bluuebunny/crossref_metadata_2025_split huggingface dataset:
Postphlebitic Syndrome: Clinical Activity and Tolerability of Desmin, New LMW Dermatan Sulfate
Authors: Andreozzi Giuseppe Maria , Signorelli Salvatore , Di Pino Luigi , Allegra Claudio , Riccioni Camillo , Cucinotta Domenico , Manopulo Roberto , Dettori Anton Giulio , Megha Alessandro , Longo Franco Nicola , Urbano Oreste , Manganaro Agatino , Buda Domenico , Zamboni Villiam , Palazzini Ernesto 
Published: July 2008

One hundred patients suffering from postphlebitic syndrome of the lower limbs were enrolled in an open, randomized, and multicenter (six centers) trial for a period of eighteen months. Patients were randomly assigned to three treatment groups to receive (for ninety consecutive days) Desmin, a new low-molecular-weight dermatan sulfate, at the dose, respectively, of 100 mg once daily by subcutaneous (SC) route (36 patients), 100 mg twice a day by SC route (33 patients), and 200 mg once daily by intramuscular (IM) route (31 patients). The general and local tolerability and the clinical efficacy of the drug were evaluated by means of clinical, instrumental, and laboratory parameters. Desmin is effective in the decompensation stage of postphlebitic syndrome; this was demonstrated by a significant reduction in the severity of a number of typical symptoms as well as by the drug's positive effect on venous tone as confirmed by phlebotensio metric examination. The daily dose of 200 mg (either SC or IM) was more effective than the 100 mg dose. The results obtained at the end of the trial (ninety days) were statisti cally better than those obtained after thirty days of treatment. This trial demonstrated that both the systemic and the local (at the site of injection) tolerability of the drug, administered for three months, were good and without significant variations in the laboratory parameters monitored.
Comparison of Factor VIII-Related Antigen and Erythrocyte Sedimentation Rate in Outpatient Management of Vasculitis
Authors: Roberts W. Neal , Brodeur James P. , DeWitt John , Carr Sheryl Z. , Wise Christopher M. , Carr Marcus E. 
Published: July 2008

Electroimmunodiffusion (Laurell rocket) determinations of factor VIII-related antigen in plasma were ordered to determine the cost/benefit ratio for factor VIII-related antigen as a putative test for endothelial damage in suspected vasculitis. Twenty-seven consecutive patients referred for vasculitis or suspected vasculitis were identified and followed up for an average of 9.1 ±months (range: one to thirty-three months) in a prospective, unblinded study performed in a clinic, associated with a 1054- bed inner-city university hospital. There was no difference in Westergren erythrocyte sedimentation rate (WESR) in patients with final diagnosis of systemic vasculitis (SV) (38 ± 12 mm/hour) compared to those without vasculitis (NV) (27 ± 7) as the final diagnosis. The mean plasma concentration of factor VIII-related antigen was significantly elevated in SV (344 ±100%) when compared with NV (147 ±39%) (P < 0.016). The factor VIII- related antigen test in this study was 2.56 times more likely (crude odds ratio) than the WESR to contribute to a change in diagnosis or therapy (P=0.016). Positive and negative predictive values (PPV and NPV) for factor VIII-related antigen (abnormal at greater than 220% of the normal value) were both 70%. PPV and NPV for WESR were 56% and 86%, respectively. The factor VIII-related test was less cost-effective than the WESR in the follow-up period unless it was important to define complete remission or differentiate vasculitis flare from infection. The authors conclude that factor VIII-related antigen is a useful test in the initial diagnosis of vasculitis.
Digital Ventriculography: Valid On-Line Calculation of Cardiac Volumes by Corrected Computer Densitometry in Coronary Artery Disease
Authors: Lehmkuhl Hans , Blunck Birgit , Altstidl Robert , Barth Karl , Bachmann Kurt 
Published: July 2008

