bluuebunny/crossref_metadata_2025 huggingface dataset:
Left ventricular apical ballooning: Not an uncommon variant of acute myocardial infarction in women
Authors: Elian Dan , Osherov Azriel , Matetzky Shlomi , Hod Hanoch , Guetta Victor , Feinberg Micha S. , Segni Elio Di
Published: June 2007

Background: Left ventricular apical ballooning, anew syndrome recently described in Japan, is characterized by chest pain, electrocardiographic changes mimicking acute myocardial infarction, and transient apical dyskinesia with normal coronary arteries. Although several studies have defined the clinical characteristics, the prevalence of this syndrome remains unclear.

Hypothesis: This study sought to determine the prevalence of left ventricular apical ballooning syndrome.

Methods: From January 2002 to September 2004, clinical, echocardiographic, and angiographic data of hospitalization and follow‐up were collected from 638 consecutive patients referred to our Heart Institute for primary percutaneous intervention.

Results: Thirteen patients (2%) were diagnosed with transient left ventricular apical ballooning. All but one patient were women, representing a 6% incidence for the female patients with acute myocardial infarction. A triggering factor was identified in eight. One patient died of cardiogenic shock. Left ventricular systolic function recovered completely within 4–5 weeks in the remaining 12 survivors.

Conclusion: This syndrome is not uncommon and should be considered particularly in female patients presenting with acute myocardial infarction.
Effect of statins and white blood cell count on mortality in patients with ischemic left ventricular dysfunction undergoing percutaneous coronary intervention
Authors: Lipinski Michael J. , Martin Robert E. , Cowley Michael J. , Goudreau Evelyne , Malloy Walter N. , Johnson Robert E. , Vetrovec George W.
Published: June 2007

Background: While morbidity and mortality were shown to be increased in the setting of an elevated white blood cell (WBC) count for patients with acute coronary syndrome, the impact of statin therapy on mortality for patients with an elevated WBC count is unknown in high‐risk patients with coronary artery disease.

Hypothesis: The goal of this study was to determine whether statin therapy improved survival in patients with elevated WBC count undergoing percutaneous coronary intervention (PCI) with preexisting left ventricular (LV) dysfunction, a population at high risk for adverse outcomes.

Methods: We retrospectively evaluated consecutive patient procedures performed at our institution from 1996 through 1999. Patients had a technically adequate angiographic left ventriculogram with a calculated ejection fraction(EF) ≤ 50%. Patients with prior coronary artery bypass graft were excluded. Mortality data were retrieved using the U.S. Social Security Death Index. Follow‐up ranged from 3.5 to 6.5 years. Means are provided with ± standard deviation, and p values <0.05 were considered significant.

Results: Of the study population of 238 patients (average EF 39 ± 9.8%, mean age 57.5 ± 12 years, 68% men) 61%un‐derwent PCI for a recent myocardial infarction, 68% received stents, and 65% were discharged on statins. Mean WBC count was 9,000 ± 3,100 cells/mm3, with 28% of patients having a WBC ≥ 10,000 cells/mm3. During follow‐up, 27% of our population died. Patients with a WBC ≥ 10,000 had worse survival than patients with WBC < 10,000 (1‐year survival: 86 vs. 96%, p<0.05; 3‐year survival: 79 vs. 89%, p<0.05). Survival was significantly improved in patients on statin therapy regardless of WBC count, but the greatest benefit tended to be in patients with WBC ≥ 10,000 (WBC ≥ 10,000; odds ratio [OR] 5.14, 95% confidence interval [CI] 1.44–19.0, WBC < 10,000; OR 2.79,95% CI 1.13–7.1). Proportional hazard regression analysis demonstrated that both statin therapy and WBC count predicted mortality.

Conclusion: Patients undergoing PCI with LV dysfunction discharged on statins had improved survival regardless of WBC count, with a trend for greater improvement in patients with elevated WBC counts. In addition, WBC count predicts mortality in this high‐risk population with LV dysfunction undergoing PCI.
Use and side‐effect profile of spironolactone in a private cardiologist's practice
Authors: Williams Eric M. , Katholi Richard E. , Karambelas Marcey R.
Published: June 2007

Background: The beneficial effects of spironolactone on the treatment of cardiovascular diseases are well known, but translating these benefits into private practice can be difficult because of the drug's side‐effect profile.

Hypothesis: When patients are monitored over the long term, spironolactone can be used safely with an acceptable side‐effect profile.

Methods: We retrospectively studied 762 patients taking spironolactone over a 7‐year period in a cardiologist's referral‐based practice and monitored them for side effects from the medication.

Results: Data were available on 762 patients. The average age of our patients when started on the medication was 67.2 ±0.5 years. Of these, 585 (76.8%) patients were treated for heart failure and 155 (20.3%) for hypertension. An average dose of 3 8.4 ± 1.4 mg of spironolactone was used for treatment of all conditions. Of the 762 patients, 81 (10.6%) experienced side effects while using the medication; 40 had hyperkalemia (5.3%), 14 had gynecomastia (1.8%), and 15 had gastritis (2%). Of the patients with hyperkalemia, average creatinine clearance decreased from 64.6 ±5.8 ml/min at therapy start to 50.3 ±5.5 ml/min at the time of onset of side effects.

