bluuebunny/crossref_metadata_2025 huggingface dataset:
Glucagon-Like Peptide 1/Glucagon Receptor Dual Agonism Reverses Obesity in Mice
Authors: Pocai Alessandro , Carrington Paul E. , Adams Jennifer R. , Wright Michael , Eiermann George , Zhu Lan , Du Xiaobing , Petrov Aleksandr , Lassman Michael E. , Jiang Guoqiang , Liu Franklin , Miller Corey , Tota Laurie M. , Zhou Gaochao , Zhang Xiaoping , Sountis Michael M. , Santoprete Alessia , Capito' Elena , Chicchi Gary G. , Thornberry Nancy , Bianchi Elisabetta , Pessi Antonello , Marsh Donald J. , SinhaRoy Ranabir
Published: July 2009

OBJECTIVE

Oxyntomodulin (OXM) is a glucagon-like peptide 1 (GLP-1) receptor (GLP1R)/glucagon receptor (GCGR) dual agonist peptide that reduces body weight in obese subjects through increased energy expenditure and decreased energy intake. The metabolic effects of OXM have been attributed primarily to GLP1R agonism. We examined whether a long acting GLP1R/GCGR dual agonist peptide exerts metabolic effects in diet-induced obese mice that are distinct from those obtained with a GLP1R-selective agonist.

RESEARCH DESIGN AND METHODS

We developed a protease-resistant dual GLP1R/GCGR agonist, DualAG, and a corresponding GLP1R-selective agonist, GLPAG, matched for GLP1R agonist potency and pharmacokinetics. The metabolic effects of these two peptides with respect to weight loss, caloric reduction, glucose control, and lipid lowering, were compared upon chronic dosing in diet-induced obese (DIO) mice. Acute studies in DIO mice revealed metabolic pathways that were modulated independent of weight loss. Studies in Glp1r−/− and Gcgr−/− mice enabled delineation of the contribution of GLP1R versus GCGR activation to the pharmacology of DualAG.

RESULTS

Peptide DualAG exhibits superior weight loss, lipid-lowering activity, and antihyperglycemic efficacy comparable to GLPAG. Improvements in plasma metabolic parameters including insulin, leptin, and adiponectin were more pronounced upon chronic treatment with DualAG than with GLPAG. Dual receptor agonism also increased fatty acid oxidation and reduced hepatic steatosis in DIO mice. The antiobesity effects of DualAG require activation of both GLP1R and GCGR.

CONCLUSIONS

Sustained GLP1R/GCGR dual agonism reverses obesity in DIO mice and is a novel therapeutic approach to the treatment of obesity.
Use of a selective serotonin reuptake inhibitor for treatment of episodes of hypertonia and kyphosis in a young adult Scottish Terrier
Authors: Geiger Kelly M. , Klopp Lisa S.
Published: July 2009

Case Description—A 2.5-year-old 12.4-kg (27.3-lb) castrated male Scottish Terrier was evaluated because of episodes of hypertonia and kyphosis for which a presumptive diagnosis of so-called Scottie cramp had been made when the dog was a puppy.

Clinical Findings—Findings of general physical, orthopedic, and neurologic examinations were within reference limits. Pelvic limb hypertonicity and kyphosis without signs of pain were induced with minimal exercise; ambulation returned to normal after a period of rest.

Treatment and Outcome—Fluoxetine, a selective serotonin reuptake inhibitor, was administered orally at a dosage of 1.2 mg/kg (0.55 mg/lb) once daily for 1 month. After this period of treatment, clinical signs of the disease were greatly reduced; the dosage of fluoxetine was changed to 0.8 mg/kg (0.36 mg/lb) twice daily, and response to treatment continued.

Clinical Relevance—Administration of benzodiazepines, vitamin E, or phenothiazines has been recommended for treatment of episodes of hypertonicity, but often does not result in control of clinical signs. It has been suggested that the pathogenesis of this disease is related to deficiencies in concentration or function of serotonin in the CNS; thus, a logical choice for treatment is administration of a serotonin reuptake inhibitor. In the dog of this report, fluoxetine resulted in good control of clinical signs. The use of an effective medication (other than a controlled substance) that is administered once or twice daily, has minimal adverse effects on the patient's mental status, and is inexpensive may lead to better owner compliance and an improved quality of life for affected dogs.
Treatment of acute epistaxis secondary to guttural pouch mycosis with transarterial nitinol vascular occlusion plugs in three equids
Authors: Delfs Kira C. , Hawkins Jan F. , Hogan Daniel F.
Published: July 2009

Case Description—2 horses and 1 pony were evaluated for right-sided (1 horse and the pony) and left-sided (1 horse) acute epistaxis of 1 day's to 1 month's duration.

Clinical Findings—Endoscopic examination of the 3 equids revealed that the hemorrhage originated from the right maxillary artery in 2 equids and from the left internal carotid artery in the third. Mycosis of the auditory tube diverticulum (guttural pouch) was detected in all 3 equids.