Cardiac catheterization facilitates the assessment of left ventricular function in coronary artery disease (CAD). Digital left ventriculography offers the potential for an on-line quantitative determination of left ventricular end-diastolic volume (LVEDV) and left ventricular end-systolic volume (LVESV). These are routinely evaluated by the area- length method (ALM), which is considered as a standard. Densitometry (DENS) is an alternative method but may lead to calculated underestimations. The purpose of this study was to investigate the accuracy of corrected DENS for LVEDV and LVESV in comparison with ALM in single-plane 30° right anterior oblique (RAO) projection. The computer densitometric correction equation was adapted from the linear regression analysis (y=0.86x+2.73) in cardiac models and applied to the analysis of digital left ventriculograms in patients suffering from CAD. The study of cardiac models yielded highly significant correlations ( r≥ 0.9; P≤ 0.001) between true volumes and both DENS and ALM. DENS and ALM correlated highly signif icantly ( r≥ 0.9; P ≤ 0.001) with a low standard error of estimate (SEE) of ±9.5 mL. The comparison of DENS and ALM in 44 patients' digital ventriculograms exhibited highly significant (r=0.74; P ≤ 0.001) correlations for noncorrected and corrected LVEDV. Systematic underestimation by DENS of LVEDV disappeared after correction and SEE decreased from ±23.7 to ±19.2 mL. DENS and ALM correlated highly significantly for LVESV (r=0.78; P ≤ 0.001; SEE ± 15.6 mL ± 13.5 mL, respectively) after correction. Following correction, mean values for DENS increased from 116 ±32 to 132 ±37 mL (LVEDV) and 50 ±22 to 55 ±25 mL (LVESV). For ALM, mean values decreased from 159 ±35 to 127 ±28 mL (LVEDV) and 55 ±25 to 46 ±21 mL (LVESV). This study shows that LVEDV and LVESV can be reliably analyzed on-line by corrected computer densitometry. Method-related errors of both DENS and ALM are present and account for minor volume deviations.
Clinical, Electrocardiographic, and Echocardiographic Features in Patients with Asymptomatic Aortic Abdominal Aneurysm
Authors: Bolognesi Roberto , Tiberti Gianluca , Azzarone Matteo , Tecchio Tiziano , Pellegrino Felice , Manca Carlo 
Published: July 2008

Cardiac involvement in peripheral vascular diseases can present interesting patho physiological aspects and can influence the prognosis. The authors evaluated the cardiac condition of patients with asymptomatic aortic abdominal aneurysm (AAAA) by using clinical, electrocardiographic, and echocardiographic techniques. Seventy-eight patients were studied, 74 men and 4 women, with ages ranging from fifty-five to eighty-one years (mean 69.5 ± 6.4). All patients were submitted to a complete clinical examination, usual blood tests, a 12-lead resting electrocardiogram, and an echo- Doppler evaluation. Forty-eight subjects (61.5%) were affected by hypertension, 53 (67.9%) were smokers, 25 (32.1%) were alcohol abusers, 39 (50%) had a history of angina pectoris, 20 (25.6%) had had previous myocardial infarction, and 30 (38.5%) were receiving active cardiovascular treatment. All patients except 2, who had chronic atrial fibrillation, manifested sinus rhythm. Electrocardiographic signs of left ventricular (LV) hypertrophy were present in 20 cases (25.6%), intraventricular conduction disturbances in 19 (24.4%), pathological Q waves in 20 (25.6%), and primary repolarization abnormalities in 25 (32.1%). Echocardiography showed a slight increase in left atrial diameter and intraventric ular septum thickness (41.5 ± 4.3 and 12.3 ± 2 mm respectively). A clearer increase was found in LV mass index (159 ± 44 g/m2). In 31 patients one or more LV asynergic segments were found. In our patients with AAAA the prevalence of major risk factors for atherosclerosis and ischemic heart disease including previous myocardial infarction was high. Echo-derived LV myocardial mass index was higher than normal even though electrocardiographic criteria for LV hypertrophy did not match echocardiographic data in all subjects. Finally a moderate prevalence of intraventricular conduction disturbances was recorded.
Comparative Ultrasonographic and Angiographic Study of Carotid Arterial Lesions in Takayasu's Arteritis
Authors: Taniguchi Nobuyuki , Itoh Kouichi , Honda Masanori , Obayashi Taminori , Nakamura Michiru , Kawai Fukiko , Irie Takasuke 
Published: July 2008

