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At least 991 records · Page 55Linked to original sources
PubMed2006

The vascular endothelin system in hypertension--recent patents and discoveries.

The discovery of endothelin two decades ago has now evolved into an intricate vascular endothelin (ET) system. Several ET isoforms, receptors, signaling pathways, agonists, antagonists, and clinical applications have been identified and documented in first-rate patents. The role of ET as one of the most potent endothelium-derived vasoconstricting factors is now complemented by a newly discovered role in vascular relaxation. ET synthesis is initiated by the transcription of ET genes in endothelial cells and the generation of the gene products preproET and big ET, which are further cleaved by specific ET converting enzymes into ET-1, -2, -3 and -4 isoforms. ET isoforms bind with different affinities to ET(A) and ET(B2) receptors in vascular smooth muscle, and stimulate [Ca(2+)](i), protein kinase C, mitogen-activated protein kinase and other signaling mechanisms of smooth muscle contraction, growth and proliferation. ET also binds to endothelial ET(B1) receptors, which mediate the release of vasodilator substances such as nitric oxide, prostacyclin and endothelium-derived hyperpolarizing factor. Endothelial ET(B1) receptors may also function in ET re-uptake and clearance. Although the effects of ET on vascular function and growth are well-recognized, the role of ET and its receptors in the regulation of blood pressure and in the pathogenesis of hypertension is not clearly established. Salt-dependent hypertension in experimental animals and some forms of moderate to severe hypertension in human may show elevated levels of plasma or vascular ET; however, other forms of hypertension show normal ET levels. The currently available ET receptor antagonists reduce blood pressure in some forms of experimental hypertension. Careful examination of recent patents may identify more effective and specific modulators of the vascular ET system for clinical use in human hypertension.

Amino Acid Sequence↗
PubMed1989

Identification of a patent paraumbilical vein by using Doppler sonography: importance in the diagnosis of portal hypertension.

The aim of this study was to determine if the addition of pulsed Doppler imaging to conventional sonography allows discrimination between true paraumbilical veins of portal hypertension and the apparent vein sometimes seen in the ligamentum teres in normal subjects. Conventional sonography and Doppler sonography of the ligamentum teres were performed in 33 normal subjects and in 39 patients with portal hypertension due to chronic liver disease. An apparent ligamentum teres vessel (i.e., hypoechoic channel) was identified on sonograms in 32 (97%) normal subjects (diameter 0.6-1.9 mm) and in 35 (90%) patients with portal hypertension (diameter 1.1-22 mm). In the portal hypertension group, the apparent vessel had a diameter of greater than 3 mm in only 20 patients (51%), but in 32 patients (82%) it was shown on Doppler examination to be a patent paraumbilical vein (i.e., hepatofugal venous signal). A patent paraumbilical vein on duplex Doppler sonography is therefore a specific sign of portal hypertension. The addition of Doppler imaging to conventional sonographic examination significantly increases the sensitivity for the diagnosis of portal hypertension by demonstration of a paraumbilical vein.

Adolescent↗
PubMedDate not supplied

Effects of hypobaric pressure on the labyrinth. Cochlear aqueduct patent.

Cats with the cochlear aqueduct patent were placed in a pressure chamber and exposed for 10 min to hypobaric pressures of 5.1 and 6.8 kPa relative to atmospheric pressure. The experiments were designed according to a program used for treatment of Meniere's disease. The perilymph, middle ear, cerebrospinal fluid (CSF), venous, arterial and chamber pressures were recorded. The results demonstrated that hypobaric effects on the labyrinth were mediated via pressure changes in the middle ear and not via a systemic vascular or CSF influence. A reduction in chamber pressure induced a relative increase in middle ear pressure. It was the rate of the hypobaric change as well as the patency of the cochlear aqueduct and the Eustachian tube function that determined the magnitude of the initial perilymph peak pressure and the duration of this pressure increase. A rapid versus a slow rate induced an initial perilymph increase of 3.4 and 2.2 kPa, respectively. This relative pressure increase was eliminated within 1 min via the patent aqueduct. Thus, neither did a longstanding perilymph pressure increase occur during the hypobaric exposure, nor did a prolonged significant reduction in perilymph pressure occur after atmospheric pressure was restored.

Animals↗
PubMed1990

Aneurysm rebleeding after treatments that leave the aneurysm sac patent.

Three operations that leave the aneurysm sac patent have been used to treat ruptured intracranial aneurysms: carotid ligation, anterior cerebral artery ligation and aneurysm wrapping. The rates of early rebleeding (0-6 months) for these operations are respectively less than 10, 3.9 and 8.6%. The long-term risks of rebleeding are at least 1% per year for anterior cerebral or carotid artery ligation and 1.5% per year for wrapping. Eighty per cent of rebleeds are fatal. Most aneurysms are still seen to be patent if angiography is performed after these treatments. Should patients who have had these operations be offered aneurysm clipping?