Treatment and Outcome—All 3 equids underwent surgery, and transarterial nitinol intravascular plugs were placed to occlude affected blood vessels. All equids survived for a long period (ie, a minimum of 1 to 2 years) and returned to their previous use. All had complete regression of clinical signs of guttural pouch mycosis without additional medical treatment.

Clinical Relevance—The use of transarterial nitinol intravascular plugs appeared to be an effective alternative to other techniques for the treatment of epistaxis secondary to guttural pouch mycosis, including transarterial occlusion devices such as embolization coils.
The Measurability of Complex-Valued Functional Sequences
Authors: Narita Keiko , Endou Noboru , Shidama Yasunari
Published: July 2009

The Measurability of Complex-Valued Functional Sequences

In this article, we formalized the measurability of complex-valued functional sequences. First, we proved the measurability of the limits of real-valued functional sequences. Next, we defined complex-valued functional sequences dividing real part into imaginary part. Then using the former theorems, we proved the measurability of each part. Lastly, we proved the measurability of the limits of complex-valued functional sequences. We also showed several properties of complex-valued measurable functions. In addition, we proved properties of complex-valued simple functions.
Solution of Cubic and Quartic Equations
Authors: Riccardi Marco
Published: July 2009

Solution of Cubic and Quartic Equations

In this article, the principal n-th root of a complex number is defined, the Vieta's formulas for polynomial equations of degree 2, 3 and 4 are formalized. The solution of quadratic equations, the Cardan's solution of cubic equations and the Descartes-Euler solution of quartic equations in terms of their complex coefficients are also presented [5].
Complex Sensory Corpuscles in the Upper Jaw of Horsfield’s Tortoise (Testudo horsfieldii)
Authors: Buchtová Marcela , Páč Libor , Knotek Zdeněk , Tichý František
Published: July 2009

The sensory corpuscles of Testudo horsfieldii in the skin of the upper lip and face were studied with light and electron microscopy. The sensory corpuscles were situated under epidermis; in the corium and also between the upper jaw bone tissues in the rostral part of oral cavity. The skin sensory corpuscles with a ramified inner core were grouped in clusters. Within the corpuscle there were several simple inner cores embedded within a common superficial capsule. The complex corpuscles have a novel structure in comparison to what has been described for sensory nerve endings in turtle. The complex sensory corpuscles probably function as mechanoreceptors important for monitoring the movement of the keratinized ridges and the most rostral part of the upper jaw, the rhamphotheci.
Phylogenetic Analysis of the Rabies Virus N-coding Region in Lithuanian Rabies Isolates
Authors: Zienius Dainius , Sajute Kristina , Žilinskas Henrikas , Stankevicius Arunas
Published: July 2009

Rabies infection among wild and domestic animals constitutes a well-known problem in Lithuania, but only one dog rabies virus isolate sequence (1992) from Lithuania was used in the European rabies virus phylogenetic analysis. The objective of this work was to determine nucleoprotein (N) gene sequences and genetically characterize the rabies virus isolates in order to learn which virus group (biotype) is circulating in reservoir species in Lithuania. Classical rabies virus isolate nucleoprotein (N) gene sequences from different parts of Lithuania were found to be closely related to each other and demonstrated nucleotide identity from 97.7 to 100% and could be placed in one lineage with 100% bootstrap support. All 12 sequences of raccoon dogs, red foxes, dogs and marten rabies viruses exhibited 97.7 - 99.0% identity to previously published sequences from Eastern parts of Poland, Estonia, Finland, and the North-Eastern part of Russia. Phylogenetic analysis revealed that all Lithuanian strains belong to the North East Europe (NEE) group of rabies virus.
Using Dominance Analysis to Determine Predictor Importance in Logistic Regression
Authors: Azen Razia , Traxel Nicole
Published: July 2009

This article proposes an extension of dominance analysis that allows researchers to determine the relative importance of predictors in logistic regression models. Criteria for choosing logistic regression R2 analogues were determined and measures were selected that can be used to perform dominance analysis in logistic regression. A simulation study, using both simple random sampling from a known population and bootstrap sampling from a single (parent) random sample, was performed to evaluate the bias, sampling distribution, and confidence intervals of quantitative dominance measures as well as the reproducibility of qualitative dominance measures. Results indicated that the bootstrap procedure is feasible and can be used in applied research to generalize logistic regression dominance analysis results to the population of interest. The procedures for determining and interpreting the general dominance of predictors in a logistic regression context are illustrated with an empirical example.
Intermolecular slip mechanism in tropocollagen nanofibrils
Authors: Gautieri Alfonso , Vesentini Simone , Redaelli Alberto , Buehler Markus J.
Published: July 2009

