tbuckley/cabot-search huggingface dataset:
Nonsurgical closure of patent ductus arteriosus: clinical application of the Rashkind PDA Occluder System.
Authors: W JRashkind, C EMullins, W EHellenbrand, M ATait
Journal: Circulation (1987)

The first successful application of a transcatheter closure technique for patent ductus arteriosus (PDA) suitable for use in infants and children was performed by us in 1977. Since that time, there has been continued improvement and simplification of the equipment as well as in the implantation technique. Following a Food and Drug Administration protocol, a multicenter study was conducted to test the safety and effectiveness of this interventional method. The clinical results from three major regional test centers (Philadelphia, Houston, and New Haven) are presented. One hundred forty-six patients from a test population of 156 were treated for PDA with use of the Rashkind PDA Occluder Systems. Successful closure was accomplished in 94 (66%) of the total cases. Ten patients (7%) retained residual ductal murmurs despite correct placement of the occlusion devices; five additional patients (3%) were considered failures due to the presence of abnormal Doppler flow patterns after the procedure. Postrelease embo...
Dilation angioplasty of congenital or operative narrowings of venous channels.
Authors: J ELock, J LBass, WCastaneda-Zuniga, B PFuhrman, W JRashkind, R VLucas
Journal: Circulation (1984)

Balloon dilation angioplasty was attempted in 10 infants and children with severe congenital or operative venous obstructions. In five children the obstructions were   and followed repair for transposition of the great vessels (four patients) or orthotopic liver transplantation (one patient). In the four patients with fixed vena caval or baffle obstructions, balloon angioplasty was successful in relieving the obstruction, decreasing the average gradient (16.0 to 4.5 mm Hg), and increasing the average diameter (3.0 to 8.9 mm) of the obstructed site. One child died 1 week later from an unrelated cerebral hemorrhage; the three survivors have had persistent clinical and angiographic improvement. The fifth child had severe systolic narrowing of the superior baffle limb caused by marked tricuspid regurgitation, which ballooned the superior limb of the baffle against the atrial roof. Angioplasty was unsuccessful in relieving this type of obstruction, which resolved with tricuspid valve replacement. ...
Lymphoscintigraphic Findings as Indicators of Lymphaticovenous Anastomosis Outcome in Patients With Extremity Lymphedema
Authors: Hye Ok Kim, Kyong-Je Woo, Bom Sahn Kim, Seo Young Kang, Byung Seok Moon, Hai-Jeon Yoon
Journal: Clinical Nuclear Medicine (2021)

Purpose This study was performed to evaluate the usefulness of lymphoscintigraphy in predicting the surgical outcomes of lymphaticovenous anastomosis (LVA) in a patient with extremity lymphedema. Patients and Methods We retrospectively evaluated 133 patients with extremity lymphedema who underwent lymphoscintigraphy followed by LVA surgery from February 2018 to March 2020. Lymphoscintigraphic findings were evaluated on the following parameters: the extent of dermal backflow (small/large), lymphatic flow patterns (trunk flow pattern/proximal-restricted pattern/distal-restricted pattern), visualization of lymph nodes, and collateral lymphatic vessels. The mean circumferential difference change before and after surgery, circumferential reduction (CR) rate (%), was used as the clinical outcome variables. Results A decrease in circumference was observed in 93 (69.9%) of 133 patients after LVA. The extent of dermal backflow and lymphatic flow patterns was significantly correlated with improved clinical outcomes after LVA. The large extent of the dermal backflow group showed a more significant CR rate than the small extent (19.27% vs 1.24%, P = 0.005). The TP group showed the most significantly decreased CR rate to 21.46%, and the proximal-restricted pattern and distal-restricted pattern groups were −2.49% and −5.33%, respectively ( P &lt; 0.001). Multivariate analysis revealed that dermal backflow and lymphatic flow patterns were independent predictors of therapeutic outcome ( P &lt; 0.001). Conclusions Our study demonstrates that pretreatment lymphoscintigraphy may help predict the therapeutic effect of LVA in patients with extremity lymphedema. Furthermore, dermal backflow and lymphatic flow patterns are independent predictors of CR rate after LVA surgery for extremity lymphedema.
Response of high-energy phosphates and lactate release during prolonged regional ischemia in vivo.
Authors: SSchaefer, G GSchwartz, J AWisneski, S DTrocha, IChristoph, S KSteinman, JGarcia, B MMassie, M WWeiner
Journal: Circulation (1992)

