bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transcranial Doppler Sonography: Collateral Pathways in Internal Carotid Artery Obstructions
Authors: Rosenkranz Karen , Langer Ruth , Felix Roland 
Published: November 2007

Fifty-four patients with stenoses and occlusions of the extracranial internal carotid artery (ICA) demonstrated by intravenous digital subtraction angiogra phy (IVDSA) were studied by extracranial duplex and transcranial Doppler. Two hundred healthy volunteers served as control group. Intracranial collateralization was demonstrated in 32 patients with ICA stenoses >80% and occlusions. Twelve patients with unilateral and 8 patients with bilateral ICA obstructions >80% showed collateral supply via the anterior (ACA) and/or posterior cerebral artery (PCA). In 5 cases of unilateral ICA oc clusion and in 7 patients with bilateral ICA stenoses >80% and occlusions, the ophthalmic artery and ACA and/or PCA served as collateral vessels. Five pa tients with ICA occlusions showed leptomeningeal anastomoses in the region of the postocclusive middle cerebral artery (MCA). All 54 patients showed normal time-mean flow velocity in the postobstruc tive MCA. In unilateral ICA stenoses >80% and occlusions, the pulsatility in dex in the ipsilateral MCA was reduced in comparison with the contralateral side, indicating that this parameter is more sensitive to hemodynamic effects of ICA obstructions than time-mean velocity.
Selective Coronary Angiography Versus Two-Dimensional Echocardiography for Diagnosis of Left Atrial Thrombi
Authors: Babic U.U. , Popovic Z. , Vucinic M. , Djurisic Z. , Pejcic P. , Grujicic S. 
Published: November 2007

Coronary angiographic findings indicative for left atrial thrombi (neovas cularization in the region of the left atrium) were compared with echocardio graphic ones. Of 214 patients who had mitral surgery, the authors had all the available data for 161 (31 of whom had left atrial thrombi). The presence of a neovascularization had a sensitivity of 61%, a specificity of 100%, predictive accuracy of 100%, and predictive value of 92%, while echocardiography had a sensitivity of 52%, specificity of 96%, predictive accuracy of 76%, and predic tive value of 89%. There was no difference in the sensitivity of both methods for the detection of thrombi located in the left atrium as a whole cavity (p< 0.05) However, coronary angiography was superior to echocardiography in the diag nosis of thrombi located in the left atrial appendage (p < 0.05). The diagnosis of left thrombi could be improved by using both methods (speci ficity 77%, predictive value 95%). Thus, selective coronary angiography is a useful diagnostic method, in addition to echocardiography, in the diagnosis of left atrial thrombi.
Detection of Coronary Artery Calcification by X-ray Computed Tomography and Its Significance: A New CT Scoring Technique
Authors: Tamiya Eiji , Matsui Hiroshi , Nakajima Toshiaki , Hada Yoshiyuki , Asano Ken-ichi 
Published: November 2007

In order to study the utility of X-ray computed tomography (CT) for the evaluation of coronary stenosis, the authors developed a scoring system for calcification seen through CT and compared the results with coronary angiographic (CAG) findings (Friesinger's scoring system). Their study included 143 patients (angina pectoris 53, myocardial infarction 44, control 46) who received both CT and CAG. Judkins method was selected for CAG, and stenosis ≧75% was defined as significant. Horizontal slices of CT from ascending aorta to cardiac apex at 1 cm intervals were imaged without contrast enhancement. CT scoring system was as follows: no calcification = 0, the length of calcification less than 1 cm = 1, 1-2 cm = 2, more than 2 cm = 3 points. They then totaled the separate scores of all the slices for each coronary artery. Sensitivity, specificity, and predictive value of CT against coronary stenosis were good (79%, 80%, 69%, respectively). The correlation between CT and CAG scores was significant (r = 0.644, p < 0.01). For all coronary arteries, no correlation was found between the CAG and CT findings for patients less than forty-five years of age. However, from 45 years of age upward, the results were significant. Until now, to the best of their knowledge, no satisfactory system to define the severity of coronary calcification has existed. Density cannot be used, because values are dependent on the area of the region of interest used. They demonstrated the considerable potential usefulness of CT in predicting the presence of coronary stenosis and analyzing its severity.
Lymphoscintigraphy in Lymphedema of the Lower Limbs Using 99mTc HSA
Authors: Nawaz M.K. , Hamad M.M. , Abdel-Dayem H.M. , Sadek S. , Eklof B.G.H. 
Published: November 2007

