bluuebunny/crossref_metadata_2025 huggingface dataset:
Embryo sac, endosperm, and seed of Nemophila (Boraginaceae) relative to taxonomy, with a remark on embryogeny in Pholistoma
Authors: Berg Rolf Y.
Published: February 2009

Studies on embryology and seed morphology are complementary to molecular phylogenetics and of special value at the genus level. This paper discusses the delimitation and evolutionary relationships of genera within the tribe Hydrophylleae of the Boraginaceae. The seven Nemophila species characterized by a conspicuous seed appendage are similar in embryology and seed structure. The ovule is tenuinucellate and unitegmic with a meristematic tapetum. The embryo sac penetrating the nucellar apex is of the Polygonum type, has short‐lived antipodal cells, and an embryo sac haustorium. The endosperm is cellular, producing two terminal endosperm haustoria, of which the chalazal has a lateral branch. Embryogeny is of the Chenopodiad type (as in Pholistoma). The seed coat is formed from the small‐celled inner epidermis of the integument. The large‐celled outer epidermis of the integument disintegrates into scattered cells. Seed pits evolve from irregularly placed inner epidermal cells of the integument. The chalazal part of the ovule produces a cucullus, that functions as an ant‐attracting elaiosome. Those species of Nemophila with a conspicuous cucullus form a natural genus. Nemophila is most closely related to Pholistoma. The integumentary seed pits of Nemophila might have evolved from ovular seed pits similar to those in Pholistoma.
Early floral development ofHeliconia latispatha(Heliconiaceae), a key taxon for understanding the evolution of flower development in the Zingiberales
Authors: Kirchoff Bruce K. , Lagomarsino Laura P. , Newman Winnell H. , Bartlett Madelaine E. , Specht Chelsea D.
Published: February 2009

We present new comparative data on early floral development ofHeliconia latispatha, an ecologically and horticulturally important tropical plant within the order Zingiberales. Modification of the six members of two androecial whorls is characteristic of Zingiberales, with a reduction in number of fertile stamen from five or six in the banana families (Musaceae, Strelitziaceae, Lowiaceae, and Heliconiaceae) to one in Costaceae and Zingiberaceae and one‐half in Marantaceae and Cannaceae. The remaining five infertile stamens in these later four families (the ginger families) are petaloid, and in Costaceae and Zingiberaceae fuse together to form a novel structure, the labellum. Within this developmental sequence, Heliconiaceae share with the ginger families the possession of an antisepalous staminode, a synapomorphy that has been used to place Heliconiaceae as sister to the ginger family clade. Here, we use epi‐illumination light microscopy and reconstruction of serial sections to investigate the ontogeny of theHeliconiaflower with emphasis on the ontogeny of the staminode. We compare floral development inHeliconiawith that previously described for other species of Zingiberales. A comparison of floral structure and development across Zingiberales is presented to better understand the evolution of the flower in this charismatic group of tropical plants.
Life-threatening overdose with lamotrigine, citalopram, and chlorpheniramine
Authors: Venkatraman N , O′Neil D , Hall AP
Published: February 2009

Lamotrigine is a commonly used agent for seizure control in epilepsy. There are limited data on the adverse effects of lamotrigine in overdose. We report a number of serious side-effects associated with a large overdose of lamotrigine. A 23-year-old female presented to the emergency department after taking an intentional overdose of 9.2 g of lamotrigine, 56 mg of chlorpheniramine, and 220 mg of citalopram. On admission, she had a reduced level of consciousness and electrocardiographic abnormalities; a widened QRS and a prolonged corrected QT (QTc) interval. Prompt treatment with early intubation, along with the use of magnesium for cardioprotection and administration of sodium bicarbonate may have aided in a quick recovery with a short intensive care stay and good outcome.
Clinical research in India
Authors: Thatte UM , Bavdekar SB
Published: February 2009

India is considered as a preferred site for conducting global clinical trials. Existence of a large treatment-naοve population, availability of English-speaking, skilled doctors, plenty of clinical material, and cost-savings are obvious advantages for carrying out clinical research in India. However, challenges exist at various levels. Lack of formal training in bioethics and research methodology, heavy burden of clinical duties and sub-optimal administrative support restrict investigators. Absence of oversight of functioning of ethics committees (ECs) and lack of mechanisms for ensuring quality of ethics review heighten societal concerns about safety of participants. Conducting research on issues not relevant to local needs and failure to ensure post-trial access further enhance society's cynicism. These issues need to be tackled through capacity building, training of investigators and EC members, strengthening of EC functioning and encouraging greater community participation.
Nicolau syndrome following intramuscular benzathine penicillin
Authors: De Sousa R , Dang A , Rataboli PV
Published: February 2009

Nicolau syndrome (NS) is a rare complication of an intramuscular injection characterized by severe pain, skin discoloration, and varying levels of tissue necrosis. The case outcomes vary from atrophic ulcers and severe pain to sepsis and limb amputation. We describe a case of a seven-year-old boy with diagnosis of NS after intramuscular benzathine penicillin injection to the ventrolateral aspect of the left thigh. Characteristic violaceous discoloration of skin and immediate injection site pain identified it as a case of NS. The case was complicated by rapid progression of compartment syndrome of the lower limb, proceeding to acute renal failure and death. Associated compartment syndrome can be postulated as a poor prognostic factor for NS.
An Unusual Peroxide‐Mediated Amination of Cycloalkanes with Nitroarenes
Authors: Deng Guojun , Chen Wenwen , Li Chao‐Jun
Published: February 2009

