tbuckley/cabot-search huggingface dataset:
Is Terlipressin Superior to Noradrenaline in the Treatment of Acute Kidney Injury in Acute‐on‐Chronic Liver Failure?
Authors: Abhinav Anand, None Shalimar
Journal: Hepatology (2018)

To the Editor: We read with interest the paper by Arora et al.1 comparing terlipressin with noradrenaline in the management of acute kidney injury (AKI) in patients with acute‐on‐chronic liver failure (ACLF). The authors designed a randomized controlled trial to compare the response to therapy, course, and outcomes between the two drugs. We agree with most of their observations, but we would like some more clarity regarding their conclusions. In this prospective study, which included all consecutive patients, the authors reported that 66.3% (120/181) of patients with ACLF had AKI with hepatorenal syndrome (HRS) and that only 4.9% (9/181) had acute tubular necrosis (ATN). In contrast, studies have reported a higher proportion (30%) of ATN among patients who have ACLF with AKI.2 Moreover, the authors reported a very high percentage (48.3% [58/120]) of patients who have ACLF with sepsis, which itself is an independent cause of ATN3; therefore, treatment with terlipressin or noradrenaline would not be of benefit in this subgroup. Although urinary sodium was <20 mEq/L for both groups, it is not clear whether the evaluation was done only on presentation or also during the hospital stay. The criteria used to differentiate ATN from AKI‐HRS need more clarification. The authors used the Asian Pacific Association for the Study of the Liver's definition of ACLF. There are multiple definitions of ACLF, and it would be worthwhile exploring the data with the European Association for the Study of the Liver‐Chronic Liver Failure definition to make the results more generalizable. The authors reported an overall high mortality (79/120 [65.8%], not 66.7% as mentioned). Although the cause of mortality is not mentioned, multiorgan dysfunction, including shock, would probably be the preterminal event in most patients. Noradrenaline is the first‐line vasopressor in the management of shock.4 Can the authors provide details of the vasopressors used in the management of shock in both groups? Did any patient in the terlipressin group receive noradrenaline and vice versa? The authors have reported that 68.3% (82/120) of patients required renal replacement therapy (RRT). RRT would be a confounding factor for comparing the response of terlipressin and noradrenaline due to a decrease in creatinine levels postdialysis. Can the authors clarify regarding the time points used for assessment of response to terlipressin or noradrenaline among those patients who received RRT? We would also like to highlight an error in figure 3A. The number mentioned in the third row under the column for day 28 does not match the number shown in the figure (should be 12 instead of 18). Potential conflict of interest Nothing to report.
Multiclinic controlled trial of bethanidine and guanethidine in severe hypertension.
Authors: E ARamirez, LElson, A SGear, J ROster, F NTalmers, J RThomas
Journal: Circulation (1977)

One hundred and eight patients with initial diastolic blood pressure in the range of 100-124 mm Hg while taking hydrochlorothiazide were assigned randomly and double-blind to hydrochlorothiazide plus either bethanidine or guanethidine. The average reduction of the fifth and sixth months' diastolic blood pressure was 18.4 mm Hg for guanethidine and 13.6 mm Hg for bethanidine (P less than 0.01). The distribution of the individual values was such that 68.8% of guanethidine treated patients achieved a diastolic level below 90 mm Hg, compared to only 45.5% of the bethanidine treated group (P less than 0.025). The degree of orthostatic fall in blood pressure was greater with bethanidine than with guanethidine (P less than 0.05). The diurnal variation of blood pressure was slightly greater with bethanidine than with guanethidine. The results significantly favor guanethidine. This study failed to demonstrate that the shorter action of bethanidine confers significantly better control of blood pressure than the lon...
TCTAP C-103 Echonavigator - Hybrid Visualization Modality for Atrioseptostomia with the Modified Stent in Patient with Severe Pulmonary Hypertension
Authors: Igor V. Buzaev, Gulchachak Khalikova, Tagir Aminov, Vladimir Plechev, Irina Evgenievna Nikolaeva, Almira Davletbaeva
Journal: Journal of the American College of Cardiology (2021)
总编导读
Authors: 乌正赉
Journal: BMJ (2009)

