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Query: UMLS:C0151744 (myocardial ischemia)
31,282 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Mortality was studied among 1271 employees of a cellulose fiber production plant in Rock Hill, South Carolina, in the United States. Each subject was employed for at least three months between 1 January 1954 and 1 January 1977 in jobs that entailed exposure to the highest concentrations of methylene chloride. In the cohort 122 deaths were identified through 1 September 1986, and mortality rates for the cohort were compared with mortality rates for York County, South Carolina. Deficit mortality was observed for cancers of the respiratory system, breast, and pancreas and from ischemic heart disease. Excess mortality was observed for cancers of the buccal cavity and pharynx and the liver and biliary tract, and for melanoma as well. The largest relative excess was for liver and biliary tract cancers. There were only four deaths in this category; however, three of the four deaths were cancer of the biliary tract (3 observed, 0.15 expected, standardized mortality ratio 20).
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PMID:Mortality of cellulose fiber production workers. 238 31

I describe methods of analysing possible aetiological factors in a follow-up survey, all of which are possible to carry out using the statistical package GENSTAT. A high haemoglobin level carried a significantly increased risk of ischaemic heart disease, and a low one an increased risk of cancer. Smoking was also an important factor. The increased risk was reasonably constant over time. Sugar intake and Quetelet's index did not significantly affect the relative risk.
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PMID:The analysis using GENSTAT of anaemia, sugar intake and quetelet's index as prognostic indicators in women. 664 37

Mortality ascertainment was extended through 1990 for a cohort of 1271 workers involved in the production of cellulose triacetate fiber at a plant in Rock Hill, South Carolina. Each subject was employed for at least three months between 1 January 1954 and 1 January 1977 in jobs that entailed exposure to the highest concentrations of methylene chloride. Median exposures in 1977 ranged from 140 to 745 ppm (8-h time-weighted average). The observed numbers of deaths from specific causes were compared with the expected numbers of deaths computed from rates in York County, South Carolina. For most causes of death, there was little if any association with employment. Among causes of particular interest, no new deaths were observed from cancer of the liver and biliary tract, although the excess from the earlier study persisted (4 observed, 1.34 expected). No excess mortality was observed for cancer of the pancreas (2 observed, 2.42 expected) or for ischemic heart disease (43 observed, 47.8 expected).
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PMID:Mortality update of cellulose fiber production workers. 815 96

The vaccinia virus forms two morphologically distinct infectious virus particles: intracellular mature virus (IMV) and extracellular enveloped virus (EEV). The envelope of EEV is a Golgi-derived membrane (wrapping membrane). A mutant (vRB10) lacks the ability to form the EEV. In medium containing a neutralizing antibody (2D5mAb), the vRB10 mutant was diluted out from infected cells, whereas the IHD-J strain of vaccinia virus replicated well. The result indicated that the 2D5mAb specifically neutralized the IMV. The 2D5-resistant EEV appeared at 6-7 hr postinfection, and over 65% of infectious virus in the culture fluid was EEV at 48 hr after infection. The EEV was resistant not only to the 2D5mAb but also against several neutralizing antibodies, including polyclonal antivaccinia serum reactive with proteins of the wrapping membrane. Freeze-thawing and other procedures that may damage the wrapping membrane converted the EEV to a form susceptible to the antibodies. Since specific infectivity was not affected by the damage or by exposure to antibody against the wrapping membrane proteins, the wrapping membrane did not directly participate in penetration. The infection process of vaccinia virus was analyzed by comparison of responses to acid treatment between normal IMV and trypsin-treated IMV. Proteolytically activated IMV infected rapidly responding to acid. The protected form virus, which was noninfectious under usual conditions, was proteolytically activated on cell membrane then responded to the acid. Proteolysis activated the virus, and an acidic condition accelerated fusion between the activated IMV and plasma membrane. The virus in the EEV wrapping membrane was the activated form that has the capacity to fuse with the cell membrane. However, the infection of intact EEV was more sensitive against lysosomotropic agents (NH4Cl, neutral red) than that of the trypsin-activated IMV. Resistance to the 2D5mAb, sensitivity to lysosomotropic agents, and acceleration of infection by acid suggested that the intact EEV penetrated by virus-endosome membrane fusion. The combined effect of the presence of wrapping membrane and the process of internalization via an endocytic mechanism rendered EEV resistant to neutralizing antibodies.
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PMID:Extracellular enveloped vaccinia virus escapes neutralization. 861 Apr 39

