Influence of acetazolamide and CO2 on extracranial flow volume and intracranial blood flow velocity.

Background And Purpose: The vasomotor response can be tested by means of transcranial Doppler sonography. If a constant vessel diameter is assumed, the flow velocity changes will reflect blood flow volume changes. This hypothesis is difficult to verify.

[Treatment with stents in the upper gastrointestinal tract].

A wide range of therapeutic methods for treatment of malignant and benign stenoses of the upper gastrointestinal tract is at one's disposal with esophageal mechanical dilatation, laser therapy, insertion of plastic tubes and stent implantation. It has become routine to insert flexible metal stents in the treatment of esophageal carcinoma and tracheoesophageal fistula. Case reports exist describing the use of flexible metal stents in complicated benign esophageal stenoses of stomach and duodenum.

Increased baseline levels of platelet P-selectin, and platelet-endothelial cell adhesion molecule-1 in patients with acute myocardial infarction as predictors of unsuccessful thrombolysis.

Background: Platelets play a pivotal role in the pathogenesis of acute myocardial infarction and their activation can cause thrombolysis to fail.

Methods: Baseline aggregation of platelets and expression of major surface receptors measured by flow cytometry were compared with clinical outcome after thrombolysis for 23 patients enrolled in the GUSTO-III trial.

Results: Failure to reperfuse (n = 3) and recurrent ischemia (n = 2) were observed in five patients who subsequently underwent emergency angioplasty.

Effect of beta-adrenoceptor stimulation on oxygen consumption and triglyceride/fatty acid cycling after exercise.

The purpose of this study was to characterize the effects of prolonged beta-adrenoceptor stimulation on O2 uptake and triglyceride/fatty acid (TG/FA) cycling during rest with and without previous exercise. Eight men performed two exercise (90 min cycling at 56 +/- 3 (SD)% of maximal O2 uptake, followed by 4.5 h bed rest) and two rest-control experiments.

Normal bone mass in bulimic women.

The aim of this study was to examine the relationship among exercise, menstrual function, and bone mineral density (BMD) in different groups of age-matched patients with eating disorders. Dieting and eating disorder history, physical activity history, and menstrual history were assessed by clinical interview in 43 bulimic and 13 anorectic young women as well as in 17 healthy control subjects (18-29 yr). BMD was assessed by dual x-ray absorptiometry.

Antecedent aspirin therapy inhibits baseline platelet activity in patients presenting with acute myocardial infarction. The GUSTO-III Platelet Substudy.

Aspirin therapy and platelet inhibition reduce the risk for the development of acute myocardial infarction (AMI). However, the effects of aspirin on baseline platelet activity in patients presenting with AMI are not known. We determined the effect of long-term aspirin use on baseline platelet activity in patients presenting with AMI, enrolled in the GUSTO-III Platelet Study.

A prospective cohort study of anterior cruciate ligament injuries in elite Norwegian team handball.

The purpose of this study was to examine gender differences in the incidence of anterior cruciate ligament (ACL) injuries in a population of high-level team handball players. We also wanted to examine injury mechanisms and possible risk factors for ACL injuries, including menstrual status. The study was done prospectively during the 1993-94, 1994-95, and 1995-96 seasons.

The concept and the development of chest pain emergency departments as a strategy in the war against heart attack.

Critical nurses in the CPED can have a very fulfilling role in expanding their influence within the hospital setting, as well as within the community to become part of the needed change to significantly reduce deaths from MI in the United States. The mission impossible becomes possible when critical care nurses are part of this challenging process. Nowhere can these efforts be better started than in emergency department committed to continuous quality improvement changes under this new paradigm.

Effects of reteplase and alteplase on platelet aggregation and major receptor expression during the first 24 hours of acute myocardial infarction treatment. GUSTO-III Investigators. Global Use of Strategies to Open Occluded Coronary Arteries.

Objectives: We sought to compare platelet characteristics after reteplase and alteplase therapy in the setting of the Global Use of Strategies to Open Occluded Coronary Arteries (GUSTO)-III trial.

Background: Platelet function may be impaired during thrombolysis in patients with an acute myocardial infarction. The effects of reteplase and alteplase on platelet aggregation and major surface antigen expression during the first 24 h of infarction therapy are unknown.

Ligament force and joint motion in the intact ankle: a cadaveric study.

The aims of this study were to measure the forces in the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) and the motion in the tibiotalar and subtalar joints during simulated weight-bearing in eight cadaver ankle specimens. An MTS test machine was used to apply compressive loads to specimens held in a specially designed testing apparatus in which the ankle position (dorsiflexion-plantarflexion and supination-pronation) could be varied in a controlled manner. The forces in the ATFL and CFL were measured with buckle transducers.

Adrenergic control of post-exercise metabolism.

After strenuous exercise there is a sustained increase in resting O2 consumption. The magnitude and duration of the excess post-exercise O2 consumption (EPOC) is a function of exercise intensity and exercise duration. Some of the mechanisms underlying the rapid EPOC component (<1 h) are well defined, while the mechanisms causing the prolonged EPOC component (>1 h) are not fully understood.

Hemisection and vital treatment of a fused tooth--literature review and case report.