The purpose of this study was to compare the usefulness of ultrasonography to that of angiography for studying arterial lesions in Takayasu's arteritis. Ultrasonographic and angiographic findings from 44 carotid arteries of 22 patients with Takayasu's arteritis (2 men and 20 women; mean age, 41.2 years) were compared. Angiography was used to classify the patency of the carotid arteries into three groups: nonstenotic, stenotic, and occlusive. Ultrasonography was also used to classify the same arteries into four groups: nonstenotic, mildly stenotic, moderately stenotic, and occlusive. Thickness of the wall (intima-media complex) of the carotid artery was measured with high-frequency transducers. Angiography showed 23 carotid arteries to be nonstenotic; 12, stenotic; and 9, occlusive; whereas ultrasonography showed 16 to be nonstenotic; 18, mildly stenotic; 7, moderately stenotic; and 3, occlusive. Results of the two diagnostic modalities correlated closely (P < 0.0001). Ultrasonography, aided by color flow imaging, detected six instances of a marginal but definite blood flow that angiography had failed to reveal. Arterial wall thickness correlated closely with the severity of ultrasonographic stenosis (P < 0.005). This thickness was 1.3 ±0.4 mm in the nonstenotic group, 1.6 ± 0.5 mm in the mildly stenotic group, 2.2 ±0.8 mm in the moderately stenotic group, and 1.9 ±0.2 mm in the occlusive group. Even the walls of the nonstenotic arteries were significantly thicker than those of the normal carotid arteries (0.7 ±0.1 mm, P < 0.01). Ultrasonography appeared to be more useful than angiography in estimating stenotic severity of the carotid artery in Takayasu's arteritis. Characteristic ultrasonic findings included luminal stenosis or occlusion on two-dimensional ultrasonograms, decrease in or lack of flow shown by color Doppler flow imaging, and concentric thickening of the carotid arterial walls. Ultrasonographic mural thickness was the most sensitive indicator of early, latent inflammation.
Efficacy of Daflon 500 mg in Venous Leg Ulcer Healing: A Double-Blind, Randomized, Controlled Versus Placebo Trial in 107 Patients
Authors: Guilhou Jean-Jacques , Dereure Olivier , Marzin Loïc , Ouvry Pierre , Zuccarelli François , Debure Clélia , Van Landuyt Hervé , Gillet-Terver Marie-Noëlle , Guillot Bernard , Levesque Hervé , Mignot Jean , Pillion Gérard , Février Benoit , Dubeaux Dominique 
Published: July 2008

The objective of this study was to evaluate the efficacy of Daflon® 500 mg (Dios)* in venous ulcers. A multicenter, double-blind, randomized, controlled versus placebo (Plac) trial was conducted, with stratification according to the size of ulcer (≤ 10 cm and > 10 cm). The protocol called for a two-month treatment with Dios (one tablet = 450 mg micronized purified Diosmin) or a placebo, two tablets/day, in addition to compression therapy. Evaluations were performed every fifteen days, from DO to D60. The primary endpoint, in accordance with Alexander House group requirements were: percentage of patients with complete ulcer healing, ie, comparison between Dios and Plac group at D60, and comparison of survival curves in each group between DO and D60 (log rank test). Secondary endpoints included ulcer surface area assessed by computerized plani metric measurements, qualitative evaluation of ulcers, and symptoms. The patients were 105 men and women ranging in age from eighteen to eighty-five years, with standard compression stocking, who were undergoing standardized local care of ulcer and had no significant arterial disease (ankle/arm systolic pressure index > 0.8). Fifty-three patients received Dios, and 52 received Plac. The 2 groups were well matched for age (m ±1 SD = seventy-one ±eleven years), gender, ulcer size, and associated disorders. Among patients with ulcer size ≤ 10 cm (Dios = 44, Plac = 47) a significantly larger number of patients had a complete ulcer healing at two months in the Dios group (n = 14) in comparison with the Plac group (n = 6) (32% vs 13%, P = 0.028) with a signifi cantly shorter time duration of healing (P = 0.037). No difference was shown for the secondary criteria, except for sensation of heavy legs (P = 0.039) and a less atonic aspect of ulcer (P = 0.030) in favor of Dios. Among the 14 patients with ulcer size > 10 cm (Dios = 9, Plac = 5), subjected to a descriptive analysis only, no ulcer healed. This study showed that a two-month course of Daflon 500 mg at a daily dose of two tablets, in addition to conventional treatment, is of benefit in patients with venous ulcer ≤ 10 cm by accelerating complete healing.
A Comparison Between Aspirin and Pentoxifylline in Relieving Claudication Due to Peripheral Vascular Disease in the Elderly
Authors: Ciocon Jerry O. , Galindo-Ciocon Daisy , Galindo Diana J. , Ciocon Jerry O. 
Published: July 2008