We report a detailed study of the shear interaction between two tropocollagen molecules, a major mechanism that contributes to the fibril mechanical behavior. Using steered molecular dynamics simulations in explicit solvent, we model the slip of two tropocollagen molecules at varying pulling rates. We find that the adhesion strength is highly sensitive to the pulling rate, and that it converges to a value of 10.12 pN Å– 1for vanishing loading rates. We find that intermolecular H-bonds play a key role in determining the resistance against slip. Our results provide quantitative details on this mechanism of load transmission inside collagen fibrils and fibers, which is crucial for the development of constitutive models of collagenous tissues at larger hierarchical levels. Such constitutive models of collagenous tissue mechanics have many applications, ranging from development of bio-inspired materials to studies in tissue engineering. By incorporating pathological collagen mutations, our studies could advance our knowledge of mechanisms underlying important collagen-related diseases like Osteogenesis Imperfecta or Ehlers – Danlos Syndrome.
Identification of model parameters from elastic/elasto-plastic spherical indentation
Authors: Niederkofler Thomas , Jäger Andreas , Lackner Roman
Published: July 2009

Spherical indentation is commonly used to study the elastic and visco-elastic response of materials at different length scales. However, depending on the strength properties of the investigated material and the geometric properties, such as sphere radius and penetration depth, plastic material response might occur, making parameter identification from load – penetration curves a difficult task. In this paper, the influence of the aforementioned parameters is investigated by means of numerical simulations, considering elasto-plastic material response. The numerical results obtained are presented in dimensionless format, finally providing (i) general rules for the specification of test parameters in the case of spherical indentation, on the one hand, and – in the case plastic deformation takes place – (ii) relations for the determination of plastic model parameters (such as the deviatoric strength) from the loading phase of the indentation test.
Penetration of a pyramid indenter into a multilayer coating
Authors: Kravchuk A. , Rymuza Z. , Jarzabek D.
Published: July 2009

A simple model of elastic – plastic penetration of a Berkovich pyramid into a multilayer coating has been developed. The model of a simply deformable body was used. It generalizes Winkler's foundation to the case of elastic – plastic deformation of each layer. The elastic – plastic deformation of a layer was modeled by Prandtl's bilinear approximation of a stress – strain curve. The homogenized coefficients of the elastic and plastic properties of the layer set and an analytical solution of the problem were found. The distribution of contact stress and depth of a pyramid indenter penetration were obtained for different angles.
Static Knee Alignment Measurements among Caucasians and African Americans: The Johnston County Osteoarthritis Project
Authors: NELSON AMANDA E. , BRAGA LARISSA , BRAGA-BAIAK ANDRESA , ATASHILI JULIUS , SCHWARTZ TODD A. , RENNER JORDAN B. , HELMICK CHARLES G. , JORDAN JOANNE M.
Published: July 2009

Objective.

To determine if knee alignment measures differ between African Americans and Caucasians without radiographic knee osteoarthritis (rOA).

Methods.

A single knee was randomly selected from 175 participants in the Johnston County Osteoarthritis Project without rOA in either knee. Anatomic axis, condylar, tibial plateau, and condylar plateau angles were measured by 1 radiologist; means were compared and adjusted for age and body mass index (BMI).

Results.

There were no significant differences in knee alignment measurements between Caucasians and African Americans among men or women.

Conclusion.

Observed differences in knee rOA occurrence between African Americans and Caucasians are not explained by differences in static knee alignment.
Serum CXCL16 Concentrations Correlate with the Extent of Skin Sclerosis in Patients with Systemic Sclerosis
Authors: YANABA KOICHI , MUROI EIJI , YOSHIZAKI AYUMI , HARA TOSHIHIDE , OGAWA FUMIHIDE , SHIMIZU KAZUHIRO , YOZAKI MARIKO , HASEGAWA MINORU , FUJIMOTO MANABU , TAKEHARA KAZUHIKO , SATO SHINICHI
Published: July 2009

Objective.

To determine serum concentrations of soluble CXCL16 and its clinical associations in patients with systemic sclerosis (SSc).

Methods.

Serum CXCL16 levels from 89 patients with SSc were examined by ELISA. In a retrospective longitudinal study, 68 sera from 28 patients with SSc were analyzed (followup 1.3 to 7.3 yrs).

Results.

Serum CXCL16 levels were elevated in patients with SSc compared with healthy controls (n = 42). Patients with diffuse cutaneous SSc (n = 52) had higher levels of CXCL16 than those with limited cutaneous SSc (n = 37). Serum CXCL16 levels correlated positively with the extent of skin sclerosis. In the longitudinal study, CXCL16 levels generally decreased on a parallel with the improvement in skin sclerosis.

Conclusion.