Carotid Arteries↗
PubMed1999

George Fulford and Victorian patent medicine men: Quack mercenaries or Smilesian entrepreneurs?

In the early twentieth century, a time when patent medicine men were stereotyped as evil and dishonest, G. T. Fulford of Brockville, Ontario made his fortune from an iron pill called Dr. Williams' Pink Pills for Pale People. Once successful, Fulford remained in Brockville where he served on the town council and gave generously to charities. In 1900 he was appointed by Laurier to the Senate. When he died in 1905 he was remembered as a kind and ethical man. His story, like that of several other prominent patent medicine men, conforms more with the ideals of Samuel Smiles than with the popular image of disrepute.

Canada↗
PubMed2006

Population-based study of the relationship between patent foramen ovale and cerebrovascular ischemic events.

OBJECTIVE: To determine whether patent foramen ovale (PFO) is a risk factor for a cryptogenic cerebrovascular ischemic event (CIE). METHODS: This case-control study of 1072 residents of Olmsted County, Minnesota, who underwent contrast transesophageal echocardiography between 1993 and 1997 included 519 controls without CIE randomly selected from the population, 262 controls without CIE referred for transesophageal echocardiography because of cardiac disease, 158 cases with incident CIE of obvious cause (noncryptogenic), and 133 cases with incident CIE of uncertain cause (cryptogenic). RESULTS: Large PFOs were detected in 108 randomly selected controls (20.8%), 22 referred controls (8.4%), 17 noncryptogenic CIE cases (10.8%), and 22 cryptogenic CIE cases (16.5%). After adjustment for age, sex, hypertension, smoking, atrial fibrillation, ischemic heart disease, and number of contrast injections, the presence of a large PFO was not significantly associated with group status (P=.07). Using the odds of the presence of large PFO in the randomly selected controls as the reference, the odds ratio (95% confidence interval) of the presence of large PFO was 0.47 (0.26-0.87) for referred controls, 0.69 (0.37-1.29) for noncryptogenic CIE cases, and 1.10 (0.63-1.90) for cryptogenic CIE cases. CONCLUSIONS: Patent foramen ovale is not a risk factor for cryptogenic ischemic stroke or transient ischemic attack in the general population. The PFO's importance in the genesis of cryptogenic CIE may have been overestimated in previous studies because of selective referral of cases and underascertainment of PFO among comparison groups of patients referred for echocardiography for clinical indications other than cryptogenic CIE.

Adult↗
PubMed2001

Recreational scuba diving, patent foramen ovale and their associated risks.

Scuba diving has become a popular leisure time activity with distinct risks to health owing to its physical characteristics. Knowledge of the behaviour of any mixture of breathable gases under increased ambient pressure is crucial for safe diving and gives clues as to the pathophysiology of compression or decompression related disorders. Immersion in cold water augments cardiac pre- and afterload due to an increase of intrathoracic blood volume and peripheral vasoconstriction. In very rare cases, the vasoconstrictor response can lead to pulmonary oedema. Immersion of the face in cold water is associated with bradycardia mediated by increased vagal tone. In icy water, the bradycardia can be so pronounced, that syncope results. For recreational dives, compressed air (i.e., 4 parts nitrogen and 1 part oxygen) is the preferred breathing gas. Its use is limited for diving to 40 to 50 m, otherwise nitrogen narcosis ("rapture of the deep") reduces a diver's cognitive function and increases the risk of inadequate reactions. At depths of 60 to 70 m oxygen toxicity impairs respiration and at higher partial pressures also functioning of the central nervous system. The use of special nitrogen-oxygen mixtures ("nitrox", 60% nitrogen and 40% oxygen as the typical example) decreases the probability of nitrogen narcosis and probably bubble formation, at the cost of increased risk of oxygen toxicity. Most of the health hazards during dives are consequences of changes in gas volume and formation of gas bubbles due to reduction of ambient pressure during a diver's ascent. The term barotrauma encompasses disorders related to over expansion of gas filled body cavities (mainly the lung and the inner ear). Decompression sickness results from the growth of gas nuclei in predominantly fatty tissue. Arterial gas embolism describes the penetration of such gas bubbles into the systemic circulation, either due to pulmonary barotrauma, transpulmonary passage after massive bubble formation ("chokes") or cardiac shunting. In recreational divers, neurological decompression events comprise 80% of reported cases of major decompression problems, most of the time due to pathological effects of intravascular bubbles. In divers with a history of major neurological decompression symptoms without evident cause, transoesophageal echocardiography must be performed to exclude a patent foramen ovale. If a cardiac right-to-left shunt is present, we advise divers with a history of severe decompression illness to stop diving. If they refuse to do so, it is crucial that they change their diving habits, minimising the amount of nitrogen load on the tissue. There is ongoing debate about the long term risk of scuba diving. Neuro-imaging studies revealed an increased frequency of ischaemic brain lesions in divers, which do not correlate well with subtle functional neurological deficits in experienced divers. In the light of the high prevalence of venous gas bubbles even after dives in shallow water and the presence of a cardiac right-to-left shunt in a quarter of the population (i.e., patent foramen ovale), arterialisation of gas bubbles might be more frequent than usually presumed.