Conclusion: Spironolactone can be used with an acceptable side‐effect profile as long as patients are monitored long‐term while receiving the medication.
Depression and thyroid axis function in coronary artery disease: Impact of cardiac impairment and gender
Authors: Bunevicius Robertas , Varoneckas Giedrius , Prange Arthur J. , Hinderliter Alan L. , Gintauskiene Vilte , Girdler Susan S.
Published: June 2007

Background: Increased rates of depression are reported in coronary artery disease (CAD). In heart disease, depression increases disability, reduces quality of life, and increases mortality.

Hypothesis: The study was undertaken to examine the relationship between depression and thyroid axis function in patients with CAD.

Methods: In all, 73 patients with CAD, consecutively admitted to a cardiac rehabilitation hospital, were assessed for depression using the Hospital Anxiety and Depression scale (HADS). Blood was drawnfor assessment of thyroid axis hormones and the N‐amino terminal fragment of the pro‐B‐type natriuretic peptide (NT‐pro BNP).

Results: The patients with CAD with depressive symptoms had a higher prevalence of cardiac failure (p = 0.04), higher NT‐pro BNP concentrations (p = 0.02), and lower free tri‐iodothyronine (T3) concentrations (p = 0.04) than patients with CAD but without depressive symptoms. They also showed a strong trend (p = 0.058) toward a higher incidence of the low T3 syndrome. Higher NT‐pro BNP concentrations were related to lowertotal T3 concentrations (r = ‐0.294, p = 0.011) and to higher reverse T3 concentrations (r = 0.353, p = 0.002). In men, higher scores of depression were related to lower total T3 concentration (r = ‐0.289, p = 0.034) and to higher NT‐pro BNP concentration (r = 0.380, p = 0.005).

Conclusion: These findings suggest that symptoms of depression in patients with CAD are associated with changes in thyroid axis function and with cardiac impairment, especially in men.
Prevention of vascular events in patients with cerebrovascular disease: Efficacy and appropriate duration of antiplatelet therapy
Authors: Habib Gabriel B.
Published: June 2007

Antiplatelet therapy has shown consistent benefit in the prevention of secondary stroke. The paucity of head‐to‐head studies of different antiplatelet regimens, assessment of comparative efficacy, and optimal treatment duration requires evaluation and comparison of clinical studies that vary extensively in design and follow‐up. Evidence for aspirin benefit in secondary stroke prevention is strong, but existing studies provide little guidance with regard to treatment duration. The efficacy of clopidogrel in secondary event prevention is significantly greater than that of aspirin for patients with a history of peripheral artery disease, but does not differ from that of aspirin for patients with a history of stroke or myocardial infarction. Relative to clopidogrel alone, the addition of aspirin to clopidogrel results in increased risk for life‐threatening bleeding episodes similar in absolute magnitude to the reduction of secondary event risk in patients with stroke. Benefits associated with clopidogrel occur early in the course of therapy; few data support clopidogrel use for longer than 1 year after stroke. Monotherapy with extended‐release dipyridamole (ER‐DP) provides reduction in secondary stroke risk similar to aspirin; however, the combination of aspirin plus ER‐DP significantly reduces risk relative to either agent alone. Compared with placebo and monotherapy with either agent, risk reduction for the aspirin plus ER‐DP combination continued through 24 months, with no concomitant increase in bleeding risk. Additional clinical studies should provide needed comparisons of efficacy and guidance with regard to optimal duration of therapy.
In‐hospital mortality among women undergoing contemporary elective percutaneous coronary intervention: A reexamination of the gender gap
Authors: Narins Craig R. , Ling Frederick S. , Fischi Michael , Peterson Derick R. , Bausch Janice , Zareba Wojciech
Published: June 2007

Background: Previous studies have indicated that, compared with men, women are at increased risk for in‐hospital mortality following percutaneous coronary intervention (PCI); however, angioplasty techniques and mortality rates have improved since earlier reports.

Hypothesis: We sought to reevaluate and explore further the relationship between gender and angioplasty outcomes in contemporary “real world” practice.

Methods: The influence of gender and other covariates on in‐hospital mortality and other adverse events among all patients who underwent elective coronary angioplasty in New York State from 1999 to 2001 (n= 106,262) was examined.

Results: In‐hospital mortality rates for elective angioplasty were low; however, women demonstrated a two‐fold mortality excess compared with men (0.6vs. 0.3%, p<0.0001). Women were older and more likely than men to demonstrate certain higher‐risk features (heart failure, class III‐IV angina, renal failure, vascular disease); however, men were more likely to have depressed ejection fraction, prior myocardial infarction, and prior coronary revascularization. Using multivariate analysis adjusting for clinical risk factors, gender remained an independent predictor of in‐hospital mortality at all ages. Women were also more likely to experience nonfatal adverse events following PCI, including more frequent need for emergency bypass surgery.

Conclusions: Despite improvements in angioplasty outcomes with time, women remain at significantly higher risk of in‐hospital death than men after elective PCI. This increased mortality is observed in every age group, even after adjusting for other significant comorbidities.
Insufficient treatment of hypercholesterolemia among patients hospitalized with chest pain
Authors: Howell Eric E. , Wright Scott M. , Bush David E. , Chandra‐Strobos Nisha , Henrikson Charles A.
Published: June 2007

Background: Although morbidity and mortality from coronary artery disease can be improved with a variety of pharmacologic interventions, many patients remain undertreated.