To evaluate the sensitivity of the serum cardiac troponin I level in detecting stress test-induced myocardial ischemia, the authors conducted a prospective study including patients admitted for chest pain to the telemetry floor of Our Lady of Mercy Medical Center at Bronx, NY. Consecutive 134 telemetry patients that agreed to participate in this study were included. All of these patients had a nuclear stress test and were divided into various groups based on the prestress test probability of having coronary artery disease. To assess serum cardiac troponin I levels, blood samples were drawn before and after stress testing and compared with the stress test results. Overall, 30 patients (22%) had reversible perfusion defects on stress images, and none (0%) had increased serum cardiac troponin I levels. One patient of 18 patients (6%) in group C with negative stress test results had an elevated serum cardiac troponin I level after the stress test, but none of group A or group B patients had elevated troponin I levels. These data show that serum cardiac troponin I levels do not increase with stress test-induced myocardial ischemia.
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PMID:Does the serum cardiac troponin I level increase with stress test-induced myocardial ischemia? 1214 81

The aim of this study was to assess the changes in hemodynamic function and myocardial perfusion of the left ventricle occurring in patients with type 1 diabetes mellitus (DM1) 47-49 months after the first assessment. We have studied 20 asymptomatic patients, five females and 15 males, aged 22-46 y. The patients were under intensive insulin treatment and had normal electrocardiogram (ECG) at rest. In all patients gated single photon emission tomography (GSPET) was performed at rest and after exercise (examination I). After 47-49 months this test was repeated (examination II). GSPET was performed 60 min after the intravenous injection of 740 MBq of technetium-99m 2-methoxy-isobutyl-isonitrile ((99m)Tc-MIBI), using a dual-headed gamma-camera. Left ventricular ejection fraction (LVEF), end diastolic volume (EDV) and end systolic volume (ESV) were calculated using quantitative GSPET (QGS). The intensity of perfusion defects was also evaluated based on a four degree QGS scale. Our results were as follows: a) In examination I, performed at rest: LVEF was 56.1%+/-7.5%, EDV 96.9+/-25.8 ml and ESV 42.6+/-16.3 ml. b) In examination I at stress: LVEF was 57.2%+/-7.5%, EDV 94.1+/-24.0 ml and ESV 40.5+/-15.5. c) In examination II performed at rest: LVEF was 58.1%+/-6.5%, EDV 112.1+/-26.1 ml and ESV 46.6+/-14.9 ml and d) In examination II at stress: LVEF 57.8%+/-5.6%, EDV 107.9+/-27.4 ml and ESV 44.9+/-14.4 ml. Significant differences were found between examinations I and II, regarding: a) EDV at rest (P<0.001) and at stress (P<0.001) and b) ESV at rest (P<0.05) and at stress (P<0.005). Correlation analysis revealed significant correlation between LVEF at rest and at stress both in examination I (r=0.83; P<0.001) and also in examination II (r=-0.897; P<0.001). Intensity of myocardial perfusion defects in examination I at rest and at stress was: 1.68+/-0.5 and 2.2+/-0.6 degrees respectively. Intensity of myocardial perfusion defects in examination II at rest and at stress was: 1.75+/-0.4 and 2.2+/-0.5 respectively. No significant differences in the intensity of these perfusion defects were found. EDV both at rest and at stress was significantly higher in examination II as compared with the examination I study. Similar, but less pronounced changes of ESV were found. This study confirms other authors' observations on LV, EDV and LV, ESV and also that the percentage of asymptomatic DM1 patients having silent myocardial ischemia is high as was in all our patients. Nevertheless, in the current literature, we were unable to find a study similar to the present one, comparing basal and after four years LV functional GSPET data, in asymptomatic DM1 patients. In conclusion, myocardial perfusion GSPET was useful as a screening test in DM1 patients in showing four years after the basal study, prodromal signs of cardiovascular disease, especially increase of left ventricular volumes and silent myocardial ischemia, in these patients. Our research on the above protocol is being continued.
Hell J Nucl Med
PMID:Evaluation of the left ventricular hemodynamic function and myocardial perfusion by gated single photon emission tomography, in patients with type 1 diabetes mellitus; prodromal signs of cardiovascular disease after four years. 1689 11

