hyperemia Caused by Aspirin in Canine Coronary Artery
Authors: Miyajima Seiichi , Aizawa Yoshifusa , Shibata Akira 
Published: July 2008

Effects of intracoronary aspirin on coronary blood flow and reactive hyperemia were evaluated in closed- chest, anesthetized dogs. In 18 dogs the left circumflex coronary artery was cannulated and perfused by arte rial blood at a constant pressure. Coronary blood flow was measured by an electromagnetic flowmeter. In tracoronary aspirin at doses of 5, 10, and 20 mg reduced coronary blood flow in a dose-dependent manner. In jection of aspirin at doses of 10 to 25 mg also inhibited reactive hyperemia following the coronary occlusion for fifteen seconds. The mean peak flow ratio was reduced from 2.13 ± 0.42 to 1.75 ± 0.35 (p < 0.005). The incre ment of coronary blood flow provoked by intracoronary arachidonic acid at doses of 150 to 300 μg was almost entirely inhibited by the pretreatment of the coronary artery with aspirin. The authors conclude that aspirin increases coronary arterial resistance in a dose-dependent manner and also restricts the maximal dilating capac ity, possibly by inhibition of pro stacyclin synthesis.
Use of Computerized Digital Thermometry for Diagnosis of Raynaud's Phenomenon
Authors: Caramaschi P. , Codella O. , Poli G. , Perbellini L. , Biasi D. , Bambara L.M. , Corrocher R. , De Sandre G. 
Published: July 2008

The authors have used computerized digital thermometry for the instrumen tal diagnosis of Raynaud's phenomenon; such a technique enables them to eval uate the temperature of the ten fingers of the hands separately in baseline conditions, during and after the "cold test." In baseline conditions the mean digital skin temperature was 31.2°C (SD 1.67) in control subjects and 26.8°C (SD 2.84) in patients suffering from Ray naud's phenomenon (p < 0.001). During the cold test the mean skin temperature decreased to 12.7°C (SD 1.94) in control subjects and to 13.0°C (SD 1.67) in patients (p=n.s.). The mean final skin temperature, at the end of the recovery period after the cold test, was 31.1°C (SD 1.76) in controls and 21.9°C (SD 2.78) in patients (p < 0.001). The sensitivity of the computerized digital thermometry was high (63.6% and 92.7% for basal and final temperature, respectively), while the specificity was 100% for both values. In conclusion, computerized digital thermometry is a useful technique for the diagnosing and quantifying the extent of Raynaud's phenomenon.
Pupil-Sparing Oculomotor Palsy Caused by Fusiform Ateriosclerotic Aneurysm of the Basilar Artery—A Case Report
Authors: Soria Emilio , Camell Helena , Dang Hien 
Published: July 2008

Paresis of the oculomotor nerve is a very rare complication of an unrup tured arteriosclerotic fusiform aneu rysm of the basilar artery. A handful of cases are described in the world literature. A fifty-four-year-old man with a history of hypertension and diabetes mellitus presented with painless par tial oculomotor palsy of sudden onset. A cerebral angiogram demonstrated a tortuous fusiform deformity of the basilar artery and the origin of the posterior cerebral arteries, indica tive of all arteriosclerotic aneurysmal dilation. A sudden onset of a pupil-sparing ophthalmoplegia is the typical history of a microvascular infarct of the third nerve, whereas pupillary sparing in aneurysmal oculomotor paresis is a very rare event. Special emphasis has been placed on the pupillary size as a guide for the indication of arteriog raphy. The many exceptions to this ruie suggest that cerebral arteriog raphy may be indicated more often than generally believed.
Evaluation of Skin Blood Flow and Venoarteriolar Response in Patients with Diabetes and Peripheral Vascular Disease by Laser Doppler Flowmetry
Authors: Belcaro Gianni , Vasdekis Spiros , Rulo Alexander , Nicolaides Andrew N. 
Published: July 2008

Skin blood flow in the distal foot was evaluated in patients with peripheral vascular disease and diabetes and compared with skin blood flow in normal volunteers by use of laser Doppler flowmetry. Resting blood flow (RBF) and standing blood flow (SBF) were recorded in a room at a constant temperature (20-22°C). The RBF was found to be different in the five groups (normal, dia betics, patients with intermittent claudication, those with rest pain and those with impending gangrene. In diabetics RBF was significantly higher than in normal subjects. Even on standing, SBF in diabetics was higher and not different from RBF, indicating an ineffective venoarteriolar response (VAR). The VAR was also reduced in pa tients with claudication and was abolished in patients with rest pain and im pending gangrene. In patients with rest pain SBF was increased. Laser Doppler flowmetry is a useful technique for evaluating skin perfusion in patients with peripheral arterial disease and for discriminating among differ ent classes of patients.
Results of Hemorheologically Active Treatment with Pentoxifylline in Patients with Cerebrovascular Disease
Authors: Schneider Rolf 
Published: July 2008