Hypothesis: This study sought to assess whether hospitalization for possible coronary artery disease would prompt initiation of appropriate lipid‐lowering therapy.

Methods: This prospective, observational study was conducted on consecutive patients with active chest pain admitted to the Emergency Department of the hospital for suspected myocardial ischemia. Elevated cholesterol, defined as low‐density lipoprotein (LDL), was > 100 mg/dl with a prior history or a new diagnosis of coronary artery disease, or an LDL > 130 mg/dl without known coronary artery disease. Data were recorded at the time of admission, discharge, and at 4‐month follow‐up.

Results: Of the patients with hyperlipidemia, 65% men and 55% women were on medication at the time of admission (p = 0.30), while at discharge, 79% men and 60% women were on treatment (p = 0.002), with similar rates of treatment at 4‐monthfollow‐up (p = 0.030). At discharge, two variables were independently associated with patients receiving lipid‐lowering therapy: age ≥ 65 years (odds ratio = 2.3; 95% confidence interval 1.2–4.5) and male gender (2.7; 15–5.0).

Conclusions: In patients hospitalized with chest pain, particularly in women, the initiation of treatment of hyperlipidemia frequently does not happen. This oversight represents a lost opportunity for making an impact on the health of this population.
Arterial baroreflex sensitivity is a good predictor of inotropic responses to a phosphodiesterase inhibitor in human heart failure
Authors: Sato Naoki , Yamamoto Takeshi , Akutsu Koichi , Fujita Nobuhiko , Asai Kuniya , Takayama Morimasa , Takano Teruo , Tanaka Keiji
Published: June 2007

Background: Experimental study has shown that blunted arterial baroreflex function markedly attenuated inotropic responses to a phosphodiesterase inhibitor (PDEI) even in normal hearts. However, whether arterial baroreflex function is related to the inotropic responsiveness to a PDEI has not been clarified in human heart failure (HF).

Hypothesis: The goal of this study was to examine the relationship between inotropic responses to a PDEI and arterial baroreflex sensitivity in human HF.

Methods: Twelve patients with HF were examined, and hemodynamic responses to milrinone (12.5,25, and 50 μg/kg, intravenous injection) and arterial baroreflex sensitivity were assessed by pulse interval‐left ventricular (LV) systolic pressure slope using nitroglycerin and phenylephrine.

Results: Milrinone (25 μg/kg) significantly increased LV dP/dt. Arterial baroreflex sensitivity was only one predictor of inotropic responses to milrinone by multivariate analysis; a strong positive correlation was also found between LV dP/dt and baroreflex sensitivity (y = 6.656× ‐ 3.326, r = 0.93, p = 0.000).

Conclusion: Inotropic effects of milrinone, a PDEI, correlated significantly with arterial baroreflex sensitivity, suggesting that the more baroreflex function was impaired, the more the inotropic effect of a PDEI was depressed in human HF.
Role of angiographic coronary artery collaterals in transient ischemic left ventricular cavity dilatation during stress echocardiography
Authors: Bangalore Sripal , Yao Siu‐Sun , Chaudhry Farooq A.
Published: June 2007

Background: The role of coronary artery collaterals in transient ischemic left ventricular (LV) dilatation (TID) during stress echocardiography is not well defined.

Hypothesis: Transient ischemic LV dilatation is a marker for extensive and severe coronary artery disease and represents patients without good collaterals.

Methods: We evaluated 212 consecutive patients (57 ± 16 years, 70% male) who had coronary angiography and stress echocardiography within a 3‐month period. This cohort of patients was divided into three groups based on type of collaterals: Group A: no collaterals; Group B: collaterals supplied by vessels without flow‐limiting stenosis (good collaterals); Group C: collaterals supplied by vessels with flow‐limiting stenosis (bad/jeopardized collaterals). In all patients, angiographic jeopardy score (AJS), ejection fraction (EF), and wall motion score index (WMSI) at rest and during stress were evaluated. Transient ischemic LV dilatation was defined as transient increase in the end‐systolic dimensions from rest to peak stress.

Results: Transient ischemic LV dilatation was present in 42 (20%) patients. Patients with TID had a lower EF, higher AJS, greater number of ischemic segments, and higher peak WMSI. Patients with TID in Group A (no collaterals) and Group C (jeopardized collaterals) had a greater percentage of multivessel disease than those in Group B (good collaterals). Presence of Group A or Group C collaterals was a predictor of TID even after controlling for multivessel disease, rest and peak WMSI, and left anterior descending artery disease.

Conclusions: Transient ischemic LV dilatation on stress echocardiography is a marker for extensive and severe coronary artery disease and represents patients with angiographically absent collaterals or those with jeopardized coronary collaterals.
Cardiac event rate in a lifestyle modification program for patients with chronic coronary artery disease
Authors: Kappagoda C. Tissa , Ma Amy , Cort Douglas A. , Paumer Linda , Lucus Debbie , Burns Jill , Amsterdam Ezra
Published: June 2007

Background: Several clinical trials have shown that intensive lifestyle modification programs have a significant impact on cardiovascular risk factors.

Hypothesis: This paper is a retrospective analysis to determine the effect of participation in a 2‐year lifestyle management program on long‐term clinical outcome in patients outside the setting of a clinical trial.