BACKGROUNDThe functional impairment of persistently ischemic, or hibernating, myocardium may serve to maintain myocardial cell viability through a reduction of energy requirements. Although previous studies have, in a variety of experimental models, independently shown variable responses in lactate metabolism and intracellular phosphates during prolonged ischemia, the responses of these metabolites under identical flow conditions have not been adequately described.METHODS AND RESULTSTo examine the responses of high-energy phosphates and lactate metabolism to prolonged ischemia induced by partial coronary artery stenosis, 12 open-chest pigs were studied using 31P nuclear magnetic resonance spectroscopy. Concurrent measurements of blood flow, segment shortening, high-energy phosphates, and lactate release (in nine animals) were made during 2 hours of regional ischemia. Subendocardial blood flow and segment shortening were persistently depressed during ischemia, with parallel reductions in ATP, phosphocrea...
Ventricular arrhythmias during the first year after acute myocardial infarction: influence of long-term treatment with metoprolol.
Authors: GOlsson, NRehnqvist
Journal: Circulation (1984)

Three hundred and one patients who had been hospitalized for acute myocardial infarction, were less than 70 years old, were in sinus rhythm, and did not have complete bundle branch block were stratified before discharge according to age, size of infarction, and type of ventricular arrhythmias as determined on a 6 hr electrocardiogram (ECG). They were thereafter randomly assigned to double-blind treatment with 100 mg bid metoprolol or placebo. Repeat 6 hr ECGs were recorded 3 days and 1, 6, and 12 months after treatment had begun. In the placebo group there was a significant increase in the proportion of patients with complex premature ventricular complexes (PVCs) (i.e., multiform, paired and R-on-T PVCs, or ventricular tachycardia) as well as increased numbers of PVCs in the patients during the follow-up. In contrast, an initial decrease in the number of PVCs (p less than .001) was found in the metoprolol group, whereas the complexity of PVCs was constant in those patients who continued on metoprolol ther...
Submucosal Tunneling Endoscopic Resetion (Ster) With Endoscopic Suture for the Treatment of A Gastric Submucosal Lesion
Authors: I Iborra, J Colan-Hernandez, A Aguilar, M Puig, I Marín, N Caballero, L González González, F Cañete, M Calafat, V Moreno de Vega, H Uchima
Journal: Endoscopy (2021)

Background and clinical case Male patient with a 20 x11 mm gastric antral submucosal lesion not defined by EUS-FNA with immunohistochemistry Considering a GIST as a possible diagnosis endoscopic resection was decided.
Rapid and complete recovery of responsiveness to adenosine and norepinephrine by regenerating arterioles of the tibialis anterior muscle of the hamster after in situ autografting.
Authors: L MMessina, B MCarlson
Journal: Circulation Research (1991)

Intravital microscopy studies of small bundles of fibers of the extensor digitorum longus muscle grafted onto the hamster cheek pouch revealed a persistent reduction in the responsiveness of regenerated arterioles to vasoactive agents. We tested the hypothesis that the recovery of responsiveness to vasoactive agents by regenerating arterioles within whole, in situ autografted tibialis anterior muscles occurs earlier and more completely than that reported for regenerating arterioles within bundles of fibers of the extensor digitorum longus muscle grafted ectopically to the hamster cheek pouch. The tibialis anterior muscles of Syrian golden hamsters were excised and soaked in bupivacaine (0.75%) for 10 minutes to ensure uniform degeneration of muscle fibers. The tendons were resutured, and the graft became revascularized spontaneously. Fluorescent intravital microscopy was used to measure the responsiveness of 10-40-microns arterioles to topically applied adenosine and norepinephrine at 7, 14, and 30 days a...
Kinetics of use-dependent ventricular conduction slowing by antiarrhythmic drugs in humans.
Authors: SRanger, MTalajic, RLemery, DRoy, CVillemaire, SNattel
Journal: Circulation (1991)

BACKGROUNDRate-dependent conduction slowing by class I antiarrhythmic agents has clinically important consequences. Class I drugs are known to produce use-dependent sodium channel blockade. If rate-dependent conduction slowing by class I agents is due to sodium channel blocking actions, the kinetics of conduction slowing should be similar to those of depression of sodium current indexes in vitro. The purpose of the present investigation was to study the onset time course of ventricular conduction slowing caused by a variety of class I agents in humans.METHODS AND RESULTSTwenty-seven patients undergoing electrophysiological evaluation for antiarrhythmic therapy were studied. Changes in QRS duration at initiation of ventricular pacing at cycle lengths of 400 and 500 msec were used to evaluate the kinetics of drug action. Mean time constants for each drug were similar to values for Vmax depression reported in vitro studies: flecainide, 24.9 +/- 11.6 beats in eight patients (versus 34.5 beats reported for Vma...
Endogenous sex hormones and cardiovascular disease in men. A prospective population-based study.
Authors: EBarrett-Connor, K TKhaw
Journal: Circulation (1988)