本期重点议题是乳腺疾病的诊治,共刊登5篇相关文章.述评栏目刊登了南京医科大学第一附属医院乳腺内分泌外科王水等撰写的乳腺增生症的几个临床问题.专家论坛栏目刊登了复旦大学附属华山医院外科邹强撰写的对乳腺增生症与乳腺癌前期病变的认识与临床处理、山东省肿瘤医院乳腺病中心刘娟娟等撰写的真空辅助乳房活检系统诊断、治疗乳腺疾病的适应证选择、中国医学科学院附属肿瘤医院外科宣立学撰写的早期乳腺癌保乳治疗的现状.综述栏目刊登了复旦大学附属肿瘤医院乳腺外科杨晨等撰写的新辅助治疗在乳腺癌应用的临床意义.这些文章可帮助全科医生了解常见乳腺疾病的诊治现状及一些进展。
Age-related changes in fibronectin expression in spontaneously hypertensive, Wistar-Kyoto, and Wistar rat hearts.
Authors: WMamuya, AChobanian, PBrecher
Journal: Circulation Research (1992)

The effects of age and blood pressure on fibronectin expression in the rat heart were studied in the normotensive Wistar and Wistar-Kyoto (WKY) strains and in the spontaneously hypertensive rat (SHR). Fibronectin mRNA expression decreased threefold between 10 and 40 weeks of age in Wistar hearts, with changes of similar magnitude occurring between 6 and 24 weeks in WKY rats. In contrast, no decrease in fibronectin mRNA was observed in SHR hearts during this time span. These results are in contrast to changes observed previously in the aorta, where an increase in fibronectin mRNA occurred with age in all three rat strains. Ribonuclease protection analysis showed a small age-specific increase in the relative content of EIIIA+ fibronectin mRNA isoforms in hearts from Wistar rats, whereas no change was found in the relative amount of either EIIIA or EIIIB isoforms in SHR hearts. Changes similar to those observed for fibronectin mRNA, although of different magnitudes, were observed in mRNA levels for collagen ...
Long-term hemodynamic assessment of the porcine heterograft in the mitral position. Late development of valvular stenosis.
Authors: L CLipson, K MKent, D RRosing, R OBonow, C LMcIntosh, JCondit, S EEpstein, A GMorrow
Journal: Circulation (1981)

We undertook a study of patients who had porcine mitral valves in place for more than 5 years and who had no clinical signs or symptoms suggestive of valve dysfunction. Of the first 54 patients who had porcine valves implanted in the mitral position, 18 were available for catheterization; all had a routine hemodynamic study postoperatively (mean 7 months) for comparison. Mean follow-up was 85 months (range 61-111 months). Compared with the early postoperative data, there was a significant increase in mean mitral valve gradient, from 5.9 +/- 0.7 to 8.6 +/- 0.7 mm Hg (p less than 0.01), and a significant decrease in calculated mitral valve area, from 2.2 +/- 0.2 to 1.7 +/- 0.2 cm2 (p less than 0.01). Moreover, seven patients showed a decrease in valve area greater than 1.0 cm2, five with valves in place for more than 80 months and only two of 11 patients with valves in place for 80 months or less (p less than 0.05). We conclude that there is a significant incidence of hemodynamic deterioration of porcine he...
Wave-front curvature as a cause of slow conduction and block in isolated cardiac muscle.
Authors: CCabo, A MPertsov, W TBaxter, J MDavidenko, R AGray, JJalife
Journal: Circulation Research (1994)

We have investigated the role of wave-front curvature on propagation by following the wave front that was diffracted through a narrow isthmus created in a two-dimensional ionic model (Luo-Rudy) of ventricular muscle and in a thin (0.5-mm) sheet of sheep ventricular epicardial muscle. The electrical activity in the experimental preparations was imaged by using a high-resolution video camera that monitored the changes in fluorescence of the potentiometric dye di-4-ANEPPS on the surface of the tissue. Isthmuses were created both parallel and perpendicular to the fiber orientation. In both numerical and biological experiments, when a planar wave front reached the isthmus, it was diffracted to an elliptical wave front whose pronounced curvature was very similar to that of a wave front initiated by point stimulation. In addition, the velocity of propagation was reduced in relation to that of the original planar wave. Furthermore, as shown by the numerical results, wave-front curvature changed as a function of t...
Coronary ostial stenosis.
Authors: C LPritchard, J GMudd, H BBarner
Journal: Circulation (1975)

Symptomatic, nonsyphilitic, acquired coronary ostial stenosis is a rare angiographic finding and was found in 0.13% of 3000 coronary angiograms. Three females with this lesion have been treated surgically. Two had left coronary ostial involvement. Coronary angiography may result in catheter tip occulsion of the ostium with chest pain, dyspnea, diaphoresis, systemic hypotension and abrupt fall in pressure at the catheter tip. Recognition of this entity is necessary for safe coronary angiography. Involvement of the left ostium carries the same serious prognosis as does left main coronary disease.
Electrophysiological effects and clinical efficacy of propafenone in children with recurrent paroxysmal supraventricular tachycardia.
Authors: BMusto, AD'Onofrio, CCavallaro, AMusto
Journal: Circulation (1988)