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A direct amination of simple cycloalkanes with nitroarenes mediated by peroxides has been discovered. Various secondary arylamines were obtained efficiently from cycloalkanes. The reaction tolerates a wide range of functionalities as well as aqueous conditions. No metal was required for this novel amination reaction.
Role of Mn of PEG in the morphology and properties of electrospun PEG/CA composite fibers for thermal energy storage
Authors: Chen Changzhong , Wang Linge , Huang Yong
Published: February 2009

As an aim toward developing novel class of form‐stable polymer‐matrix phase change materials for thermal energy storage, ultrafine composite fibers based on cellulose acetate and polyethylene glycol (PEG) with five different molecular weight (Mn) grades were prepared by electrospinning. The effects of Mn of PEG on morphology, thermal properties and mechanical properties of the composite fibers were studied by field emission scanning electron microscopy, differential scanning calorimetry, and tensile testing, respectively. It was found that the composite fibers were smooth and cylindrical shape, with the average diameters ranging from about 1000 to 1750 nm which increased with Mn of PEG. Thermal analysis results showed that the composite fibers imparted balanced thermal storage and release properties in different temperature ranges with the variation of Mn of PEG. Thermal cycling test indicated that the prepared composites had excellent thermal stability and reliability even they were subjected to 100 heating‐cooling thermal cycles. © 2009 American Institute of Chemical Engineers AIChE J, 2009
Light FCC gasoline olefin oligomerization over a magnetic NiSo4/γ‐Al2o3 catalyst in a magnetically stabilized bed
Authors: Peng Ying , Dong Minghui , Meng Xiangkun , Zong Baoning , Zhang Jinli
Published: February 2009

Magnetic NiSO4/γ‐Al2O3 catalysts were prepared by impregnating NiSO4 solutions onto the γ‐Al2O3 support containing a magnetic material of Fe3O4. Characterization by XRD, NH3‐TPD, and thermal analysis showed that the magnetic NiSO4/γ‐Al2O3 catalyst with a nickel content of 7.0% by weight had a monolayer dispersion of NiSO4 and the largest number of moderate strength acid sites, and a high specific saturation magnetization. The magnetic catalyst was evaluated for light FCC gasoline olefin oligomerization in both fixed‐bed and magnetically stabilized bed (MSB) reactors. Comparing with that in the fixed‐bed reactor, the optimal reaction temperature in the MSB lowered to 443 K, and its space velocity ranged broadly from 2.0 to 6.0 h−1. The sulfur‐free diesel distillate produced by operation of the MSB for 100 h had higher cetane number and good low‐temperature flow property, which illuminates a promising application of the MSB to manufacture clean diesel fuels with high productivity and flexibility. © 2009 American Institute of Chemical Engineers AIChE J, 2009
Positive reinforcement training in rhesus macaques—training progress as a result of training frequency
Authors: Fernström A.‐L. , Fredlund H. , Spångberg M. , Westlund K.
Published: February 2009

Positive reinforcement training (PRT) efficiency was examined as a function of training frequency in 33 pair‐ or triple‐housed female rhesus macaques. The animals were trained three times a week, once a day or twice a day, using PRT and a clicker as a secondary reinforcer. All animals were trained on 30 sessions, with an average of 5 min per training session per animal. The behaviors, trained in succession, were Targeting (reliably touching and following a Target); Collaborating (dominant animals allowing subordinates to train while stationing); Box‐training (accepting being enclosed in a small compartment while responding to Target training) and initial Injection training.

Fulfilled criteria for Targeting were obtained in 32/33 animals in a median of nine training sessions. Collaboration was obtained in 27/33 animals in a median of 15 training sessions. However, only four animals completed Box‐training during the 30 training sessions and started Injection training. When comparing training success in terms of number of training sessions, training twice a day was less efficient than the other two treatments. In terms of daily progress, our results suggest that from a management perspective, daily training is more conducive to quick training success than thrice weekly training. In addition, in this study no further advantages could be gained from training twice a day. Am. J. Primatol. 71:373–379, 2009. © 2009 Wiley‐Liss, Inc.
Stereogradient Polymers Formed by Controlled/Living Radical Polymerization of Bulky Methacrylate Monomers
Authors: Ishitake Kenji , Satoh Kotaro , Kamigaito Masami , Okamoto Yoshio
Published: February 2009

Unter Kontrolle: Das sperrige Monomer Triphenylmethylmethacrylat (TrMA) wurde mithilfe von RAFT‐Reagentien polymerisiert (RAFT: reversibler Additions‐Fragmentierungs‐Kettentransfer). Stereogradiente Polymere, in denen die Isospezifität mit Abnahme der Monomerkonzentration spontan zunahm, entstanden in einem Polymerisations‐Depolymerisations‐Gleichgewicht, durch das ein weniger stabiles wachsendes Polymerende in eine stabilere Form überführt wird (siehe Bild).

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Pattern‐Based Recognition of Heparin Contaminants by an Array of Self‐Assembling Fluorescent Receptors
Authors: Jagt Richard B. C. , Gómez‐Biagi Rodolfo F. , Nitz Mark
Published: February 2009

Starke Wirt‐Gast‐Wechselwirkungen ermöglichen die leichte Kombination polykationischer Cyclodextrin‐Bindungsmotive (blau) mit fluoreszierenden Reportern (orange), die an ein hydrophobes Gastmolekül gebunden sind (dunkelgrün). Mit diesem modularen Ansatz hergestellte supramolekulare Fluoreszenzrezeptoren wurden für die musterbasierte Erkennung negativ geladener Verunreinigungen im gerinnungshemmenden Heparin verwendet.