Plasma obtained and frozen in 1972-1974 from 1,009 white men (40-79 years old) who have been followed for 12 years was examined for endogenous sex hormone levels according to prevalent or subsequent cardiovascular disease. In these older men, no sex hormone measured (testosterone, androstenedione, estrone, or estradiol) was significantly associated with known cardiovascular disease at baseline or with subsequent cardiovascular mortality or ischemic heart disease morbidity or mortality. Sex hormone-binding globulin levels were also similar by disease status. Analyses of hormone:sex hormone-binding globulin ratios or of estrogen:androgen ratios showed a similar lack of association with cardiovascular disease. Testosterone levels were significantly inversely associated with levels of blood pressure, fasting plasma glucose, and triglyceride and body mass index. In contrast, the only significant estrogen risk factor associations were positive correlations of estrone with total plasma cholesterol, triglyceride,...
Hypertrophic cardiomyopathy in the elderly. Distinctions from the young based on cardiac shape.
Authors: H MLever, R FKaram, P JCurrie, B PHealy
Journal: Circulation (1989)

The striking clinical and pathologic features of hypertrophic cardiomyopathy have been defined almost exclusively in the young. Little is known about this condition in the elderly, although it is assumed to be part of a single disease. Accordingly, we studied 28 patients who were 65 years of age and older (mean age, 72 +/- 6.4 years) who were diagnosed as having hypertrophic cardiomyopathy by M-mode, two-dimensional, and Doppler echocardiography and compared them with a group of 28 consecutive patients with this disease who were younger than 40 years of age (mean age, 26 +/- 9.5 years). No clinically detectable differences existed between the two groups, except for an increased incidence of mild hypertension in the elderly. Echocardiography in both groups showed hypertrophy with a small left ventricular cavity, and Doppler outflow tract velocity or cardiac catheterization in most patients showed systolic anterior motion of the mitral valve or a systolic outflow tract gradient or both. Significant differen...
Inhaled corticosteroids in COPD
Authors: P S. BURGE;, P M VAN GRUNSVEN, C P VAN SCHAYCK
Journal: Thorax (1999)

Venous aneurysm of the azygos arch is a very rare cause of mediastinal mass and is usually an incidental finding on chest radiography.Nowadays the diagnosis is made by non-invasive tests such as thoracic CT scanning and/or magnetic resonance imaging.The case is described of an asymptomatic woman in whom a mediastinal mass due to an azygos vein aneurysm was diagnosed by non-invasive procedures, the aetiology of which, in all probability, was idiopathic.
The effect of ouabain, dinitrophenol, and lithium on the pacemaker current in sheep cardiac Purkinje fibers.
Authors: R SAronson, J MGelles
Journal: Circulation Research (1977)

We studied the effect of ouabain and other inhibitors of the Na-K pump on the pacemaker current (IK2) in sheep cardiac Purkinje fibers. We found that exposure to ouabain (2 X 10(7) M) caused an apparent decrease in the amplitude of the IK2 activation curve. We also found that a similar effect was caused by exposure to dinitrophenol (DNP) or lithium-substituted Tyrode's solution. Our studies showed that after prolonged (more than 60 minutes) exposure to ouabain a characteristic current noise appeared and IK2 was replaced by an oscillatory inward current (IOS). The apparent threshold for IOS was -50 to -60 mV and the peak amplitude of this current increased with increasing levels of depolarization positive to threshold. These results suggest that (1) the apparent decrease in IK2 may be a consequence of ionic redistribution due to Na-K pump inhibition; (2) cardiac glycosides cause abnormal impulse generation by an ionic mechanism separate from IK2 and involving IOS.
Contribution of endothelium-derived nitric oxide to exercise-induced vasodilation.
Authors: D MGilligan, J APanza, C MKilcoyne, M AWaclawiw, P RCasino, A AQuyyumi
Journal: Circulation (1994)