Ten patients with acute stroke and impaired erythrocyte deformability received pentoxifylline parenterally in daily doses of 1.2-1.5 g for ten days (Study A). Hemorheologic parameters: erythrocyte aggregation, erythrocyte deformability, plasma viscosity, and yield shear stress were monitored. While plasma viscosity and erythro cyte aggregation did not change sig nificantly, there was marked improve ment in erythrocyte deformability and yield shear stress. Nine patients improved clinically, 1 died. In 40 patients with lacunar in farcts (Study B) clinical and hemo rheologic data were recorded during a three-month treatment with 800 to 1,600 mg oral pentoxifylline per day. The above-quoted variables, being pathologically altered in comparison with healthy controls, were again monitored. Thirty-six patients com pleted the study (4 dropouts). Clini cally, 34 patients improved during treatment, 2 worsened. Hemorheologic variables, which were pathologically altered at baseline, improved signifi cantly. Improvement of accompanying disturbances in the retinal microcir culation (confirmed by video fluores cence angiography) during therapy indicated a close correlation between hemorheologic factors and microcir culation.
Increase of Walking Capacity After Acute Aminophylline Administration in Intermittent Claudication
Authors: Picano Eugenio , Testa Roberto , Pogliani Mauro , Lattanzi Fabio , Gaudio Vincenzo , L'Abbate Antonio 
Published: July 2008

In the presence of peripheral atherosclerotic disease, inappropriate adeno sine release during exercise might promote excessive arteriolar dilation leading to steal phenomena and ischemia. In order to test this hypothesis, IV aminophylline (6 mg/kg over fifteen min utes), a dosage known to effectively block adenosine receptors, was acutely ad ministered—in a double-blind, placebo-controlled study design—in 13 patients with intermittent claudication and documented atherosclerotic disease. All pa tients performed two treadmill exercise tests at the same hour on two consecu tive days, five minutes after aminophylline or placebo administration randomly allocated. Pain-free time was 109±133 (mean±SD) seconds after placebo and 173±165 seconds after aminophylline (p < .01); maximum time to claudication was 273±191 seconds after placebo and 397±318 seconds after aminophylline (p < .05). The authors conclude that intravenous aminophylline markedly increases the walking capacity in patients with intermittent claudication, possibly by pre venting flow maldistribution phenomena through adenosine receptors block ade.
Predictive Value of Manual ECG-Monitored Exercise Test Before Abdominal Aortic or Peripheral Vascular Surgery
Authors: Kaaja Risto , Sell Henrik , Erkola Olli , Harjula Ari 
Published: July 2008

The value of manual ECG-monitored exercise test was studied in 58 patients (39 men and 19 women) with intermittent claudication scheduled for abdominal or peripheral vascular surgery. There was a high incidence of well-known risk factors (hypercholesterolemia, smoking, and hypertension) in men and women. History of coronary artery disease (CAD) was present in 29.3% of the patients. No correlation was found between patients with single or multiple stenoses in lower extremity arteries (angiography) and CAD. Ischemic response (ECG) to manual exercise testing was positive in 14 patients (24.1%), of whom 2 (14.3%) had major cardiovascular postoperative complications. Both died of acute myocardial infarction within fourteen days. They had slow recovery (thirty to sixty minutes) of the ST segment (0.3-0.6 mV). The authors conclude that manual exercise testing might reveal serious CAD in patients with severe occlusive peripheral arterial disease of the lower extremities. In cases with slow recovery of ischemic response to exercise, coronary bypass or angioplasty could be advantageous before major vascular surgery.
Decreased Platelet Activity Without Change in Fibrinolytic Activity After Low Dosages of Fish Oil
Authors: Winther Kaj , Myrup B. , Hølmer G. , Høy C.-E. , Mehlsen J. , Schnohrt P. 
Published: July 2008