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Stabil und kristallin: Struktur und ESR‐Spektren eines Triarylgermylradikals
Authors: Drost Christian , Griebel Jan , Kirmse Reinhard , Lönnecke Peter , Reinhold Joachim
Published: February 2009

Eine radikale Sache: Nach der unerwarteten Isolierung des ersten stabilen Triarylgermylradikals .Ge[3,5‐tBu2‐2,6‐(EtO)2C6H]3 (1) in niedriger Ausbeute konnte dessen Synthese optimiert werden, was Einkristallröntgenstrukturanalyse und ESR‐spektroskopische Untersuchungen ermöglichte, deren Ergebnisse mit denen von DFT‐MO‐Rechnungen an der Modellverbindung .Ge[2,6‐(MeO)2C6H3]3 verglichen werden.

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[Co@Ge10]3−: An Intermetalloid Cluster with Archimedean Pentagonal Prismatic Structure
Authors: Wang Jian‐Qiang , Stegmaier Saskia , Fässler Thomas F.
Published: February 2009

Anorganisches Pentaprisman: Die ungewöhnliche Struktur des Anions [Co@Ge10]3−, das aus K4Ge9 und [Co(C8H12)(C8H13)] in Ethylendiamin entstand, lässt Fragen nach der Art der Bindung aufkommen. Der quasi‐D5h‐symmetrische Zintl‐Cluster ist ein einzigartiges Beispiel für einen nichtdeltaederförmigen ligandenfreien Cluster. Die delokalisierten Bindungen des Anions werden im Bild durch eines der bindenden Orbitale dargestellt.

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Ligandenstabilisierte Chalkogendikationen
Authors: Chivers Tristram , Konu Jari
Published: February 2009

Chalkogenüberträger? Die Bindungssituation im ringförmigen C2N2E2+ (siehe Bild) unterscheidet sich von der in N‐heterocyclischen Carbenen und ihren isovalenten Analoga aus dem p‐Block: Das Chalkogenzentrum hat sowohl ein freies Elektronenpaar mit π‐ als auch eines mit σ‐Symmetrie. Die labilen elektrophilen Chalkogendikationen (E2+) können vielseitige Chalkogenüberträger für eine Reihe von anorganischen und organischen Substraten sein.

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SERS Labels for Red Laser Excitation: Silica‐Encapsulated SAMs on Tunable Gold/Silver Nanoshells
Authors: Küstner Bernd , Gellner Magdalena , Schütz Max , Schöppler Friedrich , Marx Alexander , Ströbel Philipp , Adam Patrick , Schmuck Carsten , Schlücker Sebastian
Published: February 2009

In a glass house: Silica‐encapsulated self‐assembled monolayers (SAMs) on tunable gold/silver nanoshells were used as labels for surface‐enhanced Raman scattering (SERS). This concept combines the spectroscopic advantages arising from maximum surface coverage and uniform molecular orientation of the Raman reporter molecules within the complete monolayer together with the high chemical and mechanical stability of the glass shell.

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[Co@Ge10]3−: An Intermetalloid Cluster with Archimedean Pentagonal Prismatic Structure
Authors: Wang Jian‐Qiang , Stegmaier Saskia , Fässler Thomas F.
Published: February 2009

Inorganic pentaprismane: The unusual structure of the anion [Co@Ge10]3−, which was obtained by the reaction of K4Ge9 with [Co(C8H12)(C8H13)] in ethylenediamine, raises questions about chemical bonding in the anion. The Zintl ion cluster has virtual D5h symmetry and is a unique example of a ligand‐free cluster that is not a deltahedron. The delocalized chemical bonding is represented in the picture by one of the bonding orbitals of the anion.

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Design, Synthesis, andIn‐VivoPharmacological Screening ofN,3‐(Substituted Diphenyl)‐5‐phenyl‐1H‐pyrazoline‐1‐carbothioamide Derivatives
Authors: Siddiqui Nadeem , Alam Perwaiz , Ahsan Waquar
Published: February 2009

Various 3,5‐(substituted diphenyl)‐4,5‐dihydro‐pyrazole‐1‐carbothioic acid phenylamides were synthesized starting from substituted acetophenones. Structures of the compounds were confirmed on the basis of spectral data. The compounds were evaluated for their anticonvulsant and antidepressant activity. Interestingly, out of 26 compounds, four (3f,3g,3t, and3u) were found to protect 100% of the animals in the MES screen at a dose of 25 mg/kg. They were also found to have appreciable anticonvulsant activity in scPTZ screen. Two compounds,3jand3o, significantly reduced the duration of the immobility time at 25 mg/kg dose, when compared to control.
Organische Carbonate. Grüne Lösungsmittel für Synthese und Katalyse
Authors: Schäffner Benjamin , Verevkin Sergey P. , Börner Armin
Published: February 2009

Organische Carbonate (acylische und cyclische Kohlensäureester) sind schwer flüchtige, polare Lösungsmittel, welche sich durch ihre geringe Toxizität auszeichnen. Durch geschickte Wahl der Alkohole für die Estersynthese können die physikalischen Eigenschaften der resultierenden Carbonate stark beeinflusst werden. Ihr Einsatz ist in der Batterietechnik, Erdgasaufbereitung und Kosmetik weit verbreitet. In verschiedenen übergangsmetallkatalysierten Reaktionen beweist insbesondere Propylencarbonat (PC) hervorragende Lösungsmitteleigenschaften und ermöglicht aufgrund seines polaren Charakters die Reaktionsführung in Zweiphasensystemen unter Verwendung eines unpolaren zweiten Lösungsmittels. Dies ist eine Grundvoraussetzung zum Einsatz in kontinuierlichen Prozessen und zur Verringerung der Katalysatormengen.
Chemikalien für die Lederherstellung. Vom Kollagen tierischer Häute zum Werkstoff Leder
Authors: Reich Günter , Taeger Tilman
Published: February 2009