BACKGROUNDEndothelium-derived nitric oxide is an important modulator of resting vascular tone in animals and humans. However, the contribution of nitric oxide to exercise-induced vasodilation is unknown.METHODS AND RESULTSThe effect of NG-monomethyl-L-arginine (L-NMMA), an inhibitor of nitric oxide synthesis, on exercise-induced vasodilation was studied in 18 healthy subjects (mean +/- SD, 40 +/- 10 years; 10 women). Acetylcholine was used to test the efficacy of L-NMMA in inhibiting stimulation of nitric oxide synthesis and sodium nitroprusside to test the specificity of L-NMMA in inhibiting endothelium-dependent vasodilation. Intermittent handgrip exercise and infusions of acetylcholine and sodium nitroprusside were performed during intra-arterial infusion of 5% dextrose (control) and L-NMMA (4 to 16 mumol/min). Forearm blood flow was determined by strain-gauge plethysmography. Forearm oxygen extraction was measured from arterial and venous oxygen saturations. In a separate study, 10 subjects performed ...
Cytoskeletal features of rat aortic cells during development. An electron microscopic, immunohistochemical, and biochemical study.
Authors: OKocher, OSkalli, DCerutti, FGabbiani, GGabbiani
Journal: Circulation Research (1985)

Actin, vimentin, desmin, and tropomyosin distribution in rat aortic endothelial and smooth muscle cells has been studied during development using fetal (18 to 20 days of gestation), and 5- and 14-day-, and 5-, and 12-week-old rats. Endothelial cells of newborn animals actively replicate and contain many actin stress fibers, whereas, in adult animals, replication is minimal and actin stress fibers are rare. The actin, vimentin, desmin, and tropomyosin content of smooth muscle cells increases gradually from fetal to adult animals. The number of desmin-containing cells also increases from 13% in fetal rats to 51% in adult rats. The beta-actin isoform is predominant in fetal and newborn animals, but gradually the alpha-isoform becomes quantitatively the most important, as seen by bidimensional polyacrylamide gels. Several analogies exist between the features of developing smooth muscle and what is known for developing striated muscle cells. The evolution of cytoskeletal features from fetal to adult animals is...
Effect of nitroprusside on regional myocardial blood flow in coronary artery disease. Results in 25 patients and comparison with nitroglycerin.
Authors: TMann, P FCohn, L BHolman, L HGreen, J EMarkis, D APhillips
Journal: Circulation (1978)

The effect of nitroprusside on regional myocardial specific blood flow (RMBF) was evaluated in 25 patients with the xenon-133 washout technique. Six patients were normal (group 1), six patients had coronary artery disease without collateral vessels (group 2), and thirteen patients had coronary artery disease with collateral vessels (group 3). In group 1, RMBF was unchanged following nitroprusside. RMBF decreased significantly in both group 2 and group 3, including seven patients in group 3 with high-grade collateral vessels. The results were compared to the effect of nitroglycerin in 31 patients previously studied using the same technique. Mean arterial pressure and pressure-rate product were comparably reduced by both drugs. In contrast to the findings with nitroprusside, after sublingual nitroglycerin RMBF decreased markedly in normals and increased in patients with coronary artery disease and high-grade collaterals. The data suggest that nitroprusside may primarily affect resistance vessels within the ...
Post-Pyloric Enteral Feeding Tube Placement: Eletromagnetic Or Endoscopic Guided? A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: F Catache Mancini, M Pereira Funari, DTH de Moura, W Marques Bernardo, V Massaro Takamatsu Sagae, E Ide, C Makoto Sakai, F Lopes Ponte Neto, P Joaquin Ortiz Mendieta, E Guimarães Hourneaux de Moura
Journal: Endoscopy (2021)

Aims To compare endoscopic-guided placement and eletromagnetic-guided placement of enteral feeding tubes in post-pyloric position based on randomized controlled trials (RCTs).
Role of calcium and the calcium channel in the initiation and maintenance of ventricular fibrillation.
Authors: J CMerillat, E GLakatta, OHano, TGuarnieri
Journal: Circulation Research (1990)

The cellular events during the initiation and maintenance of ventricular fibrillation (VF) are poorly understood. We developed a nonischemic, isolated, perfused rabbit Langendorff preparation in which sustained VF could be induced by alternating current (AC) and which allowed changes in perfusate composition. We also used Na(+)-K+ pump inhibition (10 microM ouabain or K(+)-free perfusate) to induce VF. AC stimulation or Na(+)-K+ pump inhibition always initiated VF. Calcium channel blockade by verapamil or nitrendipine uniformly inhibited the initiation of VF in both models. During Na(+)-K+ pump inhibition, 1) VF was prevented by calcium channel blockade, despite evidence of Ca2+ overload, and 2) abolition of spontaneous sarcoplasmic reticulum-generated cytosolic Ca2+ oscillations by ryanodine or Na+ channel blockade with tetrodotoxin did not prevent VF initiation. Lowering extracellular [Ca2+] to 80 microM uniformly prevented the initiation of VF due to Na(+)-K+ pump inhibition but not that due to AC stim...
Recombinant tissue plasminogen activator in patients with pulmonary embolism: correlation of fibrinolytic specificity and efficacy.
Authors: D EVaughan, S ZGoldhaber, JKim, JLoscalzo
Journal: Circulation (1987)

