bluuebunny/crossref_metadata_2025_split huggingface dataset:
Occlusion of the External Iliac Artery—A Rare Complication of Long-Distance Running: Case Report
Authors: Bartels Claus , Nigbur Helmut , Claeys Luc , Horsch Svante 
Published: August 2008

Stenosis or complete occlusion of the iliac artery is extremely rare in long-distance runners. When pain in the thigh and buttocks develops, the diagnosis of arterial occlusive disease is often delayed in these patients, for degenerative changes in the skeletal and muscle system are more prevalent. Herein the authors present the case of a young female long-distance runner in whom the external iliac artery became occluded at the end of a 100 km course, although claudication had developed one year before. The temporal relationship between the onset of claudication and the complete arterial occlusion at the end of the last race may give further insight into the underlying pathological mechanism.
Combined Myocardial and Peripheral Revascularization of the Lower Limbs
Authors: Massimo Carlo G. , Favi Piero P. , Presenti Luigi F. , Manca Giuseppe 
Published: August 2008

In a series of 2,786 patients submitted to operation for peripheral arterial disease of the lower limbs from 1964 to 1986, the overall mortality rate was 6.9%, and 69% of these died of acute myocardial infarction (AMI). In order to reduce the incidence of AMI, from 1979 to 1990, 258 patients with lower limb ischemia were investigated for coronary artery disease (CAD). All of them had clinical signs of myocardial ischemia and were submitted to coronary arteriog raphy after previous evaluation with dipyridamole thallium scanning and echo cardiography. Severe CAD was shown in 137 patients, and combined myocardial and peripheral revascularization was planned: coronary artery by pass grafting (CABG) was performed first on 61 patients followed by peripheral operation after an average of three weeks; simultaneous procedure was per formed on 76 patients upon intraoperative decision. The overall mortality rate was 3.6%: 3.3% for staged and 3.9% for simultaneous procedure. No myocar dial infarction was registered in the early postoperative period, but peripheral graft occlusion in 5.8% (8/137) was the main complication. The actuarial five- year survival rate was 87%; the actuarial five-year patency of the peripheral grafts was 61.9%. The authors conclude that combined myocardial and peripheral revascular ization prevents early death from myocardial infarction and improves late sur vival without increasing surgical risks; with proper judgment simultaneous operations can be performed.
Experimental Study of Cardiac Lymph in Myocardial Stunning
Authors: Masuda Hiroshi , Furuzono Kohji , Kamimura Ryozo , Taira Akira 
Published: August 2008

To clarify the pathophysiology of myocardial "stunning" from the viewpoint of the cardiac lymphatic system, lymph dynamics were studied in a fifteen-minute ischemic dog model. The influences of two interventions were evaluated: active lymph drainage by hyaluronidase (500 units/kg intravenously given on occlusion) and lymph stasis (loading 10 cmH2O of hydrostatic pressure on the cardiac lymphatic system on and after occlusion). Lymph flow of the control group did not significantly change despite remarkable decreases of both regional myocardial contractility (systolic strain) and regional myocardial blood flow (RBF). Meanwhile, active lymph drainage effectively improved systolic strain from the early reperfusion period (from 62 ± 4% to 77 ± 4% of baseline for control versus lymph drainage group, respectively, P < 0.05). Significant improvement of RBF was also noted within the endocardial side. Lymph stasis gradually deteriorated systolic strain (from 65 ± 5% to 45 ± 7% for control versus lymph stasis group at 240-minute reperfusion, respectively, P < 0.05) and was accompanied by an increase of myocardial water content. In pooling and analyzing the results obtained from these groups, a positive correlation was found between lymph flow and systolic strain, and it tended to be better during the early reperfusion period (r= 0.63, P < 0.01 at fifteen-minute reperfusion r=0.49, P < 0.05 at 240-minute reperfusion). The authors conclude that the process of myocardial "stunning" can be influenced by regulating lymph flow.
Budd-Chiari Syndrome Combined With Antiphospholipid Syndrome: Case Report and Literature Review
Authors: Shimizu Shigeomi , Miyata Masahiko , Kamiike Wataru , Ito Toshinori , Nakamuro Makoto , Nomura Masaya , Negoro Shigeru , Nakamura Hitonobu , Matsuda Hikaru 
Published: August 2008