The effects of low-dose (350 mg daily) polyunsaturated fatty acids from fish oil, either in gelatine capsules or microencapsulated, were investigated in a non-blind, randomized, crossover study of 12 healthy male volunteers. The authors measured the incorporation of eicosapentaenoic acid (EPA) into platelets membranes, platelet aggregability by adenosine diphosphate (ADP) and adrenaline, and fibrinolytic activity as euglobulin lysis time, after two and six weeks of therapy. Both formulations resulted in increased incorporation of EPA into platelet membranes, and the microencapsulated formulation also significantly increased the platelet level of ADP for irreversible aggregation (by about 60%). Fish oil in gelatine capsules had a smaller, non-significant effect in the same direction. Both formulations reduced adrenaline-induced aggregability, but the effects did not attain significance. Neither formulation altered fibrinolysis. The data show that low doses of fish oil in microencapsulated form significantly lower platelet aggregability, without affecting fibrinolysis.
Tricuspid Valve Thromboembolus with Recurrent Pulmonary Embolism—A Case Report
Authors: Roistacher Nancy , Pierri Mary Kathryn , Keefe Deborah 
Published: July 2008

The authors describe a fifty-one-year-old man with multiple pulmonary emboli in whom two-dimensional echocardiography clearly showed a large mobile thrombus transiently entrapped in the chordal apparatus of the tricuspid valve, a location rarely noted except in autopsy specimens. Subsequent lung scan and echocardiograms documented clinically silent nonfatal embolization of this large thrombus to the lungs. Whereas most patients with this form of thromboembolic disease come to either surgery or autopsy, this case demonstrates how the combination of echocardiography and lung scanning can be used to differentiate the etiology of some right-heart masses.
Experimental Manufacture of a Catheter for the Measurement of Blood Flow Rate
Authors: Ota Toshiaki , Matsuda Hitoshi , Tsukube Takuro , Okada Masayoshi 
Published: July 2008

The authors manufactured an experimental catheter to obtain blood flow rate, measuring not only the flow velocity but also the vessel diameter. This catheter consists of 3F Doppler and 7F external sheath catheters, and four thin wires 3 cm in length are attached to the catheters at both tips at a 90° pitch. After the insertion of the catheter into the vessel, vessel diameter is calculated from the maximal width of the wires, which are expanded to a spindle shape inside the vessel; the maximal width is corrected with calibration metal markers also attached at the proximal site of the external sheath catheter. The flow veloc ity of the blood is calculated with the FFT (Fast Fourier Transform) analyzer. In experimental circuits as well as in the canine aorta, wires were adequately expanded, and the catheter was placed at the center of the tube or the aorta. The blood flow rate, which was calculated as a product of flow velocity and vessel diameter, was well correlated to that from the electromagnetic flowmeter, not only in the experimental circuits, but also in the canine aorta.
Value of Finger Arterial Blood Pressure in Diagnosis of Vascular Changes in Some Connective Tissue Diseases
Authors: El-Sayed Salem Mohamed , El-Girby Amira Hassan , Abd El-Moneim Nadia Ahmed , Khalil Selim Ahmed 
Published: July 2008

This study was performed in 60 patients with the following connective tissue diseases: rheumatoid arthritis (RA—20 patients), systemic lupus erythematosus (SLE—20), and progressive systemic sclerosis (scleroderma=PSS-20). Twenty normal persons served as controls. All patients and controls were subjected to complete history taking, complete physical examination, and laboratory investigations including: rheumatoid fac tor, anti-DNA, LE cell test, antinuclear factor (ANF), and ECG. Finger arterial blood pressure (FABP) readings using an 8 MHz Doppler flow detector with a 24-mm-diameter cuff at a temperature of 24°C were made in all cases and controls. The mean age of incidence in patients with RA was 37.8 years; in those with SLE, 21.5 years; in those with PSS 34.6 years; and in the control group, 33.7 years. Women were predominant both in the diseases and the control groups. The FABP was measured in all groups and the range of difference between the brachial and finger arterial blood pressure in each group was estimated. In the control group the mean difference was 27.7 mm Hg; in the RA group, 45.8 mm Hg; in the SLE group, 58.1 mm Hg; and in the PSS group, 70.9 mm Hg. There were no significant peripheral vascular changes in the small arteries in the RA group, whereas in the SLE and PSS groups there was a significant difference, which suggests different underlying microvascular changes. The FABP appears to be a diagnostic tool in the diagnosis of PSS and it helps in differentiation between various types of collagen disease in equivocal cases.
Raynaud's Syndrome, an Enigma After 130 Years
Authors: Cleophas Ton J. M. , Niemeyer Menco G. 
Published: July 2008