Fusion and gemination of permanent teeth are developmental anomalies of the dental hard tissues which may require endodontic and surgical treatment for functional, orthodontic or aesthetic reasons. Following a review of the dental literature on tooth fusion and gemination, a case of fusion of a maxillary central incisor and a supernumerary tooth and its endodontic and surgical treatment is presented.

Effect of beta-adrenoceptor blockade on postexercise oxygen consumption and triglyceride/fatty acid cycling.

In the recovery period after strenuous exercise, there is increased O2 uptake, termed the excess postexercise O2 consumption (EPOC). One of the mechanisms suggested to explain EPOC is activation of the triglyceride/fatty acid (TG/FA) cycle by catecholamines. The purpose of this study was to determine the effect of selective beta1- and nonselective beta-adrenoceptor blockade on EPOC and the TG/FA cycle.

Prevalence of doping in sports: doping control in Norway, 1977-1995.

Objective: To examine the results from doping controls conducted by the Norwegian Confederation of Sport (NCS) from 1977 to 1995.

Methods: Data were collected by combining three computerized databases and manual records on samples taken and results from analyses in the International Olympic Committee (IOC)-accredited laboratories in London, Huddinge, Cologne, and Oslo. Samples were declared positive if they contained any banned substance on the IOC list that was in effect at any given time.

Depressed platelet status in an elderly patient with hemorrhagic stroke after thrombolysis for acute myocardial infarction. GUSTO-III Investigators.

Background: Impaired platelet function has been reported in acute myocardial infarction (AMI) and stroke. However, prospective data on the changes of platelet status in patients before the occurrence of hemorrhagic stroke after thrombolytic therapy are unavailable.

Case Description: An 86-year-old male patient was among the 23 AMI patients enrolled in the platelet study for the GUSTO-III trial.

Mechanics of the anterior drawer and talar tilt tests. A cadaveric study of lateral ligament injuries of the ankle.

We analyzed the changes in lateral ligament forces during anterior drawer and talar tilt testing and examined ankle joint motion during testing, following an isolated lesion of the anterior talofibular ligament (ATFL) or a combined lesion of the ATFL and calcaneofibular ligament (CFL). 8 cadaver specimens were held in a specially designed testing apparatus in which the ankle position (dorsiflexion-plantarflexion and supination-pronation) could be varied in a controlled manner. Ligament forces were measured with buckle transducers, and joint motion was measured with an instrumented spatial linkage.

Biomechanics of ankle ligament reconstruction. An in vitro comparison of the Broström repair, Watson-Jones reconstruction, and a new anatomic reconstruction technique.

We wanted to use biomechanical testing in a cadaveric model to compare the Broström repair, the Watson-Jones reconstruction, and a new anatomic reconstruction method. Eight specimens were held in a specially designed testing apparatus in which the ankle position (dorsiflexion-plantar flexion and supination-pronation) could be varied in a controlled manner. Testing was done with intact ligaments and was repeated after sectioning of the anterior talofibular ligament and the calcaneofibular ligament and after a Broström repair, a Watson-Jones reconstruction, and a new anatomic reconstruction were performed.

A twofold reduction in the incidence of acute ankle sprains in volleyball after the introduction of an injury prevention program: a prospective cohort study.

The purpose of this study was to examine the effects of an injury prevention program, consisting mainly of an injury awareness session, technical training (with emphasis on proper take-off and landing technique for blocking and attacking) and a balance board training program, for players with recurrent sprains. Baseline data were collected during the 1992-93 season and the program was introduced during the 1993-94 season. The 1994-95 season was used to evaluate the effects of the prevention program.

Incidence of acute volleyball injuries: a prospective cohort study of injury mechanisms and risk factors.

The purpose of the study was to examine the incidence and mechanisms of acute volleyball injuries, with particular reference to possible risk factors for ankle injuries. Coaches and players in the top two divisions of the Norwegian Volleyball Federation were asked to keep records of exposure time and all acute volleyball injuries causing a player to miss at least one playing day during one season. We found 89 injuries among 272 players during 51588 player hours, 45837 h of training and 5751 h of match play.

A path forward for chest pain care: what are the expectations of each team member?

It would be impossible to expect that an immediate solution to the heart attack problem in the United States can come out of this multidisciplinary conference. A more practical goal would be the conferees coming together, seeing better what needs to be done, and using interpretative abilities to put together a logical approach which would unite both the community hospital and the community by the first step on the learning curve. Future progress will come about from the multidisciplinary team with research studies and a commitment to solving this problem on a local level.

Can Maryland become the first state to take heart disease out of first place where it has been since the turn of the century?

Heart disease has been the number one health problem in the United States since the turn of the century. It kills more Americans each year than all the American soldiers killed in all of this country's previous wars. Does it have to continue? Can this be reversed with re-engineering of information presently available? The hypothesis postulated here is that if a strategy can be successfully carried out in one state, then other states may be able to follow and pursue other strategies attempting to do the same.

The early heart attack care strategy in the war against heart attack deaths utilizing the chest pain center approach in emergency departments.

The focus of this symposium is Maryland's heart attack problem. The question is: Can the known evidence-based data on heart attacks be interpreted and applied in a systematic way that will unite efforts to reduce the significant heart attack deaths within the state? To determine this we need to go beyond what is currently being done and aim at a higher level of performance. Despite the medical advances in clot-dissolving therapies and minimally invasive surgeries, the acute prevention of heart attack death and damage has not been substantial.