CXCL16 levels were increased in patients with SSc, and correlated with the extent of skin sclerosis, suggesting that CXCL16 may have a role in the development of skin fibrosis in SSc. Blockade of CXCL16 interaction might be a potential therapeutic target in patients with SSc.
Improvement in biomass characteristics and degradation efficiency in modified UASB reactor treating municipal sewage: a comparative study with UASB reactor
Authors: Das Suprotim , Chaudhari Sanjeev
Published: July 2009

Low strength wastewaters (LSWs) are difficult to degrade efficiently in the upflow anaerobic sludge blanket (UASB) reactor. The possible reasons for poor treatment of LSWs in UASB are: (i) low mixing due to low biogas production (ii) frequent biomass washout at higher hydraulic loading rate due to low settleability of biomass. In the present study, lab scale UASB reactor and modified upflow anaerobic sludge blanket (MUASB) reactor were operated with municipal sewage containing chemical oxygen demand (COD) in range of 180–210 mg L−1 as LSW at three different hydraulic retention times (HRTs) of 8, 6, and 4 h. The changes in the biomass characteristics as well as degradation efficiency were compared with respect to time. During this operation, samples of biomass were taken from both reactors to measure total suspended solids (TSS), settling velocity, granular size and specific methanogenic activity (SMA). The overall COD removal in MUASB reactor was higher compared to UASB (84 and 67% respectively). After 150 days of operation, the settling velocity and SMA of MUASB biomass increased, but no significant change in settling velocity and SMA of UASB biomass was observed. The study shows that MUASB could be preferred over UASB for the treatment of municipal sewage as LSW. Copyright © 2009 Curtin University of Technology and John Wiley & Sons, Ltd.
Catalytic wet air oxidation of high‐strength organic coking wastewater
Authors: Han Lihua , Zhu Jing , Kang Ju , Liang Yinghua , Sun Yang
Published: July 2009

Catalytic wet air oxidation (CWAO) treatment of the high‐strength organic coking wastewater over CeCu and CeMn catalysts were studied. The main factors affecting the activities of the catalysts were investigated. Experimental results showed that in the absence of rare‐earth metal catalysts, CWAO process was also effective for high‐strength organic coking wastewater treatment. The catalyst, prepared with the active component CuCe (2:1) and carried by γ‐Al2O3/TiO2 calcined at 600 °C, has a higher activity. Up to 95.2% of the initial CODCr was removed at the reaction temperature of 180 °C and oxygen partial pressure of 1.2 MPa. The effect of the catalyst is equivalent to homogeneous catalysis improved by 60% over non‐catalytic treatment. Copyright © 2009 Curtin University of Technology and John Wiley & Sons, Ltd.
Development and application of topographic descriptors for conditional analysis of rainfall
Authors: Ferranti Emma Jayne Sakamoto , Whyatt James Duncan , Timmis Roger James
Published: July 2009

Upland rainfall is changing but regional climate models (RCMs) are poor at simulating observed precipitation in such areas of complex topography. This paper presents a method of examining observed rainfall patterns and processes under different conditions of synoptic meteorology and local topography. Objective topographic descriptors are defined and used to distinguish the modification of rainfall by local topography from that due to different synoptic conditions and climate change. A case study examining winter rainfall in Cumbria is presented. The conditional analysis method can be used to test RCM outputs so that model parameterisation can be improved. Copyright © 2009 Royal Meteorological Society
Synthesis and Electrochemical Performance of Ti4+ Doped LiV3O8
Authors: SUN Junli , JIAO Lifang , LIU Li , WEI Xin , YANG Lin , LIU Sichen , YUAN Huatang , WANG Yongmei
Published: July 2009

Layered LiTiyV3−0.8yO8 cathode materials with y=0, 0.04, 0.06, 0.08 were prepared by a sol‐gel process following a calcination at 350°C in air for 16 h, and show differences in morphological properties (shape, particle size and specific surface area) and electrochemical properties (first charge profile, reversible capacity and rate capability). The LiTiyV3−0.8yO8 powders were characterized by means of X‐ray diffraction (XRD), charge/discharge cycling, cyclic voltammetry (CV), and scanning electron microscopy (SEM). LiTiyV3−0.8yO8 was crystallized to a well layered structure. Its initial specific discharge capacity was higher than that of pristine material. When y=0.04, the sample showed the highest initial discharge capacity of 348.9 mAh·g−1 at a current density of 60 mA·g−1 in the voltage range 1.8–4.0 V, and also higher discharge capacity and better cycle ability.
Fullerene[51] with Quasi‐planar Tetracoordinate Carbons and Its Derivatives
Authors: ZHANG Congjie , JIA Wenhong , CAO Zexing
Published: July 2009

Fullerene[51] containing quasi‐planar tetracoordinate carbons and its eight modificational compounds with quasi‐planar tetracoordinate carbons have been constructed. Using B3LYP method, their structures, stabilities, and bonding properties have been investigated, indicating that the nine novel structures are stable and have big vertical detachment energies and relatively small vertical electron affinities. The structures of the nine compounds contain five‐ and six‐membered rings, as well as bigger ten‐membered rings.
Silver Nanowire Film: Green Synthesis and Its Surface Enhanced Raman Scattering
Authors: TAO Xiucheng , LU Lei , SHAO Mingwang , HUANG Xiaojia
Published: July 2009

