bluuebunny/crossref_metadata_2025_split huggingface dataset:
Absence of Enhancement of Spontaneous Echocardiographic Contrast by Thrombocytosis in a Patient with Left Ventricular Aneurysm, Primary Thrombocythemia, and von Recklinghausen Neurofibromatosis: A Case Report
Authors: Monsuez Jean-Jacques , Janier Michel , Van-Cao Alix Nguyen , Le Gall Jean-Roger 
Published: July 2008

A thirty-eight-year-old man with primary thrombocythemia, von Reck linghausen neurofibromatosis, and myocardial-infarction-related left ventricu lar aneurysm with spontaneous echocardiographic contrast was followed up, suggesting that: 1. Neurofibromatosis may promote silent myocardial infarction or ischemia. Whether involvement of cardiac sensory nerves is a possible underlying mechanism remains nevertheless uncertain. 2. Platelets, whose role in the genesis of spontaneous echocardiographic con trast has been advocated, are probably not involved in this phenomenon, even in large numbers.
Mobile String-like Thrombus on the Calcified Aortic valve in Cardioembolic Stroke—A Case Report
Authors: Yasaka Masahiro , Tsuchiya Takashi , Yamaguchi Takenori 
Published: July 2008

The calcified aortic valve has been associated with being a possible source of emboli in cardioembolic stroke. However, thrombus on the calcified aortic valve has not been identified with two-dimensional echocardiography. A seventy-two- year-old woman with calcified aortic stenosis was admitted with brain embo lism. She had not previously received any platelet antiaggregant or anticoagulant. At admission, two-dimensional echocardiography demonstrated a mobile string-like abnormal echo attached to the calcified aortic valve, which showed regression and enlargement repeatedly during admission. No symptoms or clinical data suggested infective endocarditis or nonbacterial thrombotic en docarditis. After commencement of antiplatelet therapy, the abnormal echo re gressed and disappeared. She continued to take the medication for seven months and then discontinued. Three months later, she developed recurrence of stroke, and an abnormal echo on the calcified aortic valve was again detected by two-dimensional echo cardiography. The authors believe that the abnormal echo on the calcified aortic valve was thrombus and that it was the embolic source. Calcified aortic valve may thus be a causative lesion for mobile string-like thrombus. Two-dimen sional echocardiography should be performed repeatedly in patients with calci fied aortic valve and brain embolism.
Forward Doppler Ophthalmic Artery Flow in Patients with Extracranial Carotid Artery Occlusion—A Case Report
Authors: Lee Tsong-Hai , Ryu Shan-Jin , Chen Sien-Tsong , Liu Yan-Han , Tseng Kong-Yeng 
Published: July 2008

The authors report 2 cases of common carotid artery (CCA) occlusion and 4 cases of extracranial internal carotid artery (ICA) occlusion with forward Dop pler ophthalmic artery flow. The compression test during Doppler study showed that the ophthalmic artery flow was reduced to zero when compressed contralateral to the CCA in 1 case of CCA occlusion and when compressed ipsilateral to the CCA in all 4 cases of ICA occlusion. The angiograms showed that in the 2 cases of CCA occlusion, 1 had the ophthalmic artery originating from the anterior communicating artery, and the other had subclavian steal syndrome with a reversed vertebral flow. In 3 of the 4 cases of ICA occlusion, the ophthalmic artery was found to originate from the ipsilateral middle menin geal artery. Their findings suggest that in cases of extracranial carotid artery occlusion, the forward ophthalmic artery flow is supplied from the contralateral CCA in cases of CCA occlusion and from the branches of the ipsilateral external carotid artery in cases of ICA occlusion, and the vertebrobasilar system plays a less important role.
Prophylaxis of Recurrent Deep Venous Thrombosis. A Randomized, Prospective Study Using Indobufen and Graduated Elastic Compression Stockings
Authors: Belcaro Giovanni , Laurora Giuseppe , Cesarone Maria Rosaria , De Sanctis Maria Teresa 
Published: July 2008