Edema of the lower limbs is a difficult clinical problem. Edema could be due to stasis, obstruction of the lymphatic channels, or increased production of lymph beyond the drainage capacity of the lymphatic vessels. Sometimes it is difficult to differentiate among these varieties. Lymphoscintigraphy was performed in 164 patients complaining of swelling of the lower limbs, 2 women patients with lymphedema of the upper limbs fol lowing radical mastectomy, and 5 volunteers. All patients were injected with 1 mCi of 99mT chuman serum albumin intradermally in the medial web on the dor sum of each foot. Data were acquired dynamically for both inguinal regions for forty-five minutes with a gamma camera interfaced with a computer. Static im ages were taken at ninety minutes for both legs and thighs and for the pelvis. Time activity curves were generated for the equal regions of inguinal nodes on both inguinal sides. The following patterns were recognized: normal pattern in 5 volunteers and in 57 patients, enhanced flow pattern in 17 patients, stasis with mild obstruction in 72 patients, and marked stasis with obstruction in 20 patients.
Evaluation of the Severity of Systemic Sclerosis by Nailfold Capillary Microscopy in 112 Patients
Authors: Joyal France , Choquette Denis , Roussin André , Levington Carry , Senécal Jean-Luc 
Published: November 2007

The authors used nailfold capillary microscopy (NCM) to evaluate 112 pa tients with systemic sclerosis spectrum disorders (SSc). Patients were classified as S1 if they had skin involvement proximal to the metacarpo-phalangeal joints. S2 if they had at least two minor SSc American Rheumatism Association criteria, and S3 if they had at least two CREST criteria (calcinosis, Raynaud's, esophageal motility disorder, sclerodactyly, telangiectases), without S1 or S2 criteria. Dis ease duration from the first symptom was similar in all groups (7.17 ± 8.98 years). Disease severity was determined by a total score of seven target organ involve ments. S1 patients had a greater degree of skin and pulmonary involvement, with a mean score of 26.2 ± 17.3. S2 patients had a mean score of 13.8 ± 12.4, and had mostly vascular and digestive involvement, in comparison with S3 patients (7.2 ± 7.2; p<0.001 and p<0.01 respectively). NCM sensitivity for S1 and S2 was 93.6%. NCM correlated with the degree of target organ involvement (p < 0.01). Three NCM profiles established were: "mild," normal or borderline capillaries; "moderate," other abnormalities with no capillary telangiectases; and "severe," abnormalities other than those of the mild profile, with capillary telangiectases. The positive correlation observed between the degree of skin and vascular abnormalities and the severity of digestive, renal, musculoskeletal, and pulmo nary involvement permits rapid prediction of target organ involvement by SSc at the first visit.
Beneficial Effects of Methionine on Myocardial Hemodynamic and Cellular Functions in Hemorrhagic Shock
Authors: Kapoor Rakesh , Kalra Jawahar , Prasad Kailash 
Published: November 2007

Hypochlorous acid (HOCI), produced by activated polymorphonuclear (PMN) leukocytes, has been reported to depress cardiac function and contractility. Var ious mechanisms exist for activation of PMN leukocytes during hemorrhagic shock and reperfusion. In order to determine the role of HOCI in hemorrhagic shock and reinfusion, the authors studied the effects of shock and reinfusion on the cardiac function, contractility, blood lactate, blood gases, and creatine kinase (CK) and MB fraction of CK (MBCK) with and without methionine (quencher of HOCI) in anesthetized dogs. Dogs were divided into two groups: Group I, hemorrhagic shock (two hours) and reinfusion (two hours): Group II, hemorrhagic shock and reinfusion with methionine treatment. Cardiac index, mean arterial pressure, and index of cardiac contractility were similar in the two groups during shock. Postinfusion recovery of cardiac function and con tractility was better in group II. Increases in blood lactate were similar in the two groups during shock. The rate of return of blood lactate to preshock values after reinfusion was greater in group II. The increases in serum CK and MBCK of the two groups during shock were similar but not significant. Following rein fusion the levels of these enzymes increased significantly, but the increases in group II were less. These results suggest that HOCI produced by activated PMN leukocytes may play a role in cardiac damage during hemorrhagic shock and reinfusion. Methio nine may have beneficial effects in the hemodynamic and metabolic recovery and may reduce cellular damage during hemorrhage shock and reinfusion.
Nailfold Videomicroscopy and Local Cold Test in Type I Diabetics
Authors: Gasser P. , Berger W. 
Published: November 2007