Methods: Patients with angiographically confirmed coronary artery disease (CAD) enrolled in a 2‐year program of exercise training, dietary counseling, stress management, and therapeutic education. They were accepted into the program from 1991 through December 2002. Follow‐up after completion of the program ranged from 10 to 2 years.

Results: In all, 134 patients enrolled in the program; of these, 77 completed the program and 57 failed to do so. Those who completed the program improved their effort tolerance and reached recommended goals for serum lipid and blood pressure levels. The cumulative event rate (cardiac death, myocardial infarction, and stroke) over 10 years in the patients who completed the program was 1.5%. The corresponding eventrate in patients who dropped out was 18% (p < 0.02).

Conclusions: It is suggested that patients who complete a 2‐year lifestyle modification program appear to have a favorable prognosis over an extended period of time.
Acute aortic dissection in children and adolescents: Diagnostic and after‐event follow‐up obligation to the patient and family
Authors: Fikar Charles R.
Published: June 2007

Acute aortic dissection in childhood and adolescence is a rare but life‐threatening condition with many known risk factors, most of which are heritable. The importance of determining the presence of any predisposing disorders is stressed, since all close relatives can then be screened for any such inherited trait that would make them at risk for a similar catastrophic event. Even with no obvious predisposing disorder, it may still be prudent to evaluate close kin for the presence of aortic root dilatation, since some genetic disorders have no manifestation other than acute aortic dissection secondary to aortic medial pathology. Close monitoring for at‐risk family members, including the index patient, may need to be a life‐long process.
The effect of a six‐week program of yoga and meditation on brachial artery reactivity: Do psychosocial interventions affect vascular tone?
Authors: Sivasankaran Satish , Pollard‐Quintner Suzanne , Sachdeva Rajesh , Pugeda Jaime , Hoq Sheik M. , Zarich Stuart W.
Published: June 2007

Background: Chronic stress is estimated to increase the risk of cardiovascular (CV) events two‐fold. Although stress reduction has been linked to a reduction in CV events, little is known regarding its exact mechanism of benefit.

Hypothesis: Yoga and meditation will improve parameters of endothelial function.

Methods: We examined the effects of yoga and meditation on hemodynamic and laboratory parameters as well as on endothelial function in a 6‐week pilot study. Systolic and diastolic blood pressures, heart rate, body mass index (BMI), fasting glucose, lipids, hs C‐reactive protein (CRP), and endothelial function (as assessed by brachial artery reactivity) were all studied at baseline and after 6 weeks of yoga practice.

Results: A course in yoga and meditation was given to the subjects for 1.5 h three times weekly for 6 weeks and subjects were instructed to continue their efforts at home. This prospective cohort study included 33 subjects (mean age 55 ± 11 years) both with (30%) and without (70%) established coronary artery disease (CAD). There were significant reductions in blood pressure, heart rate, and BMI in the total cohort with yoga. None of the laboratory parameters changed significantly with yoga. For the total cohort there was no significant improvement in endothelial‐dependent vasodilatation with yoga training and meditation compared with baseline (16.7% relative improvement from 7.2‐8.4%; p = 0.3). In the group with CAD, endothelial‐dependent vasodilatation improved 69% with yoga training (6.38‐10.78%; p = 0.09).

Conclusion: Yoga and meditation appear to improve endothelial function in subjects with CAD.
Relation of body fluid status to B‐type natriuretic peptide levels in patients with chronic heart failure during long‐term follow‐up
Authors: Kataoka Hajime
Published: June 2007

Background: Little is known about the relationship of body fluid status with the levels and fluctuations of B‐type natriuretic peptide (BNP) over the long term.

Hypothesis: If BNP is to become useful for monitoring of patients with chronic heart failure (HF), the levels should reliably reflect both decompensation and improvement in the patient's condition.

Methods: Forty‐six patients with chronic HF who were stable at study entry but had previous decompensation were recruited and followed up between June 2003 and September 2005. At each visit, they were examined for BNP level and HF‐related signs of body fluid retention based on physical evaluation and pleural ultrasonography.

Results: During the study period 26 patients developed decompensation and 20 maintained a stable clinical course. In the 26 decompensated patients, BNP levels fluctuated widely (110 ±73.7 pg/ml; range 25‐290 pg/ml) even during stable periods. In all but three patients in this group, the maximum BNP level during decompensation was higher than that reached during stable periods. The BNP levels also fluctuated widely (180 ± 123 pg/ml; range 16‐489 pg/ml) in the 20 stable patients with HF. In all but one patient in this group, the BNP level was lower than the maximum BNP level obtained during the previous decompensation.

Conclusions: In patients with chronic HF with previous decompensation, there was a strong link between the appearance of clinical HF sign(s) of fluid retention and an increased BNP level despite wide intraindividual fluctuations in BNP over time. Thus, BNP levels reliably reflect both decompensation and improvement.
Nitric oxide synthase inhibitors in post‐myocardial infarction cardiogenic shock—an update
Authors: Kaluski Edo , Hendler Alberto , Blatt Alex , Uriel Nir
Published: June 2007

Cardiogenic shock (CS) in acute myocardial infarction, after successful coronary angioplasty, still carries a case fatality rate of 50%. These patients succumb to a systemic metabolic storm, superimposed on extensive myocardial necrosis and stunning. Nitric oxide (NO) overproduction contributes to the pathophysiology of this morbid state. Current data regarding the physiologic effects of NO and nitric oxide synthase (NOS) inhibitors on the cardiovascular system are reviewed. Clinical trials assessing the safety and efficacy of NOS inhibitors in CS are summarized.
The effect of coronary angiography on residual renal function in patients on peritoneal dialysis
Authors: Weisbord Steven D. , Bernardini J Udith , Mor Maria K. , Harrwig Kathryn C. , Nicoletta Patricia J. , Palevsky Paul M. , Piraino B Eth
Published: June 2007

Background: The risk of intravascular radiocontrast to residual renal function (RRF) in patients on peritoneal dialysis (PD) remains largely unknown.