Seine einmaligen Werkstoffeigenschaften verdankt Leder dem Aufbau aus dem strukturell und chemisch so ideal vorgebildeten Kollagen. In den einzelnen Technologiestufen der Lederherstellung wird das Kollagen je nach Einsatzgebiet maßgeschneidert modifiziert durch Anwendung einer breiten Palette an Lederchemikalien. Die wichtigsten hier vorzustellen, war Anliegen dieses Beitrags. Leder steht nach wie vor in der Gunst der Verbraucher. Hergestellt aus einem nachwachsenden, an die menschliche Ernährung gekoppelten Rohstoff, brauchen wir keine Lederverknappung zu befürchten. Seine stetige Weiterentwicklung durch neue Lederchemikalien ist zu erwarten. “Leder ist ein alter Werkstoff mit Zukunft”!
Von Seefahrern, Meerschweinchen und Citrusfrüchten. Der lange Kampf gegen Skorbut
Authors: Streller Sabine , Roth Klaus
Published: February 2009

Obwohl der Skorbut die Menschheit von Anbeginn begleitet hat, wurde er erst im 16. Jahrhundert als Krankheit erkannt und es schloss sich eine Jahrhunderte andauernde Aneinanderreihung von kleinen Fortschritten und verpassten Chancen an. Erst zu Beginn des 20. Jahrhunderts identifizierten Wissenschaftler mit Hilfe von Meerschweinchen als Versuchstieren den Skorbut als eine Form von Mangelernährung. Dann begann ein spannender Wettlauf um die Isolierung, Strukturaufklärung und Synthese des Vitamin C. Heute ermöglicht die industrielle Vitamin‐C‐Synthese eine preiswerte Versorgung von jedermann. Diese Erfolgsgeschichte der modernen Chemie hat dafür gesorgt, dass der Skorbut aus unserem Leben nahezu vollständig verschwunden ist.
Das Glasmuseum in Wertheim am Main
Authors: Schwedt Georg
Published: February 2009

In der Brockhaus‐Enzyklopädie aus dem Jahr 2000 stehen zur Stadt Wertheim an Main und Tauber die Glasfachschule, die Forschungsgemeinschaft für technisches Glas, das Glasmuseum und die Glasindustrie an erster Stelle nach den geografischen Angaben. Das Glasmuseum in historischen Gebäuden und im Zentrum der Altstadt dokumentiert nicht nur die Geschichte der Glasindustrie in der Region, sondern beginnt mit dem Glas in der Antike.
Radionuclide assessment of cardiac performance and myocardial perfusion in congestive cardiomyopathies
Authors: Pachinger O. , Ogris E. , Sochor H. , Probst P. , Zasmeta H. , Kaindl F.
Published: February 2009

To determine the reliability of radionuclide techniques in the diagnosis of congestive cardiomyopathy (COCM), the function of the right ventricle (RV) and left ventricle (LV) was evaluated in 32 patients with COCM and 21 normal subjects using radionuclide angiography (first pass and gated blood pool scan) combined with quantitative201 thallium (Tl) myocardial perfusion imaging. In COCM parameters of RV and LV performance were significantly reduced (p .01); regional wall motion analysis revealed a reduced radial shortening ability (p 0.05). 201Tl distribution within the myocardium was not different between COCM and N; however, segmental 201Tl‐uptake was significantly reduced (p 0.01). RV free wall was visualized on 201Tl scan in 80% of patients with COCM. There was no correlation between RV free wall visualization and RV hemodynamics.

Thus these scintigrahic aspects provide an atraumatic and sensitive technique for the evaluation of patients with COCM.
The magnitude of exercise‐induced ST segment depression and the predictive value of exercise testing
Authors: Nahormek P. A. , Chahine R. A. , Raizner A. E. , Thornby J. I. , Ishimori T. , Montero A. , Luchi R. J.
Published: February 2009

To assess whether the magnitude of exercise induced ST segment depression improves the predictive value of symptom limited exercise tests, and helps in the recognition of patients with more severe coronary heart disease, 90 consecutive patients with positive treadmill tests who also underwent selective coronary arteriography were reviewed. The predictive value improved progressively with the increasing ST depression and was most reliable in a select group of patients with normal electrocardiographic baseline who were not receiving digitalis (73% with ST depression 1 mm to 100% with ST depression 4 mm). The incidence of 2 and 3 vessel disease increased from 61 % with ST depression 1 mm in the overall population to 100% with ST depression 4 mm in the select group, and the incidence of left main trunk lesions increased, respectively from 6 to 30%. The prediction of 2 and 3 vessel disease was found to be significantly greater when patients were dichotomized into those with ST depression 4 mm compared to 4 mm.