The recent literature concerning Raynaud's syndrome is reviewed. Ray naud's syndrome is as common as hypertension and diabetes. In spite of its generally benign character, it causes a lot of discomfort to individuals and sick ness absenteeism to society, especially in the colder regions of the world. The etiology remains an enigma 130 years after its first description, perhaps even more so than ever before, the many new theories proposed in the litera ture. Clearly, in a condition where seventy different etiologic theories are advo cated, the culprit lesion is obviously missing, or there is not a culprit lesion but an accumulation of conditions having nothing in common but a few symptoms. Moreover a Raynaud attack may result, not from a single event, but from a cascade of events, just as, for example, hemostasis does. Controversy about diagnosis exists all over. For example, how does one make a diagnosis? Patient history has been considered unreliable. A standardized cold test, though highly reproducible in the authors' hands, is far from common property. Raynaud's syndrome is a condition for which thirty-eight therapies have been advocated in the last three years, but the curative answer is still to come.
Observations on Plasma ANP Levels During Short-Term Transient Myocardial Ischemia Produced by PTCA in Patients with LAD Stenosis
Authors: Gasser R. , Luha O. , Dusleag J. , Eber B. , Rotman R. , Klein W. , Fueger G.R. 
Published: July 2008

Ten patients with coronary artery disease and stable angina (mean age fifty- seven) were included in the study. Five of the patients had normal left ventricu lar function, 5 had local hypokinesia or akinesia; 8 had one-stem and 2 had two- stem disease, but all had left anterior descending (LAD) lesions ranging from 75% to 100%. Ejection fraction varied between 35% and 75% (mean 59%). Im munoreactive atrial natriuretic polypeptide (ANP) levels in the femoral vein (FV) and the coronary sinus (CS) were measured before, immediately after, and up to twenty-four hours after percutaneous transluminal coronary angioplasty (PTCA) of the LAD. ANP secretion increased by 83% (FV) and 11% (CS) with in minutes after PTCA and reached control levels after thirty to sixty minutes. In patients with hypokinesia of the anterior wall, ANP secretion was significantly lower, 48% (FV) and 11% (CS) respectively. ANP secretion during PTCA was higher in patients with concomitant increase in pulmonary capillary pressure (PCP) but was also observed without an increase of PCP, suggesting ventricular ANP secretion. In conclusion, transient myocardial ischemia leads to immediate ANP secre tion even in the absence of significant pressure elevation in the left atrium. As a part of the continuous medical education program of the American Col lege of Angiology the second part of the paper reviews the mechanisms that al low the ischemic heart to counteract the ischemic condition and thus to escape from myocardial infarction. A review on this subject is presently not available in the literature.
In Vitro Pulmonary Vasorelaxant Effect of the Phosphodiesterase Inhibitor Enoximone
Authors: Yazdani Butt A. , Tuan Dinh-Xuan A. , Pepke-Zaba Joanna , Cremona George , Clelland Colin A. , Higenbottam Timothy W. 
Published: July 2008

Enoximone is a phosphodiesterase inhibitor that has both positive inotropic and systemic vasorelaxant activities. The latter are mediated by an increase in vascular smooth muscle concentration of cyclic 3'5' guanosine monophosphate. However, the effect of enoximone on pulmonary vasoreactivity is not estab lished. The authors, therefore, have studied its effect on endothelium-depend ent relaxation mediated by the endothelium-derived relaxing factor nitric oxide (NO), as well as endothelium-independent relaxation of isolated porcine pulmo nary arteries. Enoximone (10-7 to 10-4 M) caused a dose-dependent relaxation in all pulmo nary arterial rings. This relaxation neither required the presence of the endo thelium nor was affected by the addition of the inhibitor of NO synthase ω-nitro-L-arginine methyl ester (10-4 M). Also, the vasorelaxant response of the rings to the endothelium-dependent vasodilator adenosine diphosphate (10-10 to 10-5 M) was not affected by pretreatment with enoximone. The authors conclude that enoximone is a potent vasodilator that relaxes pulmonary vascular rings through mechanisms independent of the endothe lium. This endothelium-independent vasodilatory effect of enoximone makes it a potentially valuable drug for the treatment of pulmonary hypertension. This particularly applies to diseases in man where NO production by the endothelial cells is impaired.