Hypothesis: This study sought to estimate the effect of coronary angiography on RRF in patients on PD.

Methods: All patients at the VA Pittsburgh Healthcare System and University of Pittsburgh who underwent coronary angiography between 1993 and 2005 while on PD and who had RRF measured prior to angiography were identified retrospectively. For patients without a postprocedure RRF recorded, medical records were reviewed to determine whether anuria had developed. The longer‐term rate of loss of RRF among cases was compared with a composite rate of decline in RRF among cases before angiography and matched controls.

Results: Twenty‐nine patients with a mean preprocedure RRF of 4.4 ±3.2 ml/min/1.73m2 were evaluated. Of these patients, 23 (79%) had postangiography RRF assessments (mean clearance 3.4 ± 3.0 ml/min/1.73m2). One of the remaining six patients definitely became permanently anuric following angiography, one was lost to follow‐up, and there was no postprocedure RRF assessment in four others. The rate of decline in RRF in the cases was similar to the composite rate (0.07 ml/min/1.73m2/month vs. 0.09 ml/min/1.73m2/month, p = 0.53)

Conclusion: The risk for permanent anuria in patients on PD undergoing coronary angiography appears to be quite small. Patients who do not develop anuria following coronary angiography have the same gradual rate of loss of RRF as other patients on PD. Providers should be vigilant in protecting RRF in patients on PD undergoing coronary angiography.
Ultrastructural analysis of the aberrant axoneme morphogenesis in thrips (Thysanoptera, Insecta)
Authors: Paccagnini Eugenio , Mencarelli Caterina , Mercati David , Afzelius Björn A. , Dallai Romano
Published: June 2007

Thrips spermiogenesis is characterized by unusual features in the differentiating spermatid cells. Three centrioles from which three individual short flagella are initially assembled, make the early spermatid a tri‐flagellated cell. Successively, during spermatid maturation, the three basal bodies maintain a position close to the most anterior end of the elongating nucleus, so that the three axonemes are progressively incorporated in the spermatid cytoplasm, where they run in parallel to the main nuclear axis. Finally, the three axonemes amalgamate to form a microtubular bundle. The process starts with the formation of rifts at three specific points in each axonemal circumference, corresponding to sites 1,3,7 and leads to the formation of 9 microtubular rows of different length, i.e. 3 “dyads”, 3 “triads” and 3 “tetrads”. In the spermatozoon, the nucleus, the mitochondrion and the bundle of microtubules are arranged in a helicoidal pattern. The elongation of the spermatozoon is allowed by the deep anchorage of the spermatid to the cyst cell through a dense mass of material which, at the end of spermiogenesis, becomes a long anterior cylindrical structure. This bizarre “axoneme” does not show any trace of progressive movement but it is able to beat. According to the presence of dynein arms, sliding can take place only within each row and not between the rows. The possible molecular basis underlying the peculiar instability of thrips axonemes is discussed in light of the present knowledge on the organization of the axoneme in mutant organisms carrying alterations of the tubulin molecule. Cell Motil. Cytoskeleton 2007. © 2007 Wiley‐Liss, Inc.
Prognostic value of circulating chromogranin A and soluble tumor necrosis factor receptors in advanced nonsmall cell lung cancer
Authors: Gregorc Vanesa , Spreafico Anna , Floriani Irene , Colombo Barbara , Ludovini Vienna , Pistola Lorenza , Bellezza Guido , Viganò Maria Grazia , Villa Eugenio , Corti Angelo
Published: June 2007

BACKGROUND.

Increased levels of chromogranin A (CgA), a protein secreted by many neuroendocrine cells, have been detected in sera of patients with neuroendocrine tumors or renal, hepatic, or heart failure. In patients with heart failure, serum CgA correlates with tumor necrosis factor‐α (TNF) and soluble TNF receptors (sTNF‐Rs), with important prognostic implications. The prognostic value of CgA and sTNF‐Rs was investigated in advanced nonsmall cell lung cancer (NSCLC), a histologically heterogeneous group of tumors that may undergo neuroendocrine differentiation.

METHODS.

CgA and sTNF‐Rs were analyzed in the sera of 88 patients with NSCLC before chemotherapy by enzyme‐linked immunoadsorbent assay (ELISA) and in tumors by immunohistochemistry.

RESULTS.