One‐step preparation of silver nanowires on the silicon wafer has been performed successfully employing silver nitrate as silver source. The procedure was operated at room temperature employing an environmentally benign compound of ethylene glycol as reductive agent, which is a completely green route. The as‐prepared products were characterized with X‐ray diffraction, scanning electron microscopy and energy dispersive X‐ray spectrum, which reveals uniform silver nanowires with average diameter of 20 nm. These silver nanowires were used to detect Rhodamine 6G via surface‐enhanced Raman scattering. The characteristic peaks appeared when the concentration of Rhodamine 6G was 10 nmol·L−1.
Large‐scale Hydrothermal Synthesis and Characterization of Size‐controlled Lanthanum Hydroxide Nanorods
Authors: YI Ran , ZHANG Ning , SHI Rongrong , LI Yongbo , QIU Guanzhou , LIU Xiaohe
Published: July 2009

Uniform lanthanum hydroxide nanorods were successfully synthesized in large quantities through a facile hydrothermal synthetic method, in which soluble lanthanum nitrate was used to supply the lanthanum source and triethylamine (TEA) was used as both alkaline agent and complexing agent. The influences of triethylamine amount, surfactant, reaction temperature and time on the size and shape of lanthanum hydroxide nanorods were investigated in detail. Trivalent rare earth ion doped lanthanum hydroxide nanorods were also obtained in this paper. The phase structures and morphologies of the as‐prepared products were investigated in detail by X‐ray diffraction (XRD), transmission electron microscopy (TEM), selected area electron diffraction (SAED) and high‐resolution transmission electron microscopy (HRTEM). The probable formation mechanism was proposed based on the experimental results.
Heck Reactions Catalyzed by Palladium Complex Supported on 4‐Aminopyridine Resin
Authors: WU Xiangmei , PEI Wen
Published: July 2009

4‐Aminopyridine resin‐immobilized palladium catalyst was prepared by a simple procedure, which exhibited excellent activity at low loading levels for the phosphine‐free Heck vinylation of activated and non‐activated aryl or heteroaryl substrates with olefins in air. This method has the advantage of environmental benignity, generality, simplicity and potential for recycling of the resin catalyst.
A New Strategy for the Synthesis of 3‐Acyl‐coumarin Using Mesoporous Molecular Sieve MCM‐41 as a Novel and Efficient Catalyst
Authors: HERAVI Majid M. , POORMOHAMMAD Nargess , BEHESHTIHA Yahia Sh. , BAGHERNEJAD Bita , MALAKOOTI Reihaneh
Published: July 2009

3‐Acyl‐coumarins were obtained in high yields from ortho‐hydroxybenzaldehydes and ethyl acetoacetate or ethyl benzoylacetate in acetonitrile in the presence of a catalytic amount of mesoporous molecular sieve MCM‐41. 3‐Acyl‐coumarins were obtained in high yields from ortho‐hydroxybenzaldehydes and ethyl acetoacetate or ethyl benzoylacetate in acetonitrile in the presence of a catalytic amount of mesoporous molecular sieve MCM‐41.
Cyclocondensation Reations of 3‐Amino‐1,2,4‐triazole with 3‐(Benzylidene)‐6‐fluoro‐thiochroman‐4‐ones to Tetracyclically Fused Dihydropyrimidines and Pyrimidines
Authors: MA Zhengyue , YAN Guoying , ZHU Shiguo , YANG Gengliang , LUO Duqiang
Published: July 2009

The effects of reaction temperature, solvents, reaction time and 7‐aryl on the cyclocondensation reactions of 3‐amino‐1,2,4‐triazole with 3‐(benzylidene)‐6‐fluorothiochroman‐4‐ones were studied. The experimental results show that except tetracyclic fused dihydropyrimidines and pyrimidines were produced simultaneously in the cyclocondensation reactions, the dihydropyrimidines could be directly converted into pyrimidines without any dehydrogenizing reagent under high temperature. The structures of the new synthesized compounds were confirmed by 1H NMR, MS spectra, elemental analysis, and X‐ray single crystallography. The cyclocondensation mechanism for producing the tetracyclically fused dihydropyrimidines and pyrimidines was discussed.
Preparation and Characterization of Olaquindox Polyclonal Antibody
Authors: CHE Huilian , SHI Baoxia , CHEN Jinlan , ZHU Xuejia , HE Jiguo
Published: July 2009