After an episode of deep venous thrombosis (DVT) 224 patients were ran domized into four groups: a control group (A; 63 subjects); one receiving pro phylaxis with indobufen (B; 60 patients)—an oral antiplatelet agent; one using graduated elastic compression stockings (C; 53); and one receiving prophylaxis with both indobufen and graduated stockings (D; 48). Patients were monitored over a three-year period with color duplex scanning repeated every three months. In 46% of the controls there was at least one episode of recurrent DVT (RDVT). In patients receiving indobufen (group B) and using graduated com pression stockings (group C) the incidence of RDVT was significantly lower (5% and 9.43%, respectively). The incidence of RDVT was further significantly re duced by the combination of the two methods (group D) (2.08%). In conclusion, RDVT is common and often asymptomatic and can be effec tively prevented by prophylaxis with indobufen or graduated compression and more effectively by the combination of the two methods.
Diagnosis of High-Grade Stenosis of Innominate Artery
Authors: Verlato F. , Avruscio G.P. , Milite D. , Salmistraro G. , Deriu G.P. , Signorini G.P. 
Published: July 2008

Although pathology of the innominate artery (IA) is not frequent, it causes relevant impairment of extracranial circulation and sometimes cerebrovascular events. Definite differentiation of high-grade stenosis from occlusion of the IA has not been obtained until with (C.W.) Doppler and duplex system ultrasound, and thus the direct evaluation of IA is not reliable by noninvasive methods. In this study the authors suggest an indirect method, of evaluation of IA pathology based on the study of carotid, subclavian, and verte bral arteries (VA), with echo-Doppler-color-flow (EDCF) (with linear-phase ar ray, Probes of 7.5 and 5 MHz). In the last two years they studied 6 patients with, IA pathology, (2 with occlusion (occ), 1 with stenosis of 80% and 3 with subocclu sive stenosis >90%. In both patients with occ, right VA flow was inverted, and also the right common carotid (CC) was involved (occ in 1 case and inverted flow in the other ; in the 3 subocclusive stenoses a lowered systolic flow in the CC was recorded (48 vs 85cm/sec, 41 vs 77, and 23 vs 109). In the 80% stenosis, besides the inverted flow in VA, only a reduced diastolic flow in CC was also recorded (19 vs 33 cm/sec measured in the left side). All patients with high grade stenosis were successfufly confirmed by an angiographic study, including the different different degree of stenois. Five of the 6 patients underwent surgical correction with a restored flow in the previously involve, artery. Only 1 patient with occlusion is waiting for surgi cal correction. In conclusion this study shows that ECDF can be a useful tool in the of IA pathology and in differentiation of occlusion from high grade stenosis by indirect signs in the supra-aortic circulation. G.P. Signorini, M. D. Servizio di Angiologia Ospedale Civile di Padova Via Giustiniani 2 Padova 35128, Italy
Clinical and Hemodynamic Effects of Stepwise Lowering of Hemoglobin Concentration in Patients with Intermittent Claudication
Authors: Celsing Fredrik , Eriksson Maria , Markström Ulf , Rosfors Stefan 
Published: July 2008

This study evaluates the effect of stepwise lowering of the hemoglobin (Hb) concentration on maximal walking distance (MWD) and hemodynamics in pa tients with intermittent claudication. The results in a study group (n = 6) were compared with those of a control group (n = 6) whose members were not sub jected to venesections. An average decrease of Hb concentration from 151 ± 4 to 121 ± 3 g/L did not significantly influence MWD, the result being 282 ± 62 meters before venesections and 255 ± 54 meters after three to five (mean four) repeated venesections. Transcutaneous oxygen pressure was measured at the dorsum of the foot before and after exercise and did not change with a gradual decrease of the Hb concentration. Maximal heart rate, painfree walking distance, ankle pressure, and blood lactate concentration were also unchanged. An average venesection volume of about 1.4 liters whole blood within fourteen days, without isovolemic replacement, did not change the blood volume, which was 5.1 ± 0.4 liters be fore and 5.0 ± 0.5 liters after venesections. In conclusion, hemodilution accomplished by venesections did not have a clinically or physiologically beneficial effect in patients with severe intermittent claudication. However, hemodynamics and clinical symptoms were not affected by a considerable decrease in the arterial oxygen content within the normal Hb concentration range.
Electrocardiographic Diagnosis of Left Ventricular Hypertrophy in the Presence of Right Bundle Branch Block in Cases with Essential Hypertension
Authors: Nalbantgil Istemi , Önder Remzi , Kiliçcioglu Bülent , Işler Mehmet 
Published: July 2008