A forty-three-year-old woman with Budd-Chiari syndrome, who had had transcardiac membranotomy nearly three years earlier, was admitted to hospital with symptoms of abdominal discomfort and subfever for possible recurrence of the condition. Obstructions of the inferior vena cava (IVC) and hepatic veins (HVs) were thought to have recurred, and the obstructive lesions of the HVs were of the long and multiple type. Additionally, she had a high titer for antiphospholipid antibodies. To relieve abdominal discomfort, percutaneous transluminal angioplasty and medical treatment were instituted. Subsequent relief of symptoms was accompanied by an improvement in the date from laboratory investigations. The authors review 14 cases of Budd-Chiari syndrome associated with antiphospholipid syndrome previously reported in the literature and discuss the therapeutic approaches to the characteristic obstruction lesions of the IVC and HVs.
Coronary Artery Bypass Supplemented by Grafting of the Right Ventricular Branches—Case Reports
Authors: Olearchyk Andrew S. 
Published: August 2008

Seventeen patients presented with angina pectoris class IV with or without dyspnea, or with dyspnea alone. Cardiac catheterization revealed an elevated right atrial mean (6.5±3.2 mmHg), right ventricular systolic (31.3±10.3 mmHg) and diastolic (7.3±3.8 mmHg), pulmonary artery systolic (32.9±10.3 mmHg) and diastolic (15.4±5.8 mmHg), pulmonary capillary wedge (15.2±4.8 mmHg), and left ventricular end-diastolic (22.4±8.4 mmHg) pressures. The cardiac index was reduced (2.3±0.6 L/min/m2), as was the left ventricular ejection fraction (39.6±8.6%). Significant and diffuse coronary artery disease was present in 16 patients. In addition, their significant disease involved the proximal acute marginal (n = 6), or the anterior ventricular (n=5), or the anterior ventricular and acute marginal (n=1), or the conus and anterior ventricular (n=1) branches of the right coronary artery. In the remaining patients (n = 4), the latter artery had a significant lesion above or below the origin of those branches, which were free of disease per se. The right ventricular branches provided intercoronary or intracoronary collaterals, or both, in 12 patients. Coronary artery bypass (4.6 grafts per patient) included vein grafts to the circumflex artery system (n = 22) ; the internal thoracic artery (n=8), or vein (n=6), or both (n=2) grafts to the left anterior descending artery; and vein grafts to the posterior descending artery (n = 8), diagonal branch (n = 7), ramus intermedius and right coronary artery (each, n = 3), and posterior left ventricular branch (n=1). It was supplemented by the vein grafts to the anterior ventricular (n=9), the acute marginal (n=7), or the acute marginal and conus (n=1) branches. One patient also had an aortic valve replacement. Hemodynamics after the operation without pharmacologic support revealed significant decreases of the right atrial mean pressure to 4.7±2.5 mmHg (p < 0.01), pulmonary artery systolic pressure to 24±7.0 mmHg (p < 0.01), pulmonary artery diastolic pressure to 11.9±3.4 mmHg (p < 0.01), and pulmonary capillary wedge pressure to 9.6±2.9 (p < 0.01). There was a highly significant decrease of the left ventricular end-diastolic pressure as measured indirectly by pulmonary artery diastolic pressure to 11.9±3.4 mmHg (p < 0.001) and by pulmonary capillary wedge pressure to 9.6±2.9 mmHg (p < 0.001). Cardiac index increased significantly to 3.2±0.9 L/min/m2 (p < 0.01). All patients are alive and free of angina and dyspnea. Did the revascularization of the right ventricular branches contribute to a functional improvement of the right and adjacent segments of the left ventricles and the septum?
The Use of Vacuum Compression Therapy on Ischemic Lower Limbs as Assessed by Changes in Venous Blood Gases and Serum Lactate
Authors: Samy Ahmed K. , MacBain Gordon , Hutchison Alan S. 
Published: August 2008