2‐[N‐(2‐Hydroxyethyl)‐carbamoyl]‐3‐methyl‐oxoquinoxaline‐1,4‐oxides (OLA) was first mono‐esterificated by succinic acid anhydride, and was then turned into a derivative with carboxyl. The synthetic product was purified by recrystallization with a yield of 52.47%. Its chemical structure was determined by NMR, IR and MS spectra. The determined structure was used to synthese OLA hapten, which had the molecular structural characteristics of OLA. The OLA hapten and bovine serum albumin (BSA) were conjugated using the activated ester method, while the hapten and ovalbumin (OVA) were coupled by the mixed anhydride method. The UV scanning and infrared spectrum results showed that the hapten and the carrier protein were successfully coupled to BSA and OVA, with the combined ratios of 3.8:1 and 5:1, respectively. OLA‐BSA was used as the immunogen to immunize four New Zealand white rabbits, and the high titer anti‐serum produced relatively. The titers were 1:6400, 1:1600, 1:12800 and 1:6400, respectively, determined by indirect ELISA OLA‐OVA as the coating antigen. The intermediate inhibition concentration (IC50) of OLA in the indirect ELISA test was 743.3 ng/mL. The lowest detection limit (IC20) was 5.71 ng/mL. High‐purity OLA polyclonal antibody has been obtained by saturated ammonium sulfate and ion‐exchange chromatography.
Two‐dimensional echocardiographic discrimination of normal from abnormal great artery relationships
Authors: George L. , Waldman J. D. , Mathewson J. W. , Kirkpatrick S. E. , Pappelbaum S. J. , Turner S. W.
Published: July 2009

A prospective study was performed to determine the diagnostic accuracy of precordial two‐dimensional echocardiographic techniques in discriminating normal from abnormal great artery relationships. We studied 503 children using standard parasternal short‐axis view and a modified technique called rotating high long‐axis view (RHLAV). In RHLAV, there is rapid superimposition of the proximal courses of the two great arteries seen by rotation of the ultrasonic beam. Discrimination was based on the crossing great artery relationship seen with normally related great arteries (NRGA) and the parallel courses found in both transposition and malposition of the great arteries (TGA/MGA). Using the RHLAV, the great artery interrelationship was accurately determined in all 503 patients. Precordial two‐dimensional echocardiography can accurately discriminate great artery relationships and is a useful addition to other two‐dimensional echocardiographic techniques.
Can the mode of death be predicted in patients with angiographically documented coronary artery disease?
Authors: Puddu P. E. , Bourassa M. G. , Lespérance J. , Hélias J. , Danchin N. , Goulet C.
Published: July 2009

To determine whether sudden versus non‐sudden cardiac death could be predicted in high risk patients, 1157 medical patients were followed for an average of 46 months after a diagnostic coronary angiogram and 18 clinical, hemodynamic, and angiographic variables known to be associated with a high risk of mortality were analyzed. The total group of 141 deaths was classified into 3 subgroups: (1) 82 sudden deaths (<1 hour after onset of symptoms); (2) 46 deaths due to acute myocardial infarction with or without heart failure, and (3) 13 deaths unrelated to cardiac symptoms. In a subset of 64 patients, the duration of electrical systole (QTC) was calculated before angiography and before death. A comparison was made of QTCmeasurements at entry with QTCvalues of subjects with normal coronary arteries and normal left ventricular function. Deaths from cardiac causes could often be predicted from older age, male sex, history of myocardial infarction, unstable angina, congestive heart failure, abnormal cardiothoracic ratio, multivessel disease, abnormal left ventricular contraction, and abnormal ejection fraction. However, these variables did not discriminate between sudden and nonsudden cardiac deaths and both modes of death were characterized by depressed left ventricular function and multivessel coronary disease. During follow‐up the incidence of acute myocardial infarction was not different in patients with cardiac and noncardiac deaths and in long‐term survivors. However, patients dying from cardiac causes had a higher incidence of heart failure. Patients dying suddenly did not present new infarctions during follow‐up whereas patients dying from acute myocardial infarction had a 13% incidence of prior infarction and a higher incidence of heart failure. In addition, QTCat entry was longer in nonsurvivors than in normal subjects (p<0.0001) and patients experiencing sudden death exhibited the highest incidence of QTCprolongation (≥440 ms) during follow‐up (p<0.05). We conclude that: (1) although the severity of coronary disease and left ventricular dysfunction are closely related to cardiac mortality, they do not discriminate between sudden and nonsudden cardiac deaths; (2) patients experiencing sudden death are characterized by a low incidence of new myocardial infarction or congestive heart failure and prolongation of the QTCinterval during follow‐up.
Serial ambulatory monitoring in patients with unstable angina pectoris
Authors: Mooss A. N. , Aronow W. S. , Sketch M. , Mohiuddin S. M. , Ryschon K.
Published: July 2009