Thirteen percent of patients had CgA values greater than the highest value observed in normal subjects (distribution range, 9–724 ng/mL and 28–196 ng/mL, respectively). Immunohistochemical studies showed no correlation between CgA expression in tumors and serum levels. Conversely, circulating CgA was associated with worse Eastern Cooperative Oncology Group (ECOG) performance status (PS) (P = .0005), more advanced stage (P = .042), and survival, with CgA being an independent prognostic factor of poor outcome (hazards ratio [HR] 1.31 for 100 ng/mL increase; 95% confidence interval [95% CI], 1.08–1.60 [P = .0071]). sTNF‐R1 and sTNF‐R2 were also associated with ECOG PS (P = .0001 and P = .02, respectively). sTNF‐Rs was weakly correlated with circulating CgA (r = 0.39 for TNF‐R1 and r = 0.40 for TNF‐R2), suggesting a regulatory link between sTNF‐Rs and CgA secretion.

CONCLUSIONS.

Increased serum levels of CgA in NSCLC are independent from protein expression in tumors and more likely related to neuroendocrine response associated with worsening of patient condition. In addition to ECOG PS and stage, CgA is an independent indicator of poor prognosis. Cancer 2007. © 2007 American Cancer Society.
A Sense of Illumination. Remarks on a New Approach to Color Expression
Authors: Birren Faber
Published: June 2007

Color in art is traced from the Renaissance to the present. Much in the past has been taken from nature, with emphasis on optical effects involving visual appearances. Principles based on modern studies of perception offer new incentives to the artist, and new modes of expression in which brain reactions supplement visual ones.
The Colour Index
Authors: Wich Emil
Published: June 2007

An extensive international compilation of the structure and properties of dyes and pigments, as well as a system of numbering these materials, the Colour Index is a potentially valuable tool for all users of colorants. For lack of familiarity it is not as widely used as it should be. This paper describes the Colour Index and how to use it.
Location of the Nodes of Metameric Color Stimuli
Authors: Ohta Noboru , Wyszecki Gunter
Published: June 2007

Two metameric color stimuli have spectral‐power‐distribution curves which, in general, intersect at three or more wavelengths within the visible spectrum. One of these wavelengths is located in the short‐wavelength region, one in the middle‐wavelength region, and one in the long‐wavelength region. Recent work by Thornton puts these wavelengths at 448 ± 4 nm, 537 ± 3 nm, and 612 ± 8 nm, respectively. The rather precise locations of these nodes are examined in this paper. The method of generating metameric color stimuli is found to have a strong influence on the location as well as the frequency of occurrence of the nodes. Different methods will give different locations and frequency distributions, making it difficult to put much significance on Thornton's results.
Concept of correlated color temperature
Authors: Grum F. , Saunders S. B. , Macadam D. L.
Published: June 2007

The concept of color temperature has been used for many years to characterize the relative spectral distribution of energy from light sources. Since not all sources of light are blackbody radiators, the term “correlated color temperature” was devised to indicate the temperature of the blackbody with chromaticity nearest that of the source. Since the CIE has recently recommended two additional color spaces superseding the existing universally agreed system, it is important to know what effect the new recommendation will have on the correlated color temperature determination. In view of this, it has seemed appropriate to design and carry out some fundamental studies in acceptable color matching among color‐normal observers. The isotemperature lines derived from the experimental data described here are within one standard deviation of the isotemperature lines derived from the 1960 UCS diagram. Hence, there is no need to revise the isotemperature lines derived formerly.
A strategy for automatic television colur‐balance correction involving a floating white
Authors: Pearson D. E. , Ray A. K.
Published: June 2007

Experimental comparisons are reported of sensor‐derived and picture‐derived techniques for automatic colurbalance correction in colour television. Neither technique was found to ensure point mapping of scene neutrals into display neutrals at 6500 K in all circumstances. An alternative floating‐white system was investigated; quality ratings of this system showed that it performed well over a central range of colour temperatures. The results suggest that fully automatic correctors might beneficially follow a strategy of allowing the system white to float over a limited central range, applying correction graducally outside this range.
A design study simulating iridescence
Authors: Garrett Albert
Published: June 2007

The design experiment is demonstrated in the series of collage multiples running to date to fifteen separate editions under the title of “Poised.” Editions are limited to a maximum of twenty.
Global Color Metrics and Color‐Appearance Systems
Authors: Indow Tarow
Published: June 2007

The Munsell Color System, the color‐appearance system most widely used, has been constructed primarily on the basis of local perceptual uniformity. However, when it is used as a criteron for a uniform chromaticity scale, its global structure is important as well, and this structure is examined in three ways. First, the coordinates H, V, C are shown to function as a conceptual framework in identifying colors. Second, a summary of 12 studies by multidimensional scaling methods based on large color differences is given. It shows that the main part of the Munsell space is approximately Euclidean. Third, a new method based on estimation of principal hue components in each color, 120 in an experiment, yields the same result. Chromatic response functions as in opponent‐color theories are obtained with object colors by this method. In all the results with Japanese observers, 5PB and 5B appear to be too close and both deviate toward 5G compared with the Munsell notation. Whether the finding is due to the observers is discussed.
Colorimetry of Wines
Authors: Little Angela C.
Published: June 2007

Problems relating to the measurement and description of color of wines are discussed, with wines providing an example of problems of volume color specification in general. The limitations of conventional directional spectrophotometric transmittance measurements are considered for colloidal, minimally light‐scattering systems, where errors due to light lost through scatter can have profound consequences, particularly at shorter wavelengths. An alternative approach, referred to as transreflectometry, avoids the errors attributable to the directional geometry of conventional spectrophotometers. A review of its application to the colorimetry of wines considers three cases with different requirements to be met and different questions to be answered, from meeting strigent Federal Regulations in the case of very light white wines, to blending red and rosé wines to predetermined color requirements, to studying the kinetics of pigment degradation and colored polymer formation in red wines under controlled storage conditions. These studies demonstrate the versatility of a simple methodological approach which provides information relating to visually perceived color and at the same time to chemical and physical properties of the systems.
Absolute Identification of Colors in the Munsell Notation: Trainability and Systematic Shifts
Authors: Indow Tarow , Watanabe Mariko
Published: June 2007