Twenty-four patients aged 10.1 +/- 4.5 (mean +/- SD) years with recurrent paroxysmal supraventricular tachycardia underwent an electrophysiological study. Eleven patients had an overt and seven had a concealed accessory connection; six patients had no accessory connection. An orthodromic reciprocating tachycardia was inducible in 17 of 18 patients with an accessory connection, and an atrioventricular nodal reentrant tachycardia was inducible in four of six patients without accessory connection. After administration of propafenone, the sinus cycle length decreased. Intra-arterial, intranodal, and His-ventricle intervals and QRS duration increased. The atrial and ventricular effective refractory periods and anterograde and retrograde effective refractory periods of the atrioventricular node increased. The cycle length at which nodal second-degree block occurred increased. Of 18 patients with accessory connection, propafenone prolonged retrograde conduction in all, blocked anterograde conduction in five, and...
Modulation of coronary autoregulatory responses by nitric oxide. Evidence for flow-dependent resistance adjustments in conscious dogs.
Authors: T PSmith, J MCanty
Journal: Circulation Research (1993)

The present study tested the hypothesis that nitric oxide production in coronary resistance vessels is an important mechanism affecting the regulation of myocardial perfusion in unanesthetized dogs. We inhibited nitric oxide synthesis with the arginine analogue N omega-nitro-L-arginine methyl ester (L-NAME, 10 mg/kg) and maintained the compressive determinants of myocardial blood flow constant by ventricular pacing. L-NAME did not affect resting coronary blood flow and reduced the receptor-mediated increase in flow to intracoronary acetylcholine (100 micrograms/min IC) from 143 +/- 20% (mean +/- SEM) under control conditions to 31 +/- 10% after L-NAME (P < .001). Coronary autoregulatory relations were determined as steady-state coronary pressure was reduced by inflating a hydraulic occluder. Initial resistance adjustments over the autoregulatory plateau were not affected by L-NAME. Closed-loop autoregulatory gain was 0.84 +/- 0.09 under control conditions versus 0.78 +/- 0.07 after L-NAME (P = NS). As cor...
Intracardiac, intravascular, two-dimensional, high-frequency ultrasound imaging of pulmonary artery and its branches in humans and animals.
Authors: N GPandian, AWeintraub, AKreis, S LSchwartz, M AKonstam, D NSalem
Journal: Circulation (1990)

Intravascular ultrasound imaging is a promising new method for assessing vascular morphology. We evaluated the capability of intravascular ultrasound to quantify pulmonary artery (PA) morphology in vitro and explored the feasibility of in vivo PA imaging in animals and humans. In the in vitro study of 15 PA segments, we used a 20-MHz prototype ultrasound catheter. Intravascular ultrasound (y) provided crisp images of PA segments and demonstrated excellent correlations with anatomic measurements (x) in the estimation of luminal area (y = 0.89x + 2.95, r = 0.99, p less than 0.001), luminal diameter (n = 30, y = 0.79x + 0.96, r = 0.92, p less than 0.001), and vessel wall thickness (n = 60, y = 0.65x + 0.33, r = 0.85, p less than 0.001). We subsequently introduced the probe into the PA of 10 dogs and were able to obtain real-time, two-dimensional images of the main PA, its major branches, and farther smaller branches as far as the wedge level. To evaluate the in vivo feasibility of PA imaging in conscious hum...
Comprehensive analysis of the major histocompatibility complex in systemic sclerosis identifies differential HLA associations by clinical and serological subtypes
Authors: Marialbert Acosta-Herrera, Martin Kerick, Elena Lopéz-Isac, Shervin Assassi, Lorenzo Beretta, Carmen Pilar Simeón-Aznar, Norberto Ortego-Centeno, Susanna M Proudman, Nicolas Hunzelmann, Gianluca Moroncini, Jeska K de Vries-Bouwstra, Gisela Orozco, Anne Barton, Ariane L Herrick, Chikashi Terao, Yannick Allanore, Matthew A Brown, Timothy RDJ Radstake, Carmen Fonseca, Christopher P Denton, Maureen D Mayes, Javier Martin
Journal: Annals of the Rheumatic Diseases (2021)