Plant materials derived from the Aloe plant are used as cosmetic ingredients, including Aloe Andongensis Extract, Aloe Andongensis Leaf Juice, Aloe Arborescens Leaf Extract, Aloe Arborescens Leaf Juice, Aloe Arborescens Leaf Protoplasts, Aloe Barbadensis Flower Extract, Aloe Barbadensis Leaf, Aloe Barbadensis Leaf Extract, Aloe Barbadensis Leaf Juice, Aloe Barbadensis Leaf Polysaccharides, Aloe Barbadensis Leaf Water, Aloe Ferox Leaf Extract, Aloe Ferox Leaf Juice, and Aloe Ferox Leaf Juice Extract. These ingredients function primarily as skin-conditioning agents and are included in cosmetics only at low concentrations. The Aloe leaf consists of the pericyclic cells, found just below the plant's skin, and the inner central area of the leaf, i.e., the gel, which is used for cosmetic products. The pericyclic cells produce a bitter, yellow latex containing a number of anthraquinones, phototoxic compounds that are also gastrointestinal irritants responsible for cathartic effects. The gel contains polysaccharides, which can be acetylated, partially acetylated, or not acetylated. An industry established limit for anthraquinones in aloe-derived material for nonmedicinal use is 50 ppm or lower. Aloe-derived ingredients are used in a wide variety of cosmetic product types at concentrations of raw material that are 0.1% or less, although can be as high as 20%. The concentration of Aloe in the raw material also may vary from 100% to a low of 0.0005%. Oral administration of various anthraquinone components results in a rise in their blood concentrations, wide systemic distribution, accumulation in the liver and kidneys, and excretion in urine and feces; polysaccharide components are distributed systemically and metabolized into smaller molecules. aloe-derived material has fungicidal, antimicrobial, and antiviral activities, and has been effective in wound healing and infection treatment in animals. Aloe barbadensis (also known as Aloe vera)-derived ingredients were not toxic in acute oral studies using mice and rats. In parenteral studies, the LD(50) using mice was > 200 mg/kg, rats was > 50 mg/kg, and using dogs was > 50 mg/kg. In intravenous studies the LD(50) using mice was > 80 mg/kg, rats was > 15 mg/kg, and dogs was > 10 mg/kg. The 14-day no observed effect level (NOEL) for the Aloe polysaccharide, acemannan, in the diet of Sprague-Dawley rats, was 50,000 ppm or 4.1 to 4.6 g/kg day(-1). In a 3-month study using mice, Aloe vera (extracted in ethanol) given orally in drinking water at 100 mg/kg produced reproductive toxicity, inflammation, and mortality above that seen in control animals. Aloe vera extracted in methanol and given to mice at 100 mg/kg in drinking water for 3 months caused significant sperm damage compared to controls. Aloe barbadensis extracted with water and given to pregnant Charles Foster albino rats on gestational days (GDs) 0 through 9 was an abortifacient and produced skeletal abnormalities. Both negative and positive results were found in bacterial and mammalian cell genotoxicity assays using Aloe barbadensis-derived material, Aloe Ferox-derived material, and various anthraquinones derived from Aloe. Aloin (an anthraquinone) did not produce tumors when included in the feed of mice for 20 weeks, nor did aloin increase the incidence of colorectal tumors induced with 1,2-dimethylhydrazine. Aloe-emodin (an anthraquinone) given to mice in which tumor cells had been injected inhibited growth of malignant tumors. Other animal data also suggest that components of Aloe inhibit tumor growth and improve survival. Various in vitro assays also demonstrated anticarcinogenic activity of aloe-emodin. Diarrhea was the only adverse effect of note with the use of Aloe-derived ingredients to treat asthma, ischemic heart disease, diabetes, ulcers, skin disease, and cancer. Case reports include acute eczema, contact urticaria, and dermatitis in individuals who applied Aloe-derived ingredients topically. The Cosmetic Ingredient Review Expert Panel concluded that anthraquinone levels in the several Aloe Barbadensis extracts are well understood and can conform to the industry-established level of 50 ppm. Although the phototoxicity anthraquinone components of Aloe plants have been demonstrated, several clinical studies of preparations derived from Aloe barbadensis plants demonstrated no phototoxicity, confirming that the concentrations of anthraquinones in such preparations are too low to induce phototoxicity. The characterization of aloe-derived ingredients from other species is not clear. In the absence of well-characterized derivatives, biological studies of these materials are considered necessary. The studies needed are 28-day dermal toxicity studies on Aloe Andongensis Extract, Aloe Andongensis Leaf Juice, Aloe Arborescens Leaf Extract, Aloe Arborescens Leaf Juice, Aloe Ferox Leaf Extract, Aloe Ferox Leaf Juice, and Aloe Ferox Leaf Juice (ingredients should be tested at current use concentrations). In Aloe-derived ingredients used in cosmetics, regardless of species, anthraquinone levels should not exceed 50 ppm. The Cosmetic Ingredient Review Expert Panel advised the industry that the total polychlorobiphenyl (PCB)/pesticide contamination of any plant-derived cosmetic ingredient should be limited to not more than 40 ppm, with not more than 10 ppm for any specific residue and that limits were appropriate for the following impurities: arsenic (3 mg/kg maximum), heavy metals (20 mg/kg maximum), and lead (5 mg/kg maximum).
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PMID:Final report on the safety assessment of AloeAndongensis Extract, Aloe Andongensis Leaf Juice,aloe Arborescens Leaf Extract, Aloe Arborescens Leaf Juice, Aloe Arborescens Leaf Protoplasts, Aloe Barbadensis Flower Extract, Aloe Barbadensis Leaf, Aloe Barbadensis Leaf Extract, Aloe Barbadensis Leaf Juice,aloe Barbadensis Leaf Polysaccharides, Aloe Barbadensis Leaf Water, Aloe Ferox Leaf Extract, Aloe Ferox Leaf Juice, and Aloe Ferox Leaf Juice Extract. 1761 30