Right bundle branch block was diagnosed in electrocardiograms of 37 of 1085 patients with essential hypertension. Echocardiographically left ventricu lar hypertrophy was diagnosed in 14 of these 37 patients. Eighteen electrocar diographic (ECG) criteria, which were previously recommended, were deter mined in these 37 patients. The sensitivities of five criteria were found to be better than 50%. These are SV 1 ≥ 2 mm; RV6 > RV5; S III + (R + S) maximum precordial lead ≥ 30 mm; P/PR ≥ 1.6; R a VL ≥ 11 mm. However, their specificities ranged from 56.5% to 95.6%. When the combination of RV6 > RV5 and S III + (R + S) maximum precordial lead ≥ 30 mm was used, sensitivity was 57.1 and specificity was 100%. It is concluded that the presence of right bundle branch block these ECG criteria can be used for the diagnosis of left ventricular hypertrophy.
Apolipoproteins C-II and C-III in Peripheral Arterial Disease
Authors: Alessandri Cesare , Basili Stefania , Maurelli Marina , Andreozzi Paola , Colletta Anna , Paradiso Michele , Cordova Corrado 
Published: July 2008

Apolipoprotein (apo) C-II and apo C-III serum concentrations were investi gated in 119 normotriglyceridemic male subjects with peripheral arterial dis ease (PAD) or coronary heart disease (CHD) or without clinical manifestations of atherosclerotic disease. All subjects included in the study had similar blood levels of total cholesterol ( < 400 mg/dL). High-density lipoproteins cholesterol (HDL-C) subfractions and apo A-I serum levels were significantly lower in CHD patients, as were apo A-I/apo B and HDL-cholesterol/total cholesterol ratios. Apo C-II and apo C-III showed similar serum concentrations in all three groups of subjects, but apo C-II/apo C-III ratio was significantly lower in PAD patients as compared with that in CHD patients and control subjects. This study confirms that PAD may be associated with a particular lipopro tein derangement that primarily involves very low-density lipoprotein catabo lism.
Evaluation of Aortic Distensibility in Patients with Essential Hypertension by Using Cine Magnetic Resonance Imaging
Authors: Honda Toshio , Yano Kazuo , Matsuoka Hiroshi , Hamada Mareomi , Hiwada Kunio 
Published: July 2008

In order to evaluate the exact distensibility in various parts of aorta in hypertensive patients, the authors performed cine magnetic resonance (MR) in 30 normal control (NC) subjects and 30 hypertensive (HT) patients whose age and sex were matched. Cine MR was carried out at transverse sections in the ascending, descending, and abdominal aorta. Aortic diameter and area were measured in the frames of the maximum and the minimum aortic area. Aortic distensibility was calculated from the following formula: (Max area — Min area)/(Min area x ΔP), where ΔP is pulse pressure. Cardiac parameters were measured with echocardiography in all subjects. Aortic distensibility was signifi cantly lower in HT patients than in NC subjects at each transverse section (P < 0.01). Minimum diameter index (Min diameter/body surface area) and cardiac function parameter showed no significant differences between NC and HT groups. From these findings, it is suspected that hypertension is a strongly contributing factor that promotes aortic sclerosis.
Serial Changes in Coagulant Activities After Thrombolytic Therapy for Acute Myocardial Infarction
Authors: Goto Shinya , Kawai Yohko , Abe Sumihisa , Takahashi Eiichi , Handa Shunnosuke , Ogawa Satoshi , Watanabe Kiyoaki , Hori Shingo , Ikeda Yasuo 
Published: July 2008

Early reocclusion and bleeding complications are still unresolved problems in throm bolytic therapy for acute myocardial infarction (AMI). In the present study, 16 patients treated with either fibrin-specific tissue-type plasminogen activator (t-PA) or nonspecific urokinase (UK) were studied to determine the effects of thrombolytic therapy on serial hemostatic states. Hemostatic states of each patient were estimated by measuring various plasma markers at one- to two-hour intervals during the first six hours of therapy, daily during the next three days, and subsequently on day 7. Two markers of plasma thrombin generation, thrombin antithrombin III complex (TAT) and prothrombin fragment 1+2 (F 1+2), showed an activated coagulant state imme diately after thrombolytic therapy The amount of thrombin generation indicated by these markers showed significant positive correlation with direct markers of fibrinolysis such as fibrin degradation products (FDP), while it did not show any correlation with the markers for plasmin generation. The potential for coagulation as indicated by prothrombin time (%) decreased with thrombolysis using fibrin nonselective agents, owing perhaps to destruction of coagulant factors by free plasmin. ( continued on next page) Fibrinolytic activity induced by thrombolytic therapy for AMI caused transient activa tion of the coagulant system, which could contribute to early reocclusion. Fibrin nonse lective agents decreased the potential for coagulation by destroying clotting factor through the generation of free plasmin. These data provide theoretical support for simultaneous administration of anticoagulant therapy with fibrin-specific thrombolytic agents.
Local Transdermal Glyceryl Trinitrate Has an Antiinflammatory Action on Thrombophlebitis Induced by Sclerosis of Leg Varicose Veins
Authors: Berrazueta J.R. , Fleitas M. , Salas E. , Amado J.A. , Poveda J.J. , Ochoteco A. , Sánchez de Vega M.J. , Ruiz de Celis G. 
Published: July 2008