Atrophy↗
PubMed1999

[Anaphylactic shock due to "patent blue" used to search for the sentinel node].

Intraoperative search for the sentinel node using patent blue is considered a non risk procedure. We report the first case of anaphylactic shock and allergy. We emphasize the highly exceptional nature of this adverse effect previously observed in other disciplines using this coloring agent. In light of the favorable outcome in our patient and the importance of the method, this single accident would not be sufficient to contraindicate the continuing use of patent blue in ongoing research.

Anaphylaxis↗
PubMed1999

Hypoxia due to patent foramen ovale in the absence of pulmonary hypertension.

In most patients with a patent foramen ovale, blood flows from the left atrium to the right atrium in the absence of pulmonary hypertension. Our report describes a patient with a patent foramen ovale in whom flow occurred from the right atrium to the left atrium in the absence of pulmonary hypertension. We discuss hemodynamic findings and present a brief review of the pertinent medical literature regarding this phenomenon. We also discuss the role of transesophageal echocardiography in the diagnosis of this condition and in the elucidation of the underlying mechanisms, and we suggest several mechanisms that may explain the occurrence of this phenomenon in our patient.

Aged↗
PubMed2001

Gianturco Coil Occlusion of Patent Ductus Arteriosus.

Gianturco coils (Cook Cardiology, Bloomington, IN) are commonly employed to occlude restrictive patent ductus arteriosus. The clinical experience of the 1990s demonstrated efficacy and safety. This article reviews the current status of Gianturco coil occlusion of the patent ductus arteriosus. It covers the design of the available coils, patient selection for the procedure, coil selection and delivery methods, results and complications of occlusion, and financial considerations.

Journal Article↗
PubMed1997

[Analysis of paeonol in Paeonia suffruticosa Andr. and its patent preparations by supercritical fluid extraction and capillary gas chromatography].

A supercritical fluid extraction (SFE) method was developed for the extraction of paeonol in Paeonia suffruticosa Andr. and its patent preparations. A systematic method was used to optimize five variables (temperature, pressure, modifier concentration, static extracting time and CO2 dynamic extracting volume) of SFE. Sample extracts were analyzed by wide-bore capillary gas chromatography (CGC). The method showed good linearity (gamma = 0.9999) in the range of 0.1-1.6 mg.ml-1 of paeonol. The average recovery was 97.8% with RSD = 2.35% (n = 3) for Paeonia suffruticosa andr., 100.3% with RSD = 1.89% (n = 3) for its patent preparations.

Acetophenones↗
PubMed1993

[The way for carrying medicine and its containers (XI): "dosage form of patent medicine in the Edo Period"].

In the Edo period, there was a prescribed medicine and a patent one. The former was liquid preparation to be decocted and the latter was solid one. It took a lot of time to prepare a decoction medicine and it was troublesome work. A scene where a person was preparing a decoction medicine in a tumble-down house for a patient was often described in literature of the Edo period to express that they have a serious patent by a novelist. On the other hand, a solid preparation was handy to carry it and convenient for taking so that it was accepted by customers.

Dosage Forms↗
PubMed1994

[The inventive genius of pharmacists: invention patents 1836-1852].

The author calls attention to a documentation source neglected by French historians of pharmacy: invention patents. He shows how to take advantage of these documents, provides an example of their interest and analyzes globally the corpus of legally-approved patents by pharmacists from 1836 to 1852.

France↗
PubMed2001

Patent foramen ovale: pathophysiology and therapeutic options in symptomatic patients.