Technetium-99m-tetrofosmin ((99m)Tc-TF) myocardial perfusion studies have incidentally detected various extracardiac abnormalities. The interpretation of these findings may be essential for early diagnosis and treatment of important diseases. We present a rare case of a mediastinal thymoma incidently detected during myocardial perfusion imaging. A 60 year-old woman, with precardiac symptoms of possible myocardial ischemia, underwent a (99m)Tc-TF stress-rest single photon emission tomography test. Intense uptake of the radiotracer in the left paracardiac area, was observed. The computerized tomography and the magnetic resonance imaging tests revealed a mass in the left lower anterior mediastinal area. Biopsy and subsequent histology showed that this mass was a thymoma.
Hell J Nucl Med
PMID:Incidental pathologic extracardiac uptake of 99mTc-tetrofosmin in myocardial perfusion imaging. 2080 94

We conducted an extended follow-up and spatial analysis of the American Cancer Society (ACS) Cancer Prevention Study II (CPS-II) cohort in order to further examine associations between long-term exposure to particulate air pollution and mortality in large U.S. cities. The current study sought to clarify outstanding scientific issues that arose from our earlier HEI-sponsored Reanalysis of the original ACS study data (the Particle Epidemiology Reanalysis Project). Specifically, we examined (1) how ecologic covariates at the community and neighborhood levels might confound and modify the air pollution-mortality association; (2) how spatial autocorrelation and multiple levels of data (e.g., individual and neighborhood) can be taken into account within the random effects Cox model; (3) how using land-use regression to refine measurements of air pollution exposure to the within-city (or intra-urban) scale might affect the size and significance of health effects in the Los Angeles and New York City regions; and (4) what exposure time windows may be most critical to the air pollution-mortality association. The 18 years of follow-up (extended from 7 years in the original study [Pope et al. 1995]) included vital status data for the CPS-II cohort (approximately 1.2 million participants) with multiple cause-of-death codes through December 31, 2000 and more recent exposure data from air pollution monitoring sites for the metropolitan areas. In the Nationwide Analysis, the influence of ecologic covariate data (such as education attainment, housing characteristics, and level of income; data obtained from the 1980 U.S. Census; see Ecologic Covariates sidebar on page 14) on the air pollution-mortality association were examined at the Zip Code area (ZCA) scale, the metropolitan statistical area (MSA) scale, and by the difference between each ZCA value and the MSA value (DIFF). In contrast to previous analyses that did not directly include ecologic covariates at the ZCA scale, risk estimates increased when ecologic covariates were included at all scales. The ecologic covariates exerted their greatest effect on mortality from ischemic heart disease (IHD), which was also the health outcome most strongly related with exposure to PM2.5 (particles 2.5 microm or smaller in aerodynamic diameter), sulfate (SO4(2-)), and sulfur dioxide (SO2), and the only outcome significantly associated with exposure to nitrogen dioxide (NO2). When ecologic covariates were simultaneously included at both the MSA and DIFF levels, the hazard ratio (HR) for mortality from IHD associated with PM2.5 exposure (average concentration for 1999-2000) increased by 7.5% and that associated with SO4(2-) exposure (average concentration for 1990) increased by 12.8%. The two covariates found to exert the greatest confounding influence on the PM2.5-mortality association were the percentage of the population with a grade 12 education and the median household income. Also in the Nationwide Analysis, complex spatial patterns in the CPS-II data were explored with an extended random effects Cox model (see Glossary of Statistical Terms at end of report) that is capable of clustering up to two geographic levels of data. Using this model tended to increase the HR estimate for exposure to air pollution and also to inflate the uncertainty in the estimates. Including ecologic covariates decreased the variance of the results at both the MSA and ZCA scales; the largest decrease was in residual variation based on models in which the MSA and DIFF levels of data were included together, which suggests that partitioning the ecologic covariates into between-MSA and within-MSA values more completely captures the sources of variation in the relationship between air pollution, ecologic covariates, and