Subjects were asked to identify colors in the Munsell notation, without comparing with the samples of the Munsell Book of Color, and then were immediately told the values of H, V, and C. This training was carried out with 520 colors identified twice by each of five subjects, two experienced and three completely naive with the Munsell system. The effect of training was noticeable over the series of 1040 estimations, and the means of absolute deviations at the end were 3.1, 0.5, and 1.25 for H, V, and C, respectively. Systematic shifts of mean estimations from the Munsell notations were noted: saturated colors tend to be judged lighter when V < 5, there is a tendency to scale compression in the estimation of C, and colors of hue between 7.5B and 7.5B tend to shift toward B, and colors of 10PB and 2.5P, toward P.
The coloroid color system
Authors: Nemcsics Antal
Published: June 2007

Developed over two decades at the Technical University, Budapest, the Coloroid color system is an aesthetically uniform system, in which scales of hue, saturation, and lightness appear to change uniformly over their entire length, when viewed as a whole. This is not the same as perceptually uniform in the sense of even intervals of small color differences. This article discusses the concepts and derivation of the Coloroid system, relates it to the Munsell and Ostwald systems, and derives the relations of its coordinates to those of the CIE XYZ system.
CIELAB Hue‐Angle Anomalies at Low Tristimulus Ratios
Authors: McLaren K.
Published: June 2007

Hue angles calculated using the CIELAB recommendation are usually dependent on the luminance factors of the stimulus if any tristimulus ratio is below the critical figure at which the Pauli linear function is applied. This can cause errors of up to 35° in the case of stimuli of low luminance lying on the spectrum locus or purple line. Errorrs are unlikely to occur in the case of surface colors, but in the case of transparent object colors their frequency and magnitude are such as to make CIELAB unsuitable as a color space or as a color‐difference formula whenever a tristimulus ratio is below the critical figure. Practical considerations suggest that in such cases the best solution is to use a modified Judd polynomial function, and this course is suggested for consideration by the CIE Colorimetry Committee and the committee responsible for developing an ISO Standard for the color measurement of plastics.
Why and How Chromatic Adaptation Has Been Studied
Authors: Wright W. D.
Published: June 2007

The question of why chromatic adaptation has been studied has two answers: to explore the functioning of the visual mechanism and to provide useful engineering data. The question of how is answered by reviewing a series of techniques that have been used to study chromatic adaptation.
On exponents of a nonlinear model of chromatic adaptation
Authors: Nayatani Yoshinobu , Takahama Kotaro , Sobagaki Hiroaki , Hirono Junzo
Published: June 2007

Exponents to be used in a nonlinear model for chromatic adaptation by Nayatani, Takahama, and Sobagaki are discussed and determined as functions of the effective adapting levels by considering several experimental facts of color perception related to a change of adapting illuminance. The analyzed data refer to the color‐appearance attribute “colorfulness” studied by Hunt, the color appearance of a high‐reflectance sample studied by Hunt, the brightness studied by Stevens, and the chromatic adaptation effect between daylight and tungsten light studied by Breneman. By using the derived functions of the exponents it is shown that the model predicts quite well the following perceptual effects: (1) the chromatic adaptation effect between standard Illuminants D65 and A, (2) the dependence of effect (1) on the adapting luminance, (3) the increase of colorfulness of colored samples (the first Hunt effect), (4) the increase of blueness of high‐reflectance samples (the second Hunt effect), (5) the increase of bright and dark contrast of nonselective samples (the Stevens effect), and (6) the color perception of nonselective samples under a colored adapting illumination (the Helson effect). Effects (3)–(5) are observed by increasing the adapting luminance.
A better colorimetric standard observer for color‐vision studies: The stiles and burch 2° color‐matching functions
Authors: Estévez Oscar
Published: June 2007

The validity of the 1931 CIE Standard Observer color‐matching functions (c.m.f.) rests on the assumption that Vλ is a linear combination of actually measured c.m.f. It is shown here that no combination of c.m.f. can reproduce any photometric function. For research on basic questions of color vision it is suggested that the c.m.f. of the Stiles and Burch 2° preliminary study be used. These c.m.f. are reproduced here, after correction and renormalization for a calibration error in the original study. Since photometry appears to be intrinsically more complicated and less well understood than basic colorimetry, it is also suggested the two disciplines be considered as separate aspects of the visual process.
The estimation of cone spectral sensitivities
Authors: MacLeod Donald I. A.
Published: June 2007

Methods for estimating the cone spectral sensitivities are reviewed (selectively). Techniques applied to the normal eye include measurement of flicker photometric sensitivity against colored backgrounds; creation of temporary artificial dichromacy by colored bleaches; observations of the afterimages of colored bleaching lights; and transient photopic saturation by flashed backgrounds. Results from these techniques agree well with cone sensitivities estimated from studies of congenital dichromats, and these estimates are further supported by appropriately comparing normal with anomalous trichromatic matches. The indicated sensitivities for red‐ and green‐sensitive cones peak at 566 and 543 nm, respectively. Factor analysis of color‐matching functions indicates normal variation of the order of 1–1.5‐nm standard deviation.
Differences of unique‐ yellow loci between individuals
Authors: Akita Munehira , Ejima Yoshimichi , Takahashi Shigeko
Published: June 2007