Simple physical training, intermittent pneumatic compression, cardiosynchronous limb compression, pulsed short-wave radiofrequency, and external negative thigh pressure are all varieties of physiotherapeutic modalities used in the treatment of peripheral vascular disease. A vacuum compression therapy (VCT) device allows both positive and negative pressure to be applied to an enclosed limb. Lower limbs of 13 consecutive patients suffering from chronic lower limb ischemia were exposed to alternating controlled periods of negative and positive pressure. The effect of this therapy was assessed by measurements of capillary oxygen saturation (by toe pulse oximetry), femoral venous blood gases, and whole blood lactate. These measurements were carried out at three time intervals: before, immediately after, and fifteen minutes after a fifteen-minute application of VCT to the affected limb. The results showed evidence of deterioration in tissue perfusion immediately after treatment as evidenced by pulse oximetry and venous gases, followed, however, by a significant improvement in the same parameters when measured at fifteen minutes. These findings were consistent. The mean values at fifteen minutes as compared with resting values were as follows: oxygen saturation increased from 94.3 to 97.8% ( P=0.002), venous PO2 increased from 4.1 to 4.6 kPa ( P=0.003), and venous PCO2 returned to its original value at 6.6 kPa/L ( P =0.003). Hydrogen ion concentration decreased from 41.6 to 40.6 nmol/L( P=0.003) and lactate decreased from 1 to 0.91 nmol/L ( P=0.004). It is, therefore, suggested that VCT may improve peripheral tissue perfusion. The immediate posttreatment biochemical deterioration was asymptomatic and may reflect a capillary washout phenomenon and/or a tourniquet effect created by the device's rubber cuff over the patient's thigh. Further studies monitoring clinical outcomes would be required before objective benefits for VCT therapy in peripheral vascular disease could be claimed.
A Surgical Overview of 200 Patients with Acute Arterial Occlusions of the Vessels of the Arm
Authors: Kirov Buryan Alexandrov , Iani Kostadinov Zakhariev  
Published: August 2008

Two hundred patients (103 men, 97 women, average age sixty-three years) with acute arterial occlusion of the vessels of the arm (AAOVA) were treated surgically in the period from January, 1985, to May, 1991; 70.5% of the occlusions were due to emboli and 29.5% were due to primary thrombosis. The subclavian/axillary arteries were occluded in 29% of the cases, the brachial artery in 59%, and the radial/ulnar arteries in 12%; 77.6% of the subclavian/axillary obstructions were due to emboli and 22.4 to thrombosis, 72.9% of the brachial obstructions were due to emboli and 27.1% to thrombosis, and 41.7% of the radial/ulnar obstructions were due to emboli and 58.3% to thrombosis. Local anesthesia was employed for all patients. There were 49 reoperations: 27 for rethrombosis, 8 for reembolization, 9 for evacuation of hematomas or control of hemorrhage, and 5 for treatment of infection; 11 fasciotomies were performed. Ten (5%) of the patients died, primarily because of cardiac failure or strokes. In 169 patients (84.5%) one or both distal pulses were restored at the wrist with return of normal extremity function. In 22 patients (11%), distal pulses were not restored but the clinical results were satisfactory. In 9 patients (4.5%), amputation at various levels was necessary owing to delayed presentation for treatment, extended thrombosis, or poor vascular status.
Myocardial Revascularization with the Gastroepiploic Artery
Authors: Aramendi José I. , Castellanos Enrique , de Salazar Alvaro Ortiz , Onate Agustin , Munoz Fernando , Antonana Mikel 
Published: August 2008