It is concluded that the magnitude of ST segment depression definitely improves the predictive value of exercise tests as well as the ability to recognize the patients with more severe disease. However, the markedly positive exercise tests cannot be utilized to accurately predict the presence of 2 or 3 vessel disease in individual cases unless ST depression attains 4 mm or more in patients with normal electrocardiographic baselines who are not taking digitalis. In this group, the ability to predict left main trunk lesion is approximately 30%.
Concealed accessory pathway and dual av conduction: Drug‐dependent reentrant tachycardia
Authors: Gmeiner R. , Ng C. K. , GstÖTTNER M.
Published: February 2009

Electrophysiological studies were performed in a patient with paroxysmal supraventricular tachycardia and a normal surface ECG at the time of the study. Premature atrial stimulation revealed dual AV conduction and an echo zone during AV conduction over the fast and the slow pathway. The prolongation of the AV conduction time by a calcium antagonist, Ro 11‐1781, permitted the induction of tachycardias via both pathways. Premature ventricular stimulation yielded constant VA conduction times with activation of the low right atrium before the high right atrium before the left atrium. During the tachycardia, premature right ventricular beats conducted to the atrium at a time when the AV node and the His bundle would be refractory. The study suggests the simultaneous occurrence of an occult accessory bundle connecting the right ventricle to the right atrium and dual AV conduction.
Notation of physical equations no longer a problem
Authors: Gehbauer F. , Rau K. L. , NAT Rer
Published: February 2009

Physical quantities and equations are used to define the laws of natural and engineering sciences. Clarity has been brought in equal measure into the theory of physical quantities and the SI‐system of units due to the basic work of Wallot and that of national and international institutions. For practical use in this paper, the most important rules and definitions for the formulation of physical equations are treated in an elementary form and the ease of their use is demonstrated in the following examples: speed of a car, capacitance of a plate capacitor, thermal emission of the cathode of an x‐ray tube, oxygen uptake in cardiology, mole concentration and mass concentration of a substance in a solution. In addition, some important quantities and units of cardiology were summarized in a table.
Propranolol during the evolution and subsequent ten days of myocardial infarction in man: Hemodynamic, initial cardiac energetic, and neurohumoral responses
Authors: Mueller I. S. , Rao P. S. , Fletcher J. , Evans R. , Hertelendy F. , Stickley L. , Walter K.
Published: February 2009

During the evolution of transmural myocardial infarction an intensive sympathetic hyperactivity was observed. Plasmal‐norepinephrine and epinephrine contents were strikingly increased, the mean values to 2.047±1.10 (SD) and 0.947±0.48 μg/l, respectively. Propranolol (0.1 mg/kg) was administered intravenously within an average of 8.8 h of transmural myocardial infarction to 55 patients who did not show significant left ventricular failure. The drug was continued orally with an average dose of 567±20 (SD) mg q6h for 10 d. Mean plasma propranolol levels during the first 5 d ranged between 89 and 162 ng/ml. Cardiac index, left ventricular ejection fraction, and, to a lesser degree, blood pressure significantly decreased. Mean pulmonary capillary wedge pressure remained unchanged. Decreases in coronary blood flow and myocardial oxygen consumption were associated with improvement of myocardial lactate metabolism, suggesting reduced myocardial oxygen requirements. Plasma free fatty acid contents significantly decreased. Myocardial glucose extraction and respiratory quotient increased, indicating enhanced carbohydrate utilization. Prior to propranolol administration, plasma glucose and glucagon contents were increased and plasma insulin levels were inappropriately low. Initial glucagon and initiall‐norepinephrine and epinephrine contents were correlated (r = 0.54 and 0.50, p <0.01). Beta‐adrenergic blockade decreased plasma insulin contents in spite of hyperglycemia and abolished the correlation between glucagon and catecholamines. Propranolol was tolerated well by all patients; none of them developed acute left ventricular failure.

The study demonstrates that propranolol can be safely administered during the evolution and early phase of transmural myocardial infarction, if selection criteria for patients are carefully considered. Propranolol, dampening the response to acute ischemic stress, diminishes energy requirements and thus appears to be a promising drug for preservation of ischemic myocardium.
Lidoflazine and physical training in the treatment of stable angina pectoris
Authors: Ferguson R. J. , Côté P. , Bourassa M. G. , Corbara F.
Published: February 2009

An additive effect in the treatment of angina pectoris by combining lidoflazine and physical training was postulated. Twenty‐four patients were randomly divided into placebo and drug groups and subsequently underwent a 6‐month physical training program. The drug group had a significantly greater reduction in submaximal heart rate than the placebo group. Similar improvements in symptom‐limited exercise capacity were observed in both groups. Resting and maximal exercise coronary sinus blood flow and left ventricular oxygen consumption were not significantly changed with training in either group. Physical training and lidoflazine appear to influence exercise tolerance in the same manner.
Effects of morphine on left ventricular dimensions and function in patients with previous myocardial infarction
Authors: Ryan W. F. , Henning H. , Karliner J. S.
Published: February 2009

To assess the effects of morphine sulfate on left ventricular function and dimensions we administered 15 mg of this agent to 11 stable patients with previous transmural myocardial infarction. All studies were carried out in the supine position. Before morphine administration an echocardiogram was obtained, and this procedure was repeated at 15, 30, 60, 120, and 240 min after morphine. Heart rate decreased from a control value of 69±4 to 62±5 beats/min 2 h after morphine (p<0.01, analysis of variance); this slower heart rate persisted for 4 h after morphine. Left ventricular end‐diastolic dimension averaged 5.60±0.36 cm and did not change in the 4 h after morphine. Serial measurements of blood pressure, echocardiographic ejection fraction, percent of fractional shortening, and mean normalized velocity of circumferential fiber shortening also showed no significant alterations after morphine.