The foramen ovale, a remnant from the fetal circulation, remains patent through adulthood in approximately 1/4th of the general population, thus representing the most common persistent abnormality of fetal origin. In these individuals, the patent foramen ovale (PFO) permits interatrial right-to-left shunting during those periods of time when right atrial exceeds left atrial pressure. Recently, the pathophysiological aspects of the PFO have been increasingly appreciated, giving rise to disease manifestations such as paradoxical embolism, refractory hypoxemia in patients with right ventricular infarction or severe pulmonary disease, orthostatic desaturation in the setting of the rare platypnea-orthodeoxia syndrome, neurological decompression illness in divers, and migraine headache with aura. Despite the growing recognition of the PFO, particularly when associated with an atrial septal aneurysm, as risk factor for paradoxical embolism, the optimal treatment strategy for symptomatic patients remains undefined. Most patients with presumed paradoxical embolism are currently treated medically with antithrombotic medications, with a paucity of data concerning the efficacy of oral anticoagulant as opposed to antiplatelet therapy. Surgical PFO closure has proved feasible, but the procedure is associated with the well known complications of cardiac surgery, and the results have been mixed with respect to stroke prevention. The recent introduction of interatrial septal occlusion devices set the stage for a minimally invasive, percutaneous approach. The present article discusses the pathophysiology of the PFO, and the advantages and drawbacks of the different therapeutic options available for symptomatic patients.

Embolism, Paradoxical↗
PubMed2002

A novel technique to prevent displacement of inferior vena cava filter during cardiac catheterization with subsequent transcatheter closure of a patent foramen ovale in a patient with cryptogenic shock.

We describe a novel technique to prevent displacement of a previously implanted inferior vena cava filter in a patient with cryptogenic stroke who underwent transcatheter closure of a patent foramen ovale. This technique may be of use to patients with cryptogenic stroke who might benefit from transcatheter closure of their patent foramen ovale but would otherwise not be candidates for the procedure because of risk of dislodgement of previously implanted inferior vena cava filter.

Adult↗
PubMed2002

Combined percutaneous pulmonary valvuloplasty and patent foramen ovale closure in an adult with recurrent transient ischemic attacks.

We report the case of a 60-year-old man with a history of recurrent transient ischemic attacks, effort syncope, cyanosis, erythrocytosis and a systolic murmur. Echocardiography and catheterization showed severe pulmonary stenosis and a patent foramen ovale with a right-to-left shunt. The patient was submitted to combined percutaneous pulmonary valvuloplasty and patent foramen ovale closure using the Amplatzer device.

Cardiac Catheterization↗
PubMed1976

Patent ductus arteriosus in the dog: characteristics of occurrence and results of surgery in one hundred consecutive cases.

The results of surgical repair of patent ductus arteriosus (100 dogs) were compared with the results of nonsurgical treatment of this defect (14 dogs). The death rate for dogs surgically treated was 8%, with 2 deaths at surgery and 6 late postoperative deaths. In the nonsurgical group, 64% died within one year of the examination. The increased survival rate for the surgically treated group was significant ( P less than 0.001). Surgical death rate was high for dogs more than 2 years old and weighing more than 23 kg. It was concluded that surgery is the preferred method of treatment and that early surgery increases the survival rate of dogs with patent ductus arteriosus, compared with the survival rate for older, heavier dogs with the defect.

Animals↗
PubMed2003

Randomized, double-blind, placebo-controlled trial of oral artemether for the prevention of patent Schistosoma haematobium infections.

Artemether is an efficacious antimalarial drug that also displays antischistosomal properties. Laboratory studies have found that artemether curtails the development of adult worms of Schistosoma japonicum, S. mansoni and S. haematobium, and thus prevents morbidity. These findings have been confirmed in clinical trials for the former two parasites; administered orally once every 2-3 weeks, artemether significantly reduced the incidence and intensity of patent infections. Here, we present the first randomized, double-blind, placebo-controlled trial of artemether against S. haematobium, done in a highly endemic area of Côte d'Ivoire. Urine specimens from 440 schoolchildren were examined over 4 consecutive days, followed by two systematic praziquantel treatments 4 weeks apart. S. haematobium-negative children were randomized to receive 6 mg/kg artemether (N = 161) or placebo (N = 161). Medication was administered orally for a total of six doses once every 4 weeks. Adverse events were assessed 72 hours after medication, and perceived illness episodes were monitored throughout the study period. Incidence and intensity of S. haematobium infections, and microhematuria and macrohematuria were assessed 3 weeks after the final dosing. We also monitored malaria parasitemia and treated positive cases with sulfadoxine-pyrimethamine (SP). Oral artemether was well tolerated. The incidence of patent S. haematobium infections in artemether recipients was significantly lower than in placebo recipients (49% versus 65%, protective efficacy: 0.25, 95% CI: 0.08-0.38, P = 0.007). The geometric mean infection intensity in the artemether group was less than half that of the placebo recipients (3.4 versus 7.4 eggs/10 mL urine, P < 0.001). Heavy S. haematobium infections, microhematuria and macrohematuria, and the incidence of malaria parasitemia were all significantly lower in artemether recipients. In conclusion, previous findings of efficacy of artemether against S. japonicum and S. mansoni were confirmed for S. haematobium, although the protective efficacy was considerably lower. These findings enlarge the scope and potential of artemether and further contribute to discussions of its role as an additional tool for integrated schistosomiasis control.

Administration, Oral↗