To test the antiinflammatory and analgesic effects of transdermal glyceryl trinitrate (GTN) the authors carried out a double-blind, randomized, controlled clinical study in 21 patients with mild to moderate leg varicose veins who underwent vein sclerotherapy in both legs. GTN or placebo ointment was applied in a blinded protocol along the surface of the sclerosed vein every eight hours until disappearance of inflammation signs. The varicose vein in one leg was treated with GTN and compared with placebo for the vein of the other leg used as control of thrombophlebitis (TP) signs. Fifteen minutes after first application inflammation signs were observed in all cases. The intensity of inflammation signs was assessed as 26% (10.4 ±4.1) in GTN-treated veins and as 61.5% (24.6 ±6.3) ( P < 0.001) in the placebo-treated veins. One hour later only 63% of cases in the GTN group and all cases in the placebo group showed signs of TP ( P < 0.001). The reduction in the intensity of signs at this time was 7.7 ±3.9 in the GTN group and 19.7 ±6.3 in the placebo group ( P < 0.001). All veins in the GTN group were free of signs of TP in less than forty-eight hours. In the placebo group, 45% of veins required more than forty-eight hours for complete disappearance of signs of TP ( P < 0.001). The authors conclude that GTN has an antiinflammatory effect in TP induced by sclerotherapy. This action may be related to the nitric oxide released from GTN, through a direct action on the vein and the surrounding inflamed tissue.
Changes in Blood Pressure Reactivity and 24-Hour Blood Pressure Profile Occurring at Puberty
Authors: Modesti P.A. , Pela I. , Cecioni I. , Gensini G.F. , Neri Serneri G.G. , Bartolozzi G. 
Published: July 2008

To evaluate blood pressure reactivity in children and its changes in adolescents, the acute pressor response to a video-game stress test and the noninvasive ambulatory blood pressure monitoring were evaluated in 62 healthy children divided into three age groups. Basal blood pressure values were measured according to the NIH Task Force. With baseline measures and body mass index controlled for, analysis of covariance showed that the video game provoked significant and incremental cardiovascular reac tivity across the games in adolescents when compared with the two other groups of children. The same group of children showed also a significantly higher systolic ambu latory pressure during the daytime, whereas no significant difference was observed by basal BP measurement. In conclusion an increased reactivity to external stimuli was observed in adolescents, and this pattern was strictly associated with a higher daily blood pressure.
The Applicability of Color-Labeled Microspheres in a Rabbit Model of Ischemia-Reperfusion
Authors: Hasdai David , Fuchs Limor , Ohad Dan , Battler Alexander 
Published: July 2008