Objective The greatest genetic effect reported for systemic sclerosis (SSc) lies in the major histocompatibility complex (MHC) locus. Leveraging the largest SSc genome-wide association study, we aimed to fine-map this region to identify novel human leucocyte antigen (HLA) genetic variants associated with SSc susceptibility and its main clinical and serological subtypes. Methods 9095 patients with SSc and 17 584 controls genome-wide genotyped were used to impute and test single-nucleotide polymorphisms (SNPs) across the MHC, classical HLA alleles and their composite amino acid residues. Additionally, patients were stratified according to their clinical and serological status, namely, limited cutaneous systemic sclerosis (lcSSc), diffuse cutaneous systemic sclerosis (dcSSc), anticentromere (ACA), antitopoisomerase (ATA) and anti-RNApolIII autoantibodies (ARA). Results Sequential conditional analyses showed nine SNPs, nine classical alleles and seven amino acids that modelled the observed associations with SSc. This confirmed previously reported associations with HLA-DRB1*11:04 and HLA-DPB1*13:01 , and revealed a novel association of HLA-B*08:01 . Stratified analyses showed specific associations of HLA-DQA1*02:01 with lcSSc, and an exclusive association of HLA-DQA1*05:01 with dcSSc. Similarly, private associations were detected in HLA-DRB1*08:01 and confirmed the previously reported association of HLA-DRB1*07:01 with ACA-positive patients, as opposed to the HLA-DPA1*02:01 and HLA-DQB1*03:01 alleles associated with ATA presentation. Conclusions This study confirms the contribution of HLA class II and reveals a novel association of HLA class I with SSc, suggesting novel pathways of disease pathogenesis. Furthermore, we describe specific HLA associations with SSc clinical and serological subtypes that could serve as biomarkers of disease severity and progression.
Functional and morphological organization of the rabbit sinus node.
Authors: W KBleeker, A JMackaay, MMasson-Pévet, L NBouman, A EBecker
Journal: Circulation Research (1980)

In isolated right atria of the rabbit heart, we studied the activation pattern within the sinus node, using the microelectrode technique. After the electrophysiological experiments, the preparations were subjected to a correlative morphological investigation, using light or electron microscopy. Different criteria for defining the dominant pacemaker were compared. A group of at least 5000 cells, located within the central part of the node where the most characteristic tissue architecture was found, was considered to be responsible for generation of the impulse. At the ultrastructural level, this leading cell group appeared to be part of a larger uniform cell group. The number of gap junctions observed suggests that all nodal cells are coupled by these structures. Toward the periphery, the excitation wave was propagated preferentially in an oblique cranial direction toward the crista terminalis. Neither morphologically nor electrophysiologically specific pathways were found for the conduction, but the prefe...
Effects of nitroprusside on myocardial blood flow and oxygen consumption in conscious lambs with an aortopulmonary left-to-right shunt.
Authors: G PToorop, RHardjowijono, MDalinghaus, A MGerding, J HKoers, W GZijlstra, J RKuipers
Journal: Circulation (1990)

We studied the effect of vasodilation on regional myocardial blood flow and oxygen consumption of the left ventricular free wall by infusing 10 micrograms/kg/min sodium nitroprusside into 7-week-old conscious lambs with and without aortopulmonary left-to-right shunts. Resting myocardial oxygen consumption in the 13 shunt lambs was significantly higher than in the nine control lambs (989 +/- 104 [+/- SEM] vs. 432 +/- 41 mumol/min/100 g left ventricle). This was achieved by a significantly higher left ventricular myocardial blood flow (294 +/- 33 vs. 143 +/- 16 ml/min/100 g left ventricle) because the arteriovenous oxygen concentration difference across the left ventricular free wall was similar in shunt and control lambs. Infusion of nitroprusside did not significantly change myocardial oxygen consumption and regional myocardial blood flows at 10 and 50 minutes after the onset of the infusion. This occurred despite a substantial drop in aortic and left atrial pressures and stroke volume, which decreases wa...
Spatial domain analysis of late ventricular potentials. Intraoperative and thoracic correlations.
Authors: DLacroix, PSavard, MShenasa, WKaltenbrunner, RCardinal, PPagé, DJoly, DDerome, RNadeau
Journal: Circulation Research (1990)

For investigation of late potentials seen on the signal-averaged electrocardiogram, intracardiac and thoracic distributions of terminal activity were analyzed in 16 patients undergoing cryosurgery for ventricular tachycardia after remote myocardial infarction. The body surface potentials measured with 63 time-averaged unipolar leads were compared with epicardial and endocardial potential maps in six patients without and 10 patients with bundle-branch block. Intracardiac post-QRS activity, defined as extending beyond the thoracic QRS offset, was found in five of six patients without bundle-branch block (83%) and in five of 10 patients with bundle-branch block (50%), corresponding to 4 +/- 5% of the total number of electrograms in each patient. Fragmentation, double deflections, and single deflections were observed in 27%, 34%, and 39%, respectively, of these post-QRS electrograms. Post-QRS activation patterns that were stable from beat to beat showed slow propagation around or within areas of conduction bl...
Medical compared with surgical management of unstable angina. 5-year mortality and morbidity in the Veterans Administration Study.
Authors: A FParisi, SKhuri, R HDeupree, G VSharma, S MScott, R JLuchi
Journal: Circulation (1989)