Twenty-five type I diabetics (9 men, 16 women) with a mean disease duration of 19.9 years and 25 sex- and age-matched healthy control subjects were stud ied. Digital capillary blood flow measurements in combination with a local cool ing test were assessed by nailfold videocapillaroscopy using the technique of flying spot and compared with nailfold capillary microscopy in four subgroups divided according to (A) disease duration, (B) retinopathy, (C) fasting blood glucose level, and (D) HbA 1c values. Differences in morphologic capillary diame ters and capillary density were found between the diabetics and the healthy control subjects. These were attributable to the patients with retinopathy. The hemodynamic findings at rest and after local cooling were unable to differentiate either between type I diabetics and healthy controls or within the different subgroups.
Cardiovascular Disease in Male Patients with Carotid Transient Ischemic Attacks or Minor Strokes
Authors: Falke P. , Stavenow L. , Hansen F. , Lilja B. , Lindgärde F. 
Published: November 2007

The authors tested the hypothesis that coronary heart disease and lower extremity atherosclerosis occur more frequently in patients with transient ische mic attacks (TIA) than in patients with minor stroke. Thirty-three consecutive male patients with TIA and 36 with minor stroke from the carotid artery terri tory were examined with ultrasonography of the cardiac, iliac, and femoral arteries; echocardiography (UCG); electrocardiogram (ECG); thallium scinti graphy (TS) of the myocardium; and assessment of the ankle/arm index (A/AI). TS showed myocardial infarctions to be more common among TIA patients than among minor stroke patients, 54% vs 19%, p=0.019. UCG showed the frequency of left ventricular and atrial dilatation to be higher in the TIA group than in the minor stroke group, 64% vs 27%, p=0.0084. Significant artery stenosis (≥ 50%) was not, however, more frequent in the TIA group than in the minor stroke group, nor was there any significant difference between the groups in A/AI. The frequency of TS-verified myocardial infarction (MI) was higher in the subgroup with ≥ 50% carotid artery stenosis than in that with < 50% stenosis, 61% vs 25%, p=0.022, and also higher in the pathological UCG subgroup than in the normal UCG subgroup, 50% vs 15%, p=0.025. Thus, there was a greater incidence both of TS-verified MI and of UCG verified cardiac dilatation in the TIA group than in the minor stroke group but no difference between the groups in the degree of atherosclerosis either in the carotid or lower extremity regions. The findings constitute further support for a previous hypothesis of ours, that carotid TIA and minor stroke often differ in vascular pathophysiology.
Cardiosynchronous Limb Compression: Effects on Noninvasive Vascular Tests and Clinical Course of the Ischemic Limb
Authors: Steinberg Joel 
Published: November 2007

Some patients with chronic arterial obstruction of the limbs may still suffer the consequences of advanced tissue ischemia, including ulceration and rest pain, and face threatened limb loss in spite of available surgical, pharmaco logic, and other treatments. Additional therapeutic modalities were thus sought to accomplish limb salvage. A literature review indicated that most reports on R-wave-triggered circumferential limb compression (cardiosynchronous limb compression [CSC]) demonstrate its ability to augment limb arterial blood flow and improve ischemic limbs. To determine the device's efficacy and safety, and possibly confirm earlier positive reports, a systematic study was undertaken, using older, as well as newer, more electronically reliable CSC devices. The present study was designed to determine the following: 1. objectively, by noninvasive vascular tests, changes in limb blood flow, if any, by CSC 2. clinical effects of CSC, if any, on the ischemic limb 3. duration of CSC-induced limb improvements, if any 4. side effects or safety of CSC The study demonstrated that CSC treatments: 1. caused increased limb blood flow as determined by increased ankle/arm indices and hallux photoplethysmograph waveform amplitudes during treatments 2. led, in most cases, to improvement in or resolution of the presenting is chemic problem (eg, ulcer, cellulitis, rest pain) 3. induced limb improvements that persist for up to seven years 4. caused no adverse side effects
Efficacy of Antihypertensive Medication in Orthotopic Heart Transplant Recipients and its Effect on Renal Function
Authors: Schechter David , Ziady Galal M. , Lee Ann , Armitage John M. , Kormos Robert L. , Griffith Bartley P. , Hardesty Robert L. 
Published: November 2007