Between July, 1990, and January, 1992, 21 consecutive patients underwent myocardial revascularization with the use of the right gastroepiploic artery, among other grafts. They were 20 men and 1 woman, with a mean age of fifty-five years (range: thirty-seven to seventy). Previous myocardial infarction was present in 44% of patients, unstable angina in 81%, and three-vessel disease in 75%. Mean ejection fraction was 54% (range 45-67%). Two patients had had previous coronary bypass surgery. In 20 patients one or both internal mammary arteries or sequential grafts with the left internal mammary artery were used. Overall 63 coronary grafts were performed (mean 3 grafts per patient). Of these, 81% were arterial grafts and 19% saphenous vein grafts. Gastroepiploical grafts were to the following branches: posterolateral branch, 3 patients; posterior descending artery, 11; right coronary artery, 6; and the left anterior descending artery, 1 patient. Mean aortic crossclamp time was seventy-four minutes. Mean total drainage was 1600 cc. The incidence of perioperative acute myocardial infarction was 9.5%. Overall hospital mortality was represented by 2 patients, 9.5%. Mortality in primary revascularization was represented by 1 patient, 5%. The authors studied the graft patency with digital subtraction angiography and contrast injection in the celiac trunk. This was accomplished in 16 survivors (84% of total). The graft was patent in 14 patients (87%) and in 2 patients (13%) incomplete visualization of the graft was obtained. The authors conclude that the gastroepiploic artery offers a valid alternative for the revascularization of the branches of the diaphragmatic wall of the heart. It can be accomplished with low mortality and good immediate results.
Intraarticular factor IX protein or gene replacement protects against development of hemophilic synovitis in the absence of circulating factor IX
Authors: Sun Junjiang , Hakobyan Narine , Valentino Leonard A. , Feldman Brian L. , Samulski R. Jude , Monahan Paul E. 
Published: August 2008

AbstractHemophilic bleeding into joints causes synovial and microvascular proliferation and inflammation (hemophilic synovitis) that contribute to end-stage joint degeneration (hemophilic arthropathy), the major morbidity of hemophilia. New therapies are needed for joint deterioration that progresses despite standard intravenous (IV) clotting factor replacement. To test whether factor IX within the joint space can protect joints from hemophilic synovitis, we established a hemophilia B mouse model of synovitis. Factor IX knockout (FIX−/−) mice received a puncture of the knee joint capsule with a needle to induce hemarthrosis; human factor IX (hFIX) was either injected through the needle into the joint space (intraarticularly) or immediately delivered IV. FIX−/− mice receiving intraarticular FIX protein were protected from synovitis compared with mice receiving same or greater doses of hFIX IV. Next, adeno-associated virus (AAV) gene transfer vectors expressing hFIX were injected into knee joints of FIX−/− mice. Joints treated with 1010 vector genomes (vg)/joint AAV2-, AAV5-, or AAV8-hFIX or 2.5 × 109 vg/joint AAV5-hFIX developed significantly fewer pathologic changes 2 weeks after injury compared with the pathology of control injured contralateral hind limbs. Extravascular factor activity and joint-directed gene transfer may ameliorate hemophilic joint destruction, even in the absence of circulating FIX.
An 86-probe-set gene-expression signature predicts survival in cytogenetically normal acute myeloid leukemia
Authors: Metzeler Klaus H. , Hummel Manuela , Bloomfield Clara D. , Spiekermann Karsten , Braess Jan , Sauerland Maria-Cristina , Heinecke Achim , Radmacher Michael , Marcucci Guido , Whitman Susan P. , Maharry Kati , Paschka Peter , Larson Richard A. , Berdel Wolfgang E. , Büchner Thomas , Wörmann Bernhard , Mansmann Ulrich , Hiddemann Wolfgang , Bohlander Stefan K. , Buske Christian 
Published: August 2008

Abstract
Patients with cytogenetically normal acute myeloid leukemia (CN-AML) show heterogeneous treatment outcomes. We used gene-expression profiling to develop a gene signature that predicts overall survival (OS) in CN-AML. Based on data from 163 patients treated in the German AMLCG 1999 trial and analyzed on oligonucleotide microarrays, we used supervised principal component analysis to identify 86 probe sets (representing 66 different genes), which correlated with OS, and defined a prognostic score based on this signature. When applied to an independent cohort of 79 CN-AML patients, this continuous score remained a significant predictor for OS (hazard ratio [HR], 1.85; P = .002), event-free survival (HR = 1.73; P = .001), and relapse-free survival (HR = 1.76; P = .025). It kept its prognostic value in multivariate analyses adjusting for age, FLT3 ITD, and NPM1 status. In a validation cohort of 64 CN-AML patients treated on CALGB study 9621, the score also predicted OS (HR = 4.11; P < .001), event-free survival (HR = 2.90; P < .001), and relapse-free survival (HR = 3.14, P < .001) and retained its significance in a multivariate model for OS. In summary, we present a novel gene-expression signature that offers additional prognostic information for patients with CN-AML.
Misoprostol in addition to routine treatment of postpartum hemorrhage: A hospital-based randomized-controlled trial in Karachi, Pakistan
Authors: Zuberi Nadeem F , Durocher Jill , Sikander Rozina , Baber Neelofur , Blum Jennifer , Walraven Gijs 
Published: August 2008

Abstract

Background
Postpartum hemorrhage (PPH) remains a major killer of women worldwide. Standard uterotonic treatments used to control postpartum bleeding do not always work and are not always available. Misoprostol's potential as a treatment option for PPH is increasingly known, but its use remains ad hoc and available evidence does not support the safety or efficacy of one particular regimen. This study aimed to determine the adjunct benefit of misoprostol when combined with standard oxytocics for PPH treatment.