In a previous study we noted that a female observer, T, who was diagnosed as a normal trichromat, gave about 536 nm for her unique yellow, which was usually perceived as either green or yellowish‐green by other normal observers. To explore further these individual differences we conducted several preliminary experiments. When we assumed a less sensitive green function for T, who showed no sign of color anomalies with several kinds of color‐blindness tests, we showed that we could interpret the individual differences depicted in three kinds of measures of unique‐yellow loci, namely with colored background, in relative strength of r to g in the context of the opponentcolor theory, and by matching wavelengths to colored papers. One might think of the unique‐hue‐determination technique as being a new sensitive and simple way to investigate color mechanisms, for both normal and abnormal color vision.
Nonlinear nature of the opponent‐color channels
Authors: Yaguchi Hirohisa , Ikeda Mitsuo
Published: June 2007

Heterochromatic brightness matches were made between bichromatic mixtures of Λ1 and Λ2, and a 100‐trolands white reference light of 2° visual angle. A remarkable brightness reduction was found in the bichromatic mixtures, showing brightness additivity failure. The failure was especially large at the luminance ratio where hue cancellation occurred. The results were explained by assuming the brightness sensation to be mediated not only by the luminance channel but also by the red‐green and yellow‐blue opponent‐color channels, and by assuming further nonlinear transformation of responses in the opponent‐color channels.
The transformation from cone to channel sensitivities
Authors: Ingling Carl R.
Published: June 2007

Zone theories of color vision transform R, G, B cone signals to a set of summing and differencing channels. Although the general principles of this transformation are well known, there are subtleties in the transformation which are not well understood. For example: (i) The r–g channel sends two kinds of signal, depending on the spatial frequencies of the stimulus. It sends a difference or hue signal at low spatial frequencies and an additive or achromatic signal in response to high spatial frequencies. (ii) The B‐cone contribution to the r–g channel is greater by a factor of 10 for desaturated stimuli. A quantitative saturation‐dependent mechanism can account for the B‐cone input to the r–g channel.
CIE activities in the measurement of retroreflection
Authors: Moerman Jan J. B.
Published: June 2007

Following a description of a forthcoming CIE technical report, a general view is given of the parameters which are important in the photometry of retroreflectors and retro‐reflective materials, and of the errors which may occur in their measurement. The goniometer mechanism embodying the new CIE angular system for specifying and measuring retroreflectors is described. Attention is paid to the methods of calibration in determining the coefficient of luminous intensity. The photometry of retroreflective road markings is mentioned, and finally the measurement of the daytime and nighttime colour is dealt with.
Interior and exterior daylight illuminants for the colorimetry of fluorescent materials
Authors: Clarke F. J. J. , McKinnon Rona A.
Published: June 2007

The difficulties in simulating CIE Standard Illuminant D65 are considered and an interior daylight illuminant is described, Illuminant ID65, representing exterior daylight attenuated by average window glass. The benefits of Illuminant ID65 are that it represents the daylight source which most commonly occurs in the viewing of critically coloured merchandise, and that it can be practically simulated using a filtered tungsten‐halogen source. Its applicability to measurements, particularly to the assessment of fluorescent samples, is considered. The results of measurements on the two common classes of fluorescent samples are discussed and indicate that an Illuminant ID65 simulator can be used validly for the measurement of fluorescent materials, even including materials intended specifically for exterior use.
Subjective evaluation of uniform color spaces used for color‐rendering specification
Authors: Mori Leo , Fuchida Takayoshi
Published: June 2007

Three attributes of color appearance of sixteen samples illuminated by various light sources were estimated directly by two observers. The results are plotted on a subjective chroma diagram, with which the psychometricchroma diagrams calculated from the CIELUV and CIELAB spaces are compared. The comparison and numerical evaluations show that the CIELAB space is much better than the CIELUV and U* V* W* spaces in simulating surface‐color appearance under various illuminants. Substitution of the CIELAB space for the U* V* W* space used in the CIE method of color‐rendering specification is proposed.
Applying the CIE retroreflectance geometry
Authors: Venable William H.
Published: June 2007

As one of its major efforts during the past three years, the Retroreflectance Subcommittee of CIE Technical Committee 2.3 has defined a system of geometrical coordinates to be used for working with retroreflection. This coordinate system, along with an associated set of defined terms, is intended to provide a common language for describing and specifying the performance of retroreflecting materials and objects.
Truncation error in colorimetric computations
Authors: Krystek W. Erb M.
Published: June 2007

The wavelength interval 360‐830 nm relevant in colorimetric computations is sometimes truncated by the instrument used to measure the spectral characteristic of a material, or the spectral power distribution of a source, or simply by choice. The (systematic) error resulting from this truncation has been derived. Tables are given for the calculation of the truncation error in each case.
Color and human response
Authors: Birren Faber
Published: June 2007

Color has played an important role in human life and culture since the beginnings of recorded history. Here are random notes drawn from widely different sources.