We conclude that in stable patients with chronic ischemic heart disease studied in the supine position, 1) morphine exerts no effect on left ventricular dimensions, an observation which does not support the concept that this agent acts in humans by producing a “pharmacologic phlebotomy”; and 2) morphine does not alter left ventricular function at rest. Whether different results will be found in patients with increased sympathetic activity, such as occurs in the setting of an acute myocardial infarction or during an episode of acute pulmonary edema, remains to be investigated.
Effects of work and acute beta‐receptor blockade on myocardial noradrenaline release in congestive cardiomyopathy
Authors: Swedberg K. , Hjalmarson Å. , Holmberg S.
Published: February 2009

Systemic hemodynamic changes and noradrenaline concentrations in coronary sinus blood were studied at rest and during work before and after acute beta‐receptor blockade. Patients with congestive cardiomyopathy were compared to patients with primary valvular diseases and to healthy subjects. Noradrenaline concentrations were higher in coronary sinus blood than in arterial blood and increased after beta blockade and during work. Noradrenaline concentrations were more increased in patients with more pronounced myocardial failure and did not seem to separate patients with congestive cardiomyopathy from those with valvular disease. Patients with congestive cardiomyopathy showed a good hemodynamic tolerance toward acute beta blockade.
Comparison of myocardial flow, hemodynamic changes, and lactate metabolism during isoproterenol stress in patients with coronary heart disease and severe aortic stenosis
Authors: Thormann J. , Schlepper M.
Published: February 2009

The evidence of subendocardial ischemia was studied during isoproterenol stress in seven patients with aortic valve disease before (group A) and approximately 6 months after Björk‐Shiley valvular replacement (group B), in seven patients with coronary artery disease (group C), and in seven patients without heart disease (group D). Ejection fraction, thermodilution coronary sinus flow, and lactate metabolism were determined at rest and during isoproterenol stress. Potential subendocardial blood supply was estimated from a diastolic pressure‐time index (DPTI), calculated from aortic and left ventricular pressure curves, and oxygen demand, estimated from the tension‐time index (TTI). The ratio of DPTI/TTI was used to estimate the supply‐demand relationship. Impaired left ventricular myocardial function was apparent by a lack of increase of the ejection fraction during stress in groups A and C as compared to controls. After aortic valvular replacement (group B) during stress, an adequate increase of the ejection fraction, a normal stress response of the O2 supply‐demand ratio, and a lactate extraction rather than production (all p>0.05) were found. During isoproterenol infusion (at equal heart rates and normal coronary sinus flow) a significant lactate production and decreased O2 supply‐demand ratio in group A and C patients were induced, but not in group B and D patients. The more massive lactate production in group A as opposed to group C reflected subendocardial ischemia of the hypertrophic left ventricle as compared to the more regional and nonuniform distribution of ischemic areas in coronary artery disease. The results of this study suggest that ischemia and cardiac failure can be induced by isoproterenol stress in coronary artery disease as well as in hypertrophic myocardium caused by aortic stenosis. Aortic valvular replacement repaired the ischemic response found in aortic valve disease 6 months prior to surgery. Stress‐induced lactate production rather than coronary sinus flow changes allow discrimination between ischemic and nonischemic myocardium. A critical DPTI/TTI ratio (≤0.4) indicates ischemia in hypertrophic myocardium caused by aortic valve disease, but this concept does not apply to ischemia caused by coronary artery disease.
Quantification of myocardial ischemia and infarction with 201thallium scintigraphy
Authors: Nelson A. D. , Leighton R. F. , Andrews L. T. , Khullar S. C. , Ross J. N. , Budd G. C. , Gohara A.
Published: February 2009

A quantitative method for the analysis of 201thallium myocardial scintigrams, developed in an experimental infarcted dog heart model, has been compared with two nonquantitative methods for interpretation of stress myocardial scintigrams in two groups of patients studied with coronary angiography: 11 with normal coronary arteries and 14 with coronary artery disease. Three independent observers interpreted scintigrams which were 1) not computer processed; 2) corrected for background activity in lungs and chest wall; and 3) processed by a computer method which uses a uniform threshold of counts determined from the dog model to define perfusion defects. Interobserver variability as well as sensitivity and specificity of detecting coronary disease were examined.

In patients with coronary artery disease interobserver variability was improved by using the computer technique: observers agreed as to the existence of a perfusion defect in 93% of the scintigrams as compared to 55% and 81% for the unprocessed and background‐subtracted images respectively. No false positive indications of coronary disease were obtained by any of the three techniques. Use of the computer method did not improve the sensitivity of detecting coronary disease, however—71% compared to 64% for unprocessed images and 79% for background‐subtracted images. The advantages of this quantitative computer method are increased consistency of interpretation and lack of false positive diagnoses of coronary disease. An improved sensitivity of detection may be gained by varying thallium count thresholds according to anatomic location in the heart.
Ventricular septal rupture detected by cross‐sectional echocardiography
Authors: Dabrowski R. C. , Troup P. J. , Olinger G. N. , Wann L. S.
Published: February 2009

Cross‐sectional echocardiography was used to directly visualize abnormal wall motion and detect the site of ventricular septal rupture in a patient with acute inferior myocardial infarction. The presence of the defect was confirmed by injecting indocyanine green into the left ventricle at the time of cardiac catheterization. Cross‐sectional echocardiography provides a rapid, atraumatic means for evaluating patients with complicated acute myocardial infarction.
The use of propranolol and nifedipine in the medical management of angina pectoris
Authors: Fox K. M. , Jonathan A. , Selwyn A. P.
Published: February 2009

This study investigates the use of propranolol and nifedipine in the treatment of angina pectoris. The clinical response and the effects on the precordial 16‐lead electrocardiogram before and after exercise were studied in 52 patients with frequent angina pectoris. Relief of chest pain and abolition of exercise‐induced ST‐segment depression was achieved in 16 patients on treatment with propranolol alone (mean dose, 300 mg/d). Of the remaining 36 patients, the precordial area and severity of exercise‐induced ST‐segment depression were unchanged in 8 patients, of whom 2 reported they were free from chest pain, improved in 10 patients of whom 4 reported they were free of chest pain, and abolished in 14 patients, all of whom were free from chest pain following treatment with both propranolol and nifedipine (mean dose, 50 mg/d). Four patients were unable to tolerate this combination.