This study was designed to examine the ability of color-labeled microspheres to depict different states of myocardial perfusion in a rabbit model of ischemia-reperfusion. A thread was passed under the left anterior descending artery (LAD) and the first left marginal artery of anesthetized New Zealand White rabbits. Blue-labeled microspheres (500/g body wt) were injected into the left atrium. The thread was tightened in rabbits belonging to the experimental group (n = 8), and red-labeled microspheres (500/g body wt) were injected. The snare was loosened, and yellow-labeled microspheres (500/g body wt) were injected before (n = 5) or after (n = 3) methylene blue injection. In animals belonging to the "sham" group (n = 4 and n = 2, respectively), the sequence of injections was similar, but the snare was not tightened. The animals were euthanized, and 0.3-1 g sections were cut from ischemic and nonischemic regions, as determined by methylene blue in the experimental subgroups and from the corresponding regions in the "sham" subgroups. The tissue samples were digested with 4 M KOH, ethanol 70%, and ultrasonication, and the microspheres were recovered by vacuum filtration. The dye was chemically removed from the microspheres, and the photometric absorption of each sample was determined. There was no significant difference between the experimental and "sham" groups in baseline uptake of blue-labeled microspheres. Rabbits belonging to the experi mental subgroups had significantly lower mean uptake of red microspheres during ischemia relative to "sham" (0.51 ±0.08 vs 1.06 ±0.24 and 0.36 ±0.19 vs 0.91 ±0.12, respectively). After loosening of the snare there was no difference in uptake of yellow- labeled microspheres. Color-labeled microspheres depict myocardial ischemia in the rabbit. The ability of color-labeled microspheres to depict reperfusion hyperemia remains to be proved.
Evaluation of Suspected Deep Venous Thrombosis in Oncologic Patients
Authors: Keefe Deborah L. , Roistacher Nancy , Pierri Mary Kathryn 
Published: July 2008

Impedance plethysmography (IPG) and duplex scanning with color flow Doppler were performed in 100 consecutive high-risk patients with clinically suspected deep venous thrombosis. Risk factors included recent surgery (<three weeks) in 23%, malignant disease in 91%, clotting abnormalities in 32%, and limited activity in 70%. Lower limb findings of either edema, calf tenderness, or both occurred in 92%. There was agreement between the two tests in 76 patients (29 positive and 47 negative). In 12 patients the IPG was positive and the duplex negative. Four of these had extensive pelvic disease, 2 had lung cancer with an obstructive profile, and 2 had heart failure, all of which are known to cause false-positive IPG results. In the other 12 patients the IPG was negative and the duplex positive; however, 3 of these patients had nonocclusive thrombi, 5 had pelvic disease, and 1 had a hemiparesis of the involved lower limb. In 15 patients (11 with positive duplex studies and 4 with negative) a venogram was obtained and confirmed the results. All patients were followed up clinically and none developed complications suggesting inaccurate duplex results. In conclusion, the IPG is of limited utility in this population with a sensitivity of 71%, specificity of 80%, and false-negative rate of 29% when duplex Doppler and clinical outcome are used as the standard. Where available, duplex Doppler should be preferred for evaluation of suspected deep venous thrombosis in patients with extensive medical disease.
Quantitative Coronary Arteriography and Its Assessment of Atherosclerosis
Authors: Fleming Richard M. , Harrington Gordon M. , Gibbs Harry R. , Swafford Joseph 
Published: July 2008

Background. Previous work has demonstrated that quantitative coronary arteriography (QCA) can accurately measure phantom images to within ±0.1 mm and has been accepted as a reliable and reproducible method of measuring human coronary artery disease (CAD). Assessment of CAD by QCA involves the measurement of numerous variables, which are currently required to calculate stenosis flow reserve (SFR). Methods and Results. In this study 1040 stenotic lesions were analyzed by two well- accepted methods with demonstrated accuracy and reproducibility. These methods measure percent diameter stenosis (%DS), absolute diameter, percent area stenosis, length, as well as entry and exit angles to and from a stenotic coronary artery lesion respectively Based upon these results, the mean ± standard deviations and range seen in CAD were determined for each of these independent variables. This study demonstrated that atherosclerotic coronary artery lesions do not appear to exceed an entry angle of -39°, an exit angle of +35°, or an absolute length of 4.84 cm when accurately measured by QCA. It was also noted that, once percent diameter stenosis exceeded 89% (regardless (continued on next page) of the visual estimate) or percent area stenosis exceeds 99%, coronary arteries become completely occluded as measured by QCA. Conclusions. While previously suspected that once certain critical limits are exceeded in the deposit of cholesterol and calcium within the coronary artery, the artery will close, this study demonstrated by QCA what the limitations in human coronary arteries appear to be. These limits may be in part due to turbulent factors resulting in platelet activation or local mediators from endothelium of the coronary artery. ABSTRACT Contemporary quantitative coronary arteriography (QCA) was used to measure the different variables present in atherosclerotic coronary arteries. While the interaction of each of the independent variables undoubtedly plays a role in the determination of coronary artery blood flow and closure, the limitations of each of these variables have not yet been defined in humans. This study, based on the results of human coronary arteri ograms as analyzed by QCA, demonstrates the limitations of each of these variables, after which coronary arteries close and blood flow equals zero.