The authors looked at 77 patients following orthotopic heart transplant who received a triple immunosuppressive regimen including cyclosporine to see the effect of various antihypertensive medications on mean arterial blood pressure and renal function. There were 62 men and 15 women retrospectively classified into three groups according to the antihypertensive medications they received. Group 1 included 26 patients followed up for 10.7 ± 2.7 months who received hydralazine therapy. Group 2 included 32 patients followed up for 9.0 ± 3.4 months who received angiotensin-converting enzyme inhibition therapy. Group 3 included 19 patients followed up for 10.1 ± 3.3 months who received beta- adrenergic blocking agents. Mean arterial pressure (MAP), serum blood urea nitrogen (BUN), and serum creatinine (CR) were determined for each group at the start and end of the follow-up period. The MAP at the start of the study was 107 ± 14 in group 1,110 ± 13 in group 2, and 100 ± 11 in group 3. It was not statistically significantly different in any of the groups. At the end of the follow-up period, MAP was 112 ± 10, 111 ± 10, and 106 ± 12 for the three groups respectively, and it was not significantly different in any group. The serum BUN in group 3 was 25 ± 8 mg/dL at the start of the study, and it was not significantly lower than that in group 1, 28 ± 6, but it was significantly different from that in group 2, 34 ± 9, P < 0.05. At the end of the follow-up period, the difference was still maintained. Moreover, it was signifi cantly different also from the BUN of group 1. The serum CR was 1.16 ± 0.25 at the start in group 3, and it was not significantly lower than that of either group 1 (1.27 ± 0.25) or group 2 (1.38 ± 0.37). There was a significant rise of serum CR levels in all groups over the duration of the follow-up (P < 0.05) re gardless of the antihypertensive therapy they received, however, CR of group 3 was significantly lower than that of groups 1 and 2 at the end of the follow-up. The authors conclude that hypertension that develops after heart transplant is not easily controlled by medications. The deterioration in renal function over time is not related to the height of arterial blood pressure or to the antihyperten sive medications used.
Effects of Intravenous Streptokinase and CLS 2210 (Calcium Dobesilate) on the Biochemical Markers of Early Acute Myocardial Infarction: A Historic Comparison with Both Studies
Authors: Szlavy Laszlo , Repa Imre , Lengye Imre , Lamboy Laszlo 
Published: November 2007

In a previous double-blind, randomized study, CLS 2210 (a new formula tion of calcium dobesilate) or placebo was administered by intravenous infusion to 41 patients having their first acute myocardial infarction. In the present study 19 comparable patients were treated intravenously with streptokinase under iden tical contidions and the results compared with those from the previous study. In all patients administration was begun within three hours of onset of symptoms and continued over seventy-two hours. Blood samples were taken for the meas urement of serum activity of creatine kinase and its isoenzyme MB, and the se rum and urinary concentrations of myoglobin and glycosaminoglycans were also measured. The purpose of this study was to determine the effects of CLS 2210, place bo, and streptokinase on these biochemical markers of acute myocardial infarc tion, thereby assessing their actions in limiting myocardial necrosis. In the CLS 2210-treated patients, the levels of serum creatine kinase and se rum and urinary myoglobin were significantly lower than in the placebo patients throughout the seventy-two hours (p = 0.01, 0.005, 0.004 respectively). The levels of creatine kinase MB and serum glycosaminoglycan in the CLS 2210 patients were initially higher than in the placebo patients but fell below placebo levels between the fortieth and fifty-fifth hours, respectively (p = 0.89, 0.02). Only the glycosaminoglycan urinary concentrations were higher in the CLS 2210 group than in the placebo group throughout (p = 0.0005). The values for the six variables investigated showed no statistically significant difference between placebo and streptokinase. These findings suggest that CLS 2210 reduces myocardial infarct size in human subjects, probably by the same mechanisms of action (principally, improved cardiac lymphatic drainage) that have been observed in previous animal studies. Combination therapy with thrombolytic agents may, therefore, be advocated, since they exert their protective effect by other mechanisms.
Determinants of Failure in Superficial Femoral Artery Angioplasty
Authors: El-Bayar H. , Roberts A. , Hye R. , Davis G. , Freischlag J. 
Published: November 2007