This study has shown that in patients who do not respond to treatment with propranolol alone the combination of propranolol and nifedipine can be used to control not only anginal pain, but also the precordial electrocardiographic manifestations of ischemia.
Coronary artery disease confined to secondary branches of the left coronary system
Authors: Iskandrian A. S. , Klein B. L. , Segal B. L. , Kimbiris D. , Bemis C. E.
Published: February 2009

Among 3,000 patients studied by coronary arteriography during a 4‐year period, 31 patients (1%) had coronary artery disease limited to a diagonal branch of the left anterior descending (15 patients), marginal branch of the left circumflex (10 patients), or to both branches (6 patients). Ten patients had 50‐69% and twenty‐one had ⩾70% diameter narrowing. The suitability for grafting was noted in 20 patients as judged by the caliber and distribution of the diseased branches. Collaterals were noted in seven patients. Disease was present in 28 men and 3 women (age range 38‐70 years). At least one major coronary risk factor was present in 27 patients. Angina was noted in 27 patients; prior myocardial infarction was noted in 5 patients by history and in 4 by ECG. The left ventriculogram was normal in 22 patients and showed mild segmental asynergy in 9; ejection fraction was normal in all. Exercise ECGs were positive in 12 of 25 patients; exercise201 thallium scans were positive in 13. All patients responded to medical therapy.
Predictors of ventricular fibrillation or cardiac arrest in patients hospitalized for acute myocardial infarction
Authors: Tonascia J. , Szklo M. , Goldberg R. , Kennedy H.
Published: February 2009

A community‐wide study of patients hospitalized with acute myocardial infarction in metropolitan Baltimore was conducted to examine socio‐demographic and clinical characteristics in association with ventricular fibrillation and cardiac arrest (VF/CA). Multivariate analyses revealed that variables significantly associated with occurrence of VF/CA included older age (60 years or older), male sex, and a history of cigarette smoking. These factors allow the identification of subgroups of patients hospitalized with acute myocardial infarction at high risk for the subsequent development of VF/CA, in whom prophylactic therapy and close surveillance are especially recommended.
Facial Swelling: A Complication of Transvenous Pacing
Authors: Deanfield J. E. , Fox K. M. , Allison D. J.
Published: February 2009

Summary: A case of progressive venous thrombosis involving the superior vena cava is reported following implantation of a permanent transvenous pacemaker. Acute symptoms in the arm appeared after 18 months, but the symptoms of superior vena caval obstruction developed gradually, three years after pacemaker insertion. The diagnosis was confirmed by cavography and symptoms resolved with heparin therapy. Long‐term anticoagulation is indicated when thrombosis is responsible for this uncommon but important complication of transvenous pacing.
Hemodynamics before and after physical endurance training in patients with myocardial infarction under various physical and psychomotor stress tests
Authors: Buchwalsky R.
Published: February 2009

Summary: This hemodynamic study was done in 23 post myocardial infarction patients. The peripheral and central hemodynamics were examined by repeated er‐gometer tests, heart volume estimations, and heart catheterizations under various provocative techniques such as dynamic bicycle ergometer load, static hand grip load, volume load, atrial pacing, and psychomotor stress. After a 5‐week period of endurance training we found a marked and statistically significant increase (40%) of maximal work tolerance and a significant decrease (10%) in heart rate and atrial blood pressure at rest and on equal levels of work load. No significant influence was seen on central (pulmonary) pressure readings at rest or on equal levels of work load beside the higher venous oxygen extraction. These peripheral effects of physical training were seen for all provocative tests, and also for those which were not trained as static and volume load and psychomotor stress.
Invasive and Noninvasive Assessment of Pulmonic Regurgitation: Clinical, angiographic, phonocardiographic, echocardiographic, and doppler ultrasound correlations
Authors: Chandraratna P. A. N. , Wilson D. , Imaizumi T. , Ritter W. S. , Aronow W. S.
Published: February 2009

Summary: Three patients with pulmonic regurgitation and no evidence of pulmonary hypertension were investigated. These patients had low pitched diastolic murmurs which increased on inspiration, evidence of connective tissue disease as manifested by lax joints and hyperextensible skin, and marked hilar dance which extended up to the peripheral vessels. Suprasternal echocardiography revealed dilatation and increased systolic expansion of the right pulmonary artery (RPA) (25% and 28%, respectively) in two patients; the third patient had a normal RPA dimension in diastole and a marked increase in diameter (88%) in systole. Thus, these three patients demonstrated hyperdistensibility of the RPA. The spectral signal from the pulsed Doppler echocardiograph showed evidence of turbulent blood flow in diastole (wide dispersion of the dots) in the right ventricular outflow tract in all three patients. This pattern was indicative of pulmonic regurgitation. In summary, the combined use of echocardiography and Doppler ultrasound is useful in the evaluation of patients with pulmonic regurgitation.
Beta‐Blocker Therapy Evaluated by Radionuclide Angiography: A study in chronic stable angina
Authors: Lessem J.
Published: February 2009