Peripheral vascular disease (PVD) commonly presents with leg claudication during walking and eventually limits the walking distance and daily activities. Aspirin or pentox ifylline are commonly prescribed to improve blood flow. Aspirin works through its antiplatelet aggregation mechanism, and pentoxifylline increases the red blood cell flex ibility, which leads to increased tissue perfusion. Data on comparative studies of these drugs for improving claudication in the elderly are limited. The objective of this study was to compare pain relief offered by either aspirin or pentoxifylline for walking leg pain in the elderly with PVD. Patients sixty-five years or older with claudication were randomly assigned to receive aspirin or pentoxifylline. Their reported level of walking claudication pain with use of the visual analogue scale (0-5) and the distance walked during exercises were recorded. Six weeks later the same parameters were recorded and results were compared with Student's t test, and a P value less than 0.05 was considered a statistically significant difference. Of the 90 patients who participated, 45 received aspirin (325 mg daily) and 45 were prescribed pentoxifylline (400 mg tid) for six weeks. Both the aspirin and the pentoxifylline groups reported a moderate level of pain (2/5) and remained about the same (2/5 for aspirin and 1/5 for pentoxifylline, P = 0.9, NS) after six weeks. However, the pentoxifylline group reported a farther walking distance of 2 miles compared with the aspirin group of 1.2 miles (P < 0.05). The level of pain did not change significantly with either aspirin or pentoxifylline, but the walking distance was farther with the pentoxi fylline group.
Immunohistochemical and Ultrastructural Examination of Smooth Muscle Cells in Aortocoronary Saphenous Vein Grafts
Authors: Yamada Takahiro , Shiraishi Ryo , Taki Kenji , Nakano Shigeo , Tokunaga Osamu , Itoh Tsuyoshi 
Published: July 2008

In this study, phenotypic modulation and remodulation of smooth muscle cells and associated intermediate filament expression were demonstrated by means of immunohistochemistry and ultrastructure to understand the development of intimal hyperplasia in aortocoronary saphenous vein grafts. In nongrafted saphenous veins, all smooth muscle cells expressed vimentin and desmin and were of a contractile form. In saphenous vein grafts showing stenotic intimal hyperplasia (luminal stenosis < 75%), expression of desmin was notably lower, whereas that of vimentin was higher. The cells were shown to be of a synthetic phenotype, suggesting modulation from the original contractile form. In saphenous vein grafts showing occlusive intimal hyperplasia (luminal stenosis >76%), desmin expression in smooth muscle cells was increased again, and such cells were of a contractile form, suggesting remodulation from the synthetic phenotype. Some of the smooth muscle cells of the synthetic phenotype were positive for an antibody against proliferation cell nuclear antigen. Smooth muscle cells of the contractile form were negative for this antibody. The study suggests that smooth muscle cells of synthetic phenotype are highly respon sible for "growing" intimal hyperplasia of aortocoronary saphenous vein grafts.
Effects of Trimetazidine on Heart Rate Variability and Left Ventricular Systolic Performance in Patients with Coronary Artery Disease After Percutaneous Transluminal Angioplasty
Authors: Birand Ahmet , Kudaiberdieva Gulmira Z. , Batyraliev Talantbek A. , Akgul Ferit , Usal Ayhan 
Published: July 2008

Fifty-one patients (mean age 51.6 ± 7.1 years) with angiographically proven coronary artery disease (CAD) entered the study. In 26 patients (Group I), trimetazidine treatment started twenty-four hours after percutaneous transluminal coronary angioplasty (PTCA). Another 25 patients (Group II) without trimetazidine treatment were kept as controls. The groups were comparable by age, gender, risk factors of CAD, coronary anatomy, left ventricular performance, and heart rate variability indices at baseline state. Power spectral analysis of heart rate variability and two-dimensional and Doppler echocardiographic examinations were performed before PTCA, and twenty-four hours, ten days, thirty days, and three months after PTCA. A statistically significant improvement of left ventricular systolic performance (P<0.001), augmentation of the parasympathetic band of heart rate variability (P<0.001), and decline of P1/P2 ratio (P<0.01) were evident in patients treated with trimetazidine, while no apparent changes were observed in controls. The intergroup analysis also showed marked difference between groups as recorded on the day 30 and month 3 of observation (P<0.001). During follow-up period recurrences of angina pectoris and ischemia were registered in Group II, while no evidence of ischemia was discerned in Group I patients. In conclusion, trimetazidine modulates the autonomic control of heart rate, ie, reduces sympathetic overactivity and augments vagal influences, improves left ventricular contractility, and diminishes the clinical manifestations of ischemia in patients with CAD after PTCA.
Management of Abdominal Aortic Prosthetic Graft Infection Requiring Emergent Treatment
Authors: Mingoli Andrea , Sapienza Paolo , di Marzo Luca , Sgarzini Giovanna , Burchi Claudia , Modini Claudio , Cavallaro Antonino , Mingoli Andrea 
Published: July 2008