Although results of iliac artery balloon angioplasty have been shown to be good, there are much less data regarding initial success and durability of superficial femoral artery (SFA) dilation. The authors retrospectively reviewed the results of 22 patients treated for 27 SFA lesions between 1981 and 1986. Mean age was 64.5 years (fifty-five to seventy-six). Results were analyzed with respect to initial, early (< twelve months), and late (> twelve months) angiographic and clinical success. Indications were claudication (22), nonhealing ulcer (3), and rest pain (2). Mean follow-up was 30.9 months; 100% at one year and 92% at two years. Initial failure occurred in 9 (33%) lesions. There were 2 early and 2 late failures for a cumulative patency rate of 90.3% and 78% at one and two years, respectively. Predictors of clinical failure were: (1) initial—age, SFA occlusion, and angioplasty rating; (2) early—age, SFA occlusion, degree of atherosclerosis, and angioplasty rating; (3) late—angioplasty rating. There were 3 complications (11%). The authors conclude that: (1) 33% of attempted SFA angioplasties were initially unsuccessful and that the cumulative patency rate was 78% at two years. (2) Age is predictive of initial and early failure; SFA occlusion, of initial and early failure; degree of atherosclerosis, of early failure; and angioplasty appearance, of initial, early, and late failures. (3) Complications did not result in limb loss or require surgery.
Long-Term Clinical and Duplex Follow-up After Proximal Vertebral Artery Reconstruction
Authors: Van Schil Paul E. Y. , Ackerstaff Robert G. A. , Vermeulen Freddy E. E. , Eikelboom Bert C. , Schepens Marc A. A. 
Published: November 2007

From 1977 to 1989, 28 patients, 18 men and 10 women, underwent 29 proxi mal vertebral artery reconstructions. Indications were vertebrobasilar insuffi ciency in 17 patients and TIA or stroke in 6. Five were asymptomatic. Procedures performed were endarterectomy in 20, reimplantation in 5, venous bypass in 3, and decompression in 1 case. Concomitant procedures were coro nary artery bypass grafting (6) and carotid, subclavian, or innominate artery revascularization (14). There was no operative mortality. There were 3 early reoperations for occlu sion, bleeding, and lymph fistula, respectively. Except for 1 foreign patient recent clinical follow-up was complete. Mean follow-up was 85.6 months (range 17-146). During follow-up 10 patients died. Causes were mainly cardiac (3), carcinoma (3), and stroke (2). Seventeen pa tients were alive, 13 had no cerebrovascular symptoms, 2 sustained a hemi spherical stroke, 1 was only slightly improved, and 1 had a drop attack 131 months after operation. Five and ten-year actuarial survival rates were 85% and 51 % respectively. Follow-up with duplex scan was available in 26 patients and was complete in 24. Mean duplex follow-up was 78.6 months (range 3-146). Significant abnor malities were noted in 6 but with symptoms in only 1 patient. Mean time to restenosis was 77.3 months. Late angiographic control in 10 patients correlated well with duplex findings. Proximal vertebral artery reconstruction yields good clinical long-term results, and duplex scan is a useful tool in the follow-up of these patients.
Practical Aspects of Infant Feeding
Authors: Sly R. Michael 
Published: November 2007

New parents find themselves devoting a large share of their time to preparation of milk mixtures and feeding of their infant. This subject has probably received more attention in the medical literature than any other aspect of infant care, especially in years gone by. Most of the studies have dealt with determin ing the most appropriate formula for the health and growth of the infant. One evi dent conclusion is that normal, healthy, full term infants thrive on a wide variety of mix tures. Nevertheless practical considerations are still of major importance in the selection of the proper milk mixture. While recommendations regarding the me chanics of formula preparation have hereto fore been generally uniform, recent research has suggested that practicality may also be pertinent in this area.
Moniliasis, Steatorrhea, Diabetes Mellitus, Cirrhosis, Gallstones, and Hypoparathyroidism in a 10-Year-Old Boy
Authors: Stickler Gunnar B. , Peyla Thomas L. , Dower John C. , Logan George B. 
Published: November 2007

What disease states are occasionally associ ated with hypogarathyraidisna? Is there any explanation for the association of moniliasis or steatorrhea in the syndrome re ported ? Is there a familial incidence of the syndrome of hypoparathyroidism, Addison's disease and moniliasis?