Blood samples from 24 patients who received recombinant human tissue-type plasminogen activator (rt-PA) for angiographically documented acute pulmonary embolism were examined to identify and quantify fibrinolysis. Before and after the intravenous administration of 50 mg rt-PA over a 2 hr period, levels of total fibrinogen, fibrin(ogen) degradation products (FDP), and cross-linked fibrin degradation products (XDP) were measured in each patient. Elevated levels of XDP were found in all patients before treatment (mean 2.0 micrograms/ml, normal less than 0.2 microgram/ml), and these increased 12-fold with treatment. Fibrinogen levels fell 30% and FDP levels increased 24-fold for the entire group of patients. Over this 2 hr period, 10 of 24 patients (responders) demonstrated 25% or greater improvement in the extent of pulmonary artery thrombus as quantified by Urokinase Pulmonary Embolism Trial score, and these patients were found to have a significantly lower XDP/FDP ratio after rt-PA (p less than .04) than t...
Determination of coronary flow reserve by parametric imaging.
Authors: O MHess, M JMcGillem, S FDeBoe, I MPinto, K PGallagher, G BMancini
Journal: Circulation (1990)

Nine mongrel dogs were instrumented with electromagnetic flow probes (EMF) to measure coronary blood flow through the left anterior descending (LAD) and left circumflex (LCx) coronary arteries at rest and after maximal coronary vasodilation (1 mg/kg/min adenosine). Relative coronary blood flow was determined by parametric imaging in the left posterior oblique projection using digital subtraction angiography (DSA). Transmural myocardial perfusion of the LAD and LCx beds was determined with tracer-labeled microspheres. Coronary flow reserve (maximal coronary blood flow divided by resting blood flow) was calculated under control conditions and after constriction of the proximal LAD or LCx by a screw occluder. Heart rate decreased significantly from 140 beats/min at rest to 122 beats/min after adenosine (p less than 0.001) and from 134 (rest) to 120 beats/min (adenosine; p less than 0.05) after coronary constriction. Peak systolic pressure was kept constant with an aortic constrictor. Left ventricular end-dia...
Hemoglobin inhibits endothelium-dependent relaxation to acetylcholine in human coronary arteries in vivo.
Authors: PCollins, JBurman, H IChung, KFox
Journal: Circulation (1993)

BACKGROUNDThe endothelium can regulate vascular tone by releasing both endothelium-derived relaxing factor (EDRF or nitric oxide) and contracting factors. To date, there has only been circumstantial evidence to indicate EDRF activity in vivo in human coronary arteries. Using human hemoglobin as a specific inhibitor, the hypothesis that acetylcholine-induced coronary vasodilation is due to EDRF release was tested.METHODS AND RESULTSWe studied the response of normal coronary arteries to acetylcholine (an endothelium-dependent vasodilator) and isosorbide dinitrate (an endothelium-independent vasodilator) in seven patients. The specificity of any vasodilator response was assessed by the infusion of reduced free human hemoglobin. Hemoglobin 10(-5) M infusion alone had no effect on coronary artery diameter. Drugs were infused into the coronary artery, and the diameter changes were assessed by quantitative angiography. Acetylcholine 10(-7) M increased left anterior descending coronary artery diameter from contro...
Vascular injury and time course of smooth muscle cell proliferation after experimental holmium laser angioplasty.
Authors: SHassenstein, HHanke, JKamenz, MOberhoff, SHanke, RRiessen, K KHaase, EBetz, K RKarsch
Journal: Circulation (1992)

BACKGROUNDIn vitro experiments have shown that holmium laser energy can effectively ablate even calcified plaque in human arterial vessels. Because high-energy densities from holmium lasers can easily be transmitted through quartz fibers, this solid-state laser has been suggested as an alternative intraluminal treatment of atherosclerotic plaque.METHODS AND RESULTSTo develop an intimal plaque, 35 New Zealand White rabbits underwent electrical stimulation of their right carotid artery for 28 days. Subsequently, in 25 rabbits, holmium laser angioplasty (wavelength, 2.12 microns; pulse duration, 150 microseconds; energy density, 350 mJ/mm2) was performed. To study the morphological results, the vessels were excised after 7, 14, 28, and 42 days. Cross sections were analyzed in regard to laser-specific injury. Staining of alpha-actin was used to identify smooth muscle cells (SMCs). After bromodeoxyuridine labeling, the extent of proliferation (number of cells undergoing DNA synthesis) was determined by using a...