We performed a prospective study by dual‐channel ambulatory monitoring performed for 24 to 72 hours immediately after hospitalization for unstable angina. The incidence of ST‐segment depression or elevation or ventricular tachycardia or complex premature ventricular complexes (PVCs) in 42 consecutive patients with unstable angina due to coronary artery disease (39 by coronary arteriography) was investigated. During ambulatory monitoring, 28 of 42 patients (67%) exhibited ST‐segment depression or elevation, 13 of 42 patients (31%) had ventricular tachycardia or complex PVCs, and 31 of 42 patients (74%) had either ST‐segment depression or elevation, ventricular tachycardia, or complex PVCs. Ventricular tachycardia or complex PVCs occurred in 10 of 20 patients (50%) with abnormal left ventricular function and in 3 of 22 patients (14%) with normal left ventricular function (p<0.025). We found that 72 hours of ambulatory monitoring was not more useful than 48 hours in detecting the incidence of ST‐segment depression or elevation, ventricular tachycardia, or complex PVCs. Ambultory monitoring did not help in clinically differentiating patients with left main or 3‐vessel disease from 1‐vessel or 2‐vessel disease. In addition, ambulatory monitoring did not help in predicting which patients with unstable angina would require coronary artery surgery.
Congestive heart failure in valvular heart disease in pregnancies with and without valvular prostheses and anticoagulant therapy
Authors: Sheikhzadeh A. , Ghabusi P. , Hakim S H. , Wendler G. , Sarram M. , Tarbiat S.
Published: July 2009

The course and complications of pregnancies in 46 patients with valvular disease and congestive heart failure with or without valve prostheses are described. In group I consisting of 33 women without valve replacement and without anticoagulant therapy one thromboembolic event was seen, emergency closed or open heart surgery was necessary five times. One stillbirth happened after open heart surgery. In group II, of 13 patients with prosthetic valve replacement and anticoagulation therapy there was no thromboembolism, but 2 spontaneous abortions and 2 premature stillbirths; 2 fetuses died after delivery, 3 had congenital abnormalities. Pregnancies in patients with valvular disease and congestive heart failure can be sustained relatively safely for the mother, even if emergency heart surgery becomes necessary. Heart surgery and anticoagulation treatment carry a higher risk for the fetus. Uterine blood loss is not increased, if coumadine treatment is switched to heparin administration shortly before delivery.
Prediction of single versus multivessel disease following myocardial infarction using 201thallium scintigraphy and electrocardiographic stress testing
Authors: Weiss R. J. , Morise A. P. , Raabe D. S. , Sbarbaro J. A.
Published: July 2009

We evaluated 50 patients who suffered a single myocardial infarction with graded electrocardiographic stress testing, 201thallium myocardial perfusion imaging and coronary angiography to assess the role of noninvasive indices as predictors of single versus multivessel coronary artery disease. Multivessel involvement was defined angiographically as the presence of two or more major coronary arteries with at least a 70% intraluminal diameter narrowing. Multivessel disease was defined scintigraphically as the presence of stress and/or redistribution perfusion defects in the distribution of more than one coronary artery. The results of stress electrocardiography were not useful in differentiating patients with single (9/16 positive) versus multivessel (22/34 positive) disease. The degree of exercise‐induced ST‐segment depression was also not helpful. Stress 201thallium imaging did offer limited additional information with correct predictions of multivessel disease in 21 of 26 patients. Predictions of single‐vessel disease were accurate in 11 of 24 patients. Eleven of these 13 incorrect predictions of single‐vessel disease were due to the relative insensitivity of the thallium stress image to perceive defect in the anterior wall when the left anterior descending artery had significant obstruction at catheterization. Further refinements of stress perfusion imaging are needed before this method can be used to reliably separate patients with single and multivessel disease after myocardial infarction.
Reversal of left ventricular hypertrophy with captopril: Heterogeneity of response among hypertensive patients
Authors: Mujais S. K. , Fouad F. M. , Tarazi R. C.
Published: July 2009

Reversal of left ventricular hypertrophy (LVH) has been reported not to occur with all antihypertensive agents. Moreover, a dissociation between blood pressure response to medical therapy and reversal of ventricular hypertrophy has been previously observed. To evaluate the effects of captopril we studied the electrocardiographic (ECG) changes in 26 severe hypertensive patients who received the drug for more than one year. In 14 patients with normal pretreatment ECG, captopril controlled blood pressure effectively [132±2.9 (SE) to 104±3.9 mmHg, p<0.001], but had no effect on ECG voltage. In 12 patients with pretreatment LVH, two different response patterns were observed despite similar blood pressure control (144±4.9 to 102±3.1 mmHg and 148±7.3 to 109±7.3 mmHg, p<0.001 for both): seven had complete normalization of ECG while five had residual LVH pattern. No significant difference was found between the latter two groups in regard to age, sex, weight, etiology of hypertension, pretreatment ECG voltage, blood pressure, plasma renin activity, duration of treatment and duration of maintained blood pressure control. The reversal of LVH pattern occurred early (between 12 to 16 months) with no overall correlation between lowering of blood pressure and ECG voltage changes. The heterogeneity of response observed in this study suggests that factors other than blood pressure control modify the reversal of cardiac hypertrophy by antihypertensive therapy.
Endomyocardial biopsy with fluoroscopic and two‐dimensional echocardiographic guidance: Case report of a patient suspected of having multiple cardiac tumors
Authors: Copeland J. G. , Valdes‐Cruz L. , Sahn D. J.
Published: July 2009