We evaluated medical in comparison to surgical plus medical (surgical) treatment of unstable angina using a prospective randomized protocol that stratified patients by clinical presentation and by invasive evaluation of left ventricular (LV) function. Clinical presentations were as follows--type 1: progressive or new onset angina relieved by medication; type 2: prolonged bouts of angina poorly or incompletely relieved by medication. Abnormal LV function was arbitrarily defined as ejection fraction less than 0.50 or LV end-diastolic pressure 16 mm Hg or more. Of 468 patients, 237 were assigned to medical and 231 to surgical therapy. There were 374 type 1 and 94 type 2 patients. LV function was normal in 334 and abnormal in 134 patients. Compared with results at 24 months, this 60-month follow-up study showed important differences in survival for patients with three-vessel disease: 75% for medical and 89% for surgical patients (p less than 0.02). The cumulative 5-year rate of repeat hospitalizations for car...
Difficult Biliary Cannulation in the ERCP: Repeated Ercp After Precut, Percutaneous Or EUS Guided Alternative Procedure? Analysis in a Tertiary Care Center
Authors: P Stathopoulos, P Lerner, P Astheimer, L Breitling, A Mahnken, U Denzer
Journal: Endoscopy (2021)

Aims: Introduction ERCP is the standard procedure for biliary drainage. In case of difficult biliary access alternative procedures consist of precut intervention with repeated ERCP, percutaneous access or EUS guided intervention. We analyzed frequency and success rate of used procedures in the daily praxis.
A Growing Inflammatory Mass of Gastrosplenic Ligament Mimicking Recurrent Colon Cancer on FDG PET/CT
Authors: Guohua Shen, Rang Wang, Anren Kuang
Journal: Clinical Nuclear Medicine (2021)

Abstract A 64-year-old man diagnosed with colon cancer underwent left hemicolectomy 1 year ago. The postoperative pathological stage was T4a N0 M0. Serial follow-up CT scans revealed a growing soft-tissue mass in the gastrosplenic ligament. FDG PET/CT was then performed for further restaging, and intense FDG uptake was observed inside the lesion, whereas no other abnormal uptake was seen. A solitary recurrence was suspected, and he underwent surgical resection. Histopathologic findings confirmed the diagnosis of chronic inflammation. This case demonstrates how a growing FDG-avid inflammatory mass of surgical site could easily be mistaken for recurrence.
Mechanism of selective epicardial activation delay during acute myocardial ischemia in dogs.
Authors: AArenal, CVillemaire, SNattel
Journal: Circulation (1993)

BACKGROUNDPrevious studies have shown that acute myocardial ischemia in the dog results in much greater activation delays in epicardial than endocardial tissue. These results have been interpreted to indicate enhanced sensitivity of epicardial conduction properties to acute ischemia. This study was designed to test the hypothesis that the ischemic epicardial activation delay during supraventricular rhythms is due to slow conduction across the ischemic myocardial wall prior to epicardial activation and not to enhanced epicardial conduction slowing per se.METHODS AND RESULTSChanges in epicardial and endocardial activation were measured with transmural decapolar needle electrodes during successive 5-minute left anterior descending coronary artery (LAD) occlusions separated by 30-minute reperfusion periods. Occlusions were performed during left atrial pacing, right ventricular pacing with a stimulating electrode located along the longitudinal axis of epicardial fiber orientation in the ischemic zone, or left ...
The influence of cold stress on the myosin heavy chain expression of cardiac and smooth muscle in normotensive and spontaneously hypertensive female rats.
Authors: KAdler, PBoels, UGanten, DGanten, IMorano
Journal: Circulation Research (1991)

Cold exposure (6 weeks at 4 degrees C) of normotensive (Wistar-Kyoto) and stroke-prone spontaneously hypertensive female rats led to cardiac hypertrophy (in stroke-prone spontaneously hypertensive rats), increased the level of plasma thyroxine, and increased the alpha-myosin heavy chain expression in the left ventricle. In contrast, myosin heavy chain expression of both main mesenteric artery and uterus was not affected by cold stress and chronic hypertension, suggesting different regulation of myosin heavy chain expression in smooth and cardiac muscle in vivo.