The purpose of this study was to investigate mortality and morbidity rates and long-term outcome of patients who underwent emergency treatment of abdominal aortic prosthetic graft infection. Between January 1984 and December 1993, 18 men aged fifty-nine ±sixteen years were operated on as an emergency for an acute life-threatening complication of aortic prosthetic graft infection. The grafts had been implanted for abdominal aortic aneurysm in 9 patients and aortoiliac occlusive disease in 9, from one to one hundred seventy months previously. Five (28%) patients presented with a hemorrhagic shock due to a fistula between the vascular reconstruction and the small bowel (4 patients) or the right ureter (1 patient) and 13 (72%) had generalized sepsis. The grafts were always radically explanted. Extraanatomic revascularization procedures included 6 axillopopliteal and 12 axillofemoral bypass grafts. Operative mortality was 39% (7 patients), and 3 (9%) limbs were amputated within thirty days. Two (11%) patients died after seven and twelve months, respectively, of septic complications, and 1 (5%) patient died after six months from an unrelated cause. Eight (73%) patients are still alive at a mean follow-up of fifty ±thirty-four months, but in 3 the extraanatomic bypass was removed for infection and 5 major amputations were performed. Two-year survival and limb salvage rates were 44% and 50%, respectively. Aortic prosthetic graft infections that require emergent treatment continue to demon strate high early and late mortality and limb loss rates despite aggressive intervention and limb salvage procedures. Newer methods of managing these complications should continue to be investigated.
Transcranial Doppler Velocities in Patients with Thromboangiitis Obliterans
Authors: Matchev Stefan , Petrov Vesselin , Batchvarova Vera , Maljakova Anastasia , Doneva Svetlana , Matchev Stefan 
Published: July 2008

The idea of cerebrovascular injury in cases of thromboangiitis obliterans was not strange to Leo Buerger, but Jäger (1932), as well Lindenberg and Spatz (1939), first established it. The aim of this study was to investigate the hemodynamics in the basal cerebral arteries by means of transcranial Doppler in patients with thromboangiitis obliterans. Thirty patients (all men; average age 40.03 ±16.4 years) were included—one group twenty-four to forty years of age and another group forty-one to fifty years of age. The results show that the blood flow velocities in middle and anterior cerebral arteries in both groups of patients were significantly lower than in healthy persons. The trends towards reduction of blood flow velocity were also evident in posterior cerebral arteries. The authors describe in detail 2 patients who suffered major ischemic stroke. Cerebrovascular disorders in Buerger's disease are probably more frequent than supposed and have to be taken into account.
Posterior Right Diagonal Artery
Authors: Margaris Nikolaos G. , Kostopoulos Konstantinos G. , Nerantzis Christos E. , Filippatos Gerasimos S. , Kardaras Fotis G. , Salahas Anastasios I. , Antonellis John P. , Ifandis George P. , Kranidis Athanassios I. , Tavernarakis Anthony G. , Margaris Nikolaos G. 
Published: July 2008

The purpose of this prospectively performed study was the angiographic visualization of the posterior right diagonal artery (PRDA) and its differentiation from the epicardial branches of the right coronary artery (RCA), that is, the right marginal artery and the posterior descending artery (PDA). The authors prospectively studied the angiographic findings of 607 patients who underwent coronary angiography. The incidence of the angiographically demonstrated PRDA and its distinction from other epicardial branches arising from the distal third of the RCA was the main point of interest. Two types of PDA in those cases where PRDA was present were also demonstrated. Of the patients examined, 535 had dominant right coronary circulation, 59 had left dominant coronary circulation, and 13 had balanced coronary circulation. PRDA was present in 81 patients with right dominant coronary circulation (15.1%), in 2 patients with balanced coronary circulation (15.4%), and in none with left dominant coronary circulation. PRDA was revealed in 48 (40%) of 120 patients with a short PDA and in only 33 (8%) of 415 patients having long PDA. It is imperative to search always for the PRDA, when one is studying coronary arte riographies, bearing in mind that this artery may perfuse the inferior part of the posterior interventricular septum and the adjoining area, depending on the type of PDA.