Summary: In order to evaluate the negative inotropic effects of sotalol, metoprolol, and propranolol in patients with chronic stable angina pectoris, left ventricular ejection fraction (LVEF) was measured with radionuclide angiography and echocardiography. Fifteen patients entered the study, which was designed as a randomized crossover trial. The patients served as their own control at all times. Surprisingly, LVEF increased when measured by echocardiography in all three treatment periods, and decreased in the propranolol period when measured by radionuclide methods. The changes were not significant. There was no negative inotropic effect registered during any of the three drug treatments.
Aberrant origin of the left coronary artery from the proximal right coronary artery: Diagnostic features and pre‐ and postoperative course
Authors: Liberthson R. R. , Zaman L. , Weyman A. , Kiger R. , Dinsmore R. E. , Leinbach R. C. , Strauss H. W. , Buckley M. J.
Published: February 2009

Summary: In this report, we present the pre and late postoperative course of a patient with severe angina secondary to aberrant origin or the left coronary artery from the proximal right coronary artery (Fig. 1). We illustrate the noninvasive diagnosis and evaluation of this patient by two‐dimensional ultrasound and stress thallium imaging, and the pre and late postoperative angi‐ographic and thallium perfusion findings.
Verapamil in effort‐induced angina pectoris in patients with normal coronary arteries
Authors: Hasin Y. , Rod J. L. , Lewis B. S. , Gotsman M. S.
Published: February 2009

Summary: Two patients with classical effort‐induced angina pectoris associated with abnormal ST‐segment depression on graded exercise testing and normal coronary arteriograms are described. Both patients deteriorated during treatment with propranolol, and became asymptomatic during treatment with verapamil with normal graded exercise tests. Verapamil may thus improve an inadequate vasodilatatory response of the coronary vascular bed to effort.
Methacholine provocation of prinzmetal's variant angina pectoris: A revised perspective
Authors: Stang J. M. , Kolibash A. J. , Bush C. A. , Schorling J. B.
Published: February 2009

We report 13 patients with unequivocal Prinzmetal's variant angina pectoris as the entire experience with this syndrome during a 7‐year period in a single institution. The clinical diagnosis of this relatively uncommon disorder is emphasized. Five patients were given 10 mg of methacholine subcutaneously. Three demonstrated subsequent delayed appearance of chest pain, ECG change, and coronary vasospasm following early appearance of muscarinic effects. Two Prinzmetal patients had no provocation of variant angina following methacholine, though they did experience significantly less blood pressure fall in response to muscarinic provocation. Another 23 subjects with incompletely explained chest pain given methacholine had neither ECG change nor spasm. Methacholine provocation of variant angina need not necessarily implicate a parasympathomimetic mechanism for otherwise spontaneous episodes. Rather, provocation would appear to occur via the customary reflex adrenergic response to drug‐induced hypotension. Methacholine is probably safe though unreliable as an agent to be used for spasm provocation.
Oxygen consumption in adult patients during cardiac catheterization
Authors: Dehmer G. J. , Firth B. G. , Hillis L. D.
Published: February 2009

The determination of cardiac output by the Fick principle requires the quantitation of the arterio‐venous oxygen (O2) content difference across the pulmonary bed and the O2 consumption. Since a correct measurement of O2 consumption may be difficult, an assumed value is sometimes substituted into this equation. Despite this practice, there is no appropriate reference standard for O2 consumption applicable to the adult catheterization laboratory. Therefore, we determined O2 consumption in 108 patients (69 men and 39 women, mean age, 49 years) at the time of catheterization by multiplying the arteriovenous O2 content difference by the indicator dilution cardiac output, thereby eliminating errors related to the collection and analysis of a timed collection of expired air. O2 consumption index (O2 consumption/m2 of body surface area) averaged 126 ± 26 ml/min/m2 (mean±SD), but there was wide variability (65–250 ml/min/m2). O2 consumption was not affected by patient age or sex but was lower in those who were mildly sedated before catheterization (sedated, 121±22 ml/min/m2; nonsedated, 132±28 ml/min/m2; p = 0.023). Thus, O2 consumption varies greatly among adults at the time of cardiac catheterization, so that any attempt at estimating this variable is fraught with major potential error.
Influence of ipratropiumbromide on heart rate and hemodynamics in patients with sinus bradycardia
Authors: Kikis D. , Esser H. , Heinrch K.
Published: February 2009

In 13 patients with sinus bradycardia, heart rate and hemodynamics were recorded before and 3, 30, 60, and 120 minutes following intravenous administration of 0.5 mg ipratropiumbromide (Itrop® by C. H. Boehringer Sohn, Ingelheim, West Germany). Heart rate already started to rise during the injection of ipratropiumbromide. It increased by an average of 78% three minutes following the administration as compared to pretreatment control values. Mean heart rate still was markedly increased by an average of 26% at 120 min following the injection of the drug. This effect of ipratropiumbromide on heart rate was accompanied by an increase in cardiac index while stroke volume decreased due to a decrease in ejection fraction and diastolic filling time.
Absence of secular changes in the prognosis of patients with an initial myocardial infarction
Authors: Goldberg R. J. , Kennedy H. L. , Gore J. M.
Published: February 2009

A community‐based study was conducted in metropolitan Baltimore in which secular trends in the in‐hospital and long‐term prognosis of 935 male and female patients hospitalized with an initial myocardial infarction were examined for the two periods of 1966–1967 and 1971. The in‐hospital case fatality rate among males in both periods remained unchanged (19.0% vs 19.0%), whereas there was a decrease over time among women hospitalized in 1966–1967 as compared to those in 1971 (37.2% vs 26.6%) (p<0.10). For patients discharged alive from the hospital and followed up for as long as 10 years, no significant differences in overall survival were observed between male patients discharged in 1966–1967 and 1971 or between female patients discharged in these two periods. These findings may reflect the lack of major therapeutic advances in the care of the acute coronary patient between the two study periods and, therefore, support continuing efforts directed at the primary and secondary prevention of the atherosclerotic process.