mortality. Intra-Urban Analyses were conducted for the New York City and Los Angeles regions. The results of the Los Angeles spatial analysis, where we found high exposure contrasts within the Los Angeles region, showed that air pollution-mortality risks were nearly 3 times greater than those reported from earlier analyses. This suggests that chronic health effects associated with intra-urban gradients in exposure to PM2.5 may be even larger between ZCAs within an MSA than the associations between MSAs that have been previously reported. However, in the New York City spatial analysis, where we found very little exposure contrast between ZCAs within the New York region, mortality from all causes, cardiopulmonary disease (CPD), and lung cancer was not elevated. A positive association was seen for PM2.5 exposure and IHD, which provides evidence of a specific association with a cause of death that has high biologic plausibility. These results were robust when analyses controlled (1) the 44 individual-level covariates (from the ACS enrollment questionnaire in 1982; see 44 Individual-Level Covariates sidebar on page 22) and (2) spatial clustering using the random effects Cox model. Effects were mildly lower when unemployment at the ZCA scale was included. To examine whether there is a critical exposure time window that is primarily responsible for the increased mortality associated with ambient air pollution, we constructed individual time-dependent exposure profiles for particulate and gaseous air pollutants (PM2.5 and SO2) for a subset of the ACS CPS-II participants for whom residence histories were available. The relevance of the three exposure time windows we considered was gauged using the magnitude of the relative risk (HR) of mortality as well as the Akaike information criterion (AIC), which measures the goodness of fit of the model to the data. For PM2.5, no one exposure time window stood out as demonstrating the greatest HR; nor was there any clear pattern of a trend in HR going from recent to more distant windows or vice versa. Differences in AIC values among the three exposure time windows were also small. The HRs for mortality associated with exposure to SO2 were highest in the most recent time window (1 to 5 years), although none of these HRs were significantly elevated. Identifying critical exposure time windows remains a challenge that warrants further work with other relevant data sets. This study provides additional support toward developing cost-effective air quality management policies and strategies. The epidemiologic results reported here are consistent with those from other population-based studies, which collectively have strongly supported the hypothesis that long-term exposure to PM2.5 increases mortality in the general population. Future research using the extended Cox-Poisson random effects methods, advanced geostatistical modeling techniques, and newer exposure assessment techniques will provide additional insight.
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PMID:Extended follow-up and spatial analysis of the American Cancer Society study linking particulate air pollution and mortality. 1962 30

Several techniques have been applied for the assessment of severe congenital heart diseases (SCHD) including echocardiography, cardiac catheterization with angiocardiography, and more recently, cardiovascular multi detector tomography and magnetic resonance imaging (MRI). The value of gated single photon emission tomography (GSPET) myocardial perfusion imaging (MPI) and radionuclide ventriculography (RNV) for evaluating myocardial ischemia, tissue viability, and left ventricular function in SCHD is less apparent. The risk of radiation exposure is greatest in the youngest patients. Both, GSPET MPI and RNV seem to be underutilized in pediatric clinical practice due to increased radiation exposure. We have reviewed basic and specific technical and diagnostic aspects, as well as specific clinical indications of GSPET MPI and RNV in children with SCHD in comparison with other cardiology methods. Some of our own tests are also presented where they apply. In conclusion, GSPET MPI and RNV can provide clinical relevant information of functional significance of SCHD in pediatric patients especially when the other cardiology methods are indeterminate. With regard to radiation exposure appropriate patient selection and recommendations for reduction of radiation exposure are of great importance.
Hell J Nucl Med
PMID:The diagnostic role of gated myocardial perfusion imaging and radionuclide ventriculography in severe congenital heart disease. 2208 51


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