Methods
A randomized controlled trial was conducted in four Karachi hospitals from December 2005 – April 2007 to assess the benefit of a 600 mcg dose of misoprostol given sublingually in addition to standard oxytocics for postpartum hemorrhage treatment. Consenting women had their blood loss measured after normal vaginal delivery and were enrolled in the study after losing more than 500 ml of blood. Women were randomly assigned to receive either 600 mcg sublingual misoprostol or matching placebo in addition to standard PPH treatment with injectable oxytocics. Both women and providers were blinded to the treatment assignment. Blood loss was collected until active bleeding stopped and for a minimum of one hour after PPH diagnosis. Total blood loss, hemoglobin measures, and treatment outcomes were recorded for all participants.

Results
Due to a much lower rate of PPH than expected (1.2%), only sixty-one patients were diagnosed and treated for their PPH in this study, and we were therefore unable to measure statistical significance in any of the primary endpoints. The addition of 600 mcg sublingual misoprostol to standard PPH treatments does, however, suggest a trend in reduced postpartum blood loss, a smaller drop in postpartum hemoglobin, and need for fewer additional interventions. Women who bled less overall had a significantly smaller drop in hemoglobin and received fewer additional interventions. There were no hysterectomies or maternal deaths among study participants. The rate of transient shivering and fever was significantly higher among women receiving misoprostol

Conclusion
A 600 mcg dose of misoprostol given sublingually shows promise as an adjunct treatment for PPH and its use should continue to be explored for its life-saving potential in the care of women experiencing PPH.

Trial Registration
Clinical trials.gov, Registry No. NCT00116480
Development and validation of a preference based measure derived from the Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR) for use in cost utility analyses
Authors: McKenna Stephen P , Ratcliffe Julie , Meads David M , Brazier John E 
Published: August 2008

Abstract

Background
Pulmonary Hypertension is a severe and incurable disease with poor prognosis. A suite of new disease-specific measures – the Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR) – was recently developed for use in this condition. The purpose of this study was to develop and validate a preference based measure from the CAMPHOR that could be used in cost-utility analyses.

Methods
Items were selected that covered major issues covered by the CAMPHOR QoL scale (activities, travelling, dependence and communication). These were used to create 36 health states that were valued by 249 people representative of the UK adult population, using the time trade-off (TTO) technique. Data from the TTO interviews were analysed using both aggregate and individual level modelling. Finally, the original CAMPHOR validation data were used to validate the new preference based model.

Results
The predicted health state values ranged from 0.962 to 0.136. The mean level model selected for analyzing the data had good explanatory power (0.936), did not systematically over- or underestimate the observed mean health state values and showed no evidence of auto correlation in the prediction errors. The value of less than 1 reflects a background level of ill health in state 1111, as judged by the respondents. Scores derived from the new measure had excellent test-retest reliability (0.85) and construct validity. The CAMPHOR utility score appears better able to distinguish between WHO functional classes (II and III) than the EQ-5D and SF-6D.

Conclusion
The tariff derived in this study can be used to classify an individual into a health state based on their responses to the CAMPHOR. The results of this study widen the evidence base for conducting economic evaluations of interventions designed to improve QoL for patients with PH.
Disseminated peritoneal hydatidosis following blunt abdominal trauma: A case report
Authors: Shah Nimish J , Vithalani Nikunj K , Chaudhary Rahul K , Mohite Prashant N 
Published: August 2008

Abstract
A middle age lady presented with abdominal pain was diagnosed to have multiple peritoneal and hepatic hydatid cysts on CT scan. Retrospectively she was found to have suffered blunt abdominal trauma.