An 18‐year‐old female with multiple intra‐cardiac masses was further evaluated using percutaneous endomyocardial biopsy of the right ventricle and right atrium. Fluoroscopy was used to visualize the course of the bioptome and simultaneous two‐dimensional echo‐cardiography was used to image the masses thus improving the surgeon' chance of obtaining diagnostic tissue.
Amrinone: A weaning agent in catecholamine dependence
Authors: Levene D. , Secter R. A.
Published: July 2009

Amrinone, a new inotropic agent, has been used successfully in refractory chronic congestive heart failure. Intravenous and subsequently oral amrinone administered in a setting of acute myocardial infarction and dopamine dependence allowed the catecholamine to be successfully weaned after volume loading, digitalization and vasoconstrictors failed to terminate dopamine dependence. There was the expected fall in filling pressure and increase in cardiac index and ejection fraction. Intravenous amrinone may be tried in refractory catecholamine dependence after conventional weaning methods have failed.
The importance of pre‐ and postinfarction angina on timolol‐related reduction in mortality and reinfarction
Authors: Gundersen T. , Kjekshus J.
Published: July 2009

The importance of a history of angina pectoris on long‐term timolol treatment after myocardial infarction was studied with respect to mortality and reinfarction. The analyses were performed retrospectively using cohorts from the Norwegian timolol multicenter study. In patients without angina pectoris prior to the infarction, timolol treatment reduced mortality by 61 % and the occurrence of first nonfatal reinfarction by 16.9% as compared with placebo. Patients with preinfarction angina had a reduction in mortality of 21.8% and in first nonfatal reinfarction of 48.6%. The frequency of angina pectoris increased from 38% in both treatment groups before the infarction to 59% in the placebo group and 52% in the timolol group the first 6 months after the infarction. In patients without postinfarction angina pectoris, timolol treatment reduced mortality by 30.7% and the number of first nonfatal reinfarctions by 22.7%. The reductions in mortality and reinfarction in patients with postinfarction angina were 43.8% and 38.5%, respectively. Thus, the decision for timolol treatment after myocardial infarction should not be dependent on pre‐ and postinfarction angina.
Readability of literature written for cardiac patients
Authors: Conroy R. M. , Mulcahy R.
Published: July 2009

The readability of 28 books and leaflets available to cardiac patients at a Dublin hospital was assessed. Mean required reading age was 14.3 years, and only 21 % of the texts had a reading age of 12 or less. Fifty percent of 1088 cardiac patients attending the hospital had no more than an elementary school education and therefore would have been able to read at most one‐fifth of the available patient literature.
Early detection of diastolic impairment in long‐standing hypertension by a noninvasive volume challenge method
Authors: Marmor A. T. , Blondheim D. S. , Frankel A. , Satinger A. , Front D.
Published: July 2009

A simple, easily reproducible, noninvasive, provocative test for the assessment of early diastolic impairment in long‐standing hypertension is presented. Volume challenge of the heart was produced by elevating the subject's legs to 45° for 5 minutes, thus increasing the venous return to the right heart. Using gated radionuclide ventriculography and Fourier analysis, the atrial structures were delineated and time‐activity curves were generated. Early diastolic emptying slope of the left atrium was used to assess left ventricular compliance changes in hypertensives. The left atrial early diastolic emptying rate was markedly reduced in 38 hypertensive patients (45.5±15.4 counts/s) when compared with 14 healthy subjects (78± 16 counts/s). The legs‐up procedure induced subsequent decrease in left atrial emptying rate in patients with long‐standing hypertension and left ventricular hypertrophy (‐27.4± 11 %). In patients with recent onset hypertension there was a depressed early diastolic emptying rate (55.79±10 counts/s), but a “normal” response to the legs‐up procedure (an increase in left atrial emptying rate: 12.84±7%). Global ejection fraction was normal in all subjects studied, decreasing after induction of augmented venous return in long‐standing hypertension. Reduction in left atrial early diastolic emptying rate, caused by the legs‐up manoeuvre appears to be an early and sensitive indicator of the left ventricular diastolic impairment in essential hypertension.
Poor responsiveness of heart rate to treadmill exercise in vasospastic angina
Authors: Sato I. , Tomobuchi Y. , Funahashi T. , Ohe T. , Kamakura S. , Matsuhisa M. , Haze K. , Shimomura K.
Published: July 2009

Heart rate response to submaximal graded treadmill exercise was measured in 45 patients with vasospastic angina, 31 with effort angina, and 40 normal controls. There was no difference of resting heart rate among the three groups. Vasospastic angina showed significantly poor responsiveness of heart rate to exercise at every stage: stage 1, 2.5 km/h (10%), stage 3, 4.5 km/h (10%), stage 5,5.5 km/h (14%), stage 7, 5.5 km/h (22%), when compared with those in normal controls. The effort angina group also showed lower heart rates at stages 3 and 5 than those in control subjects, although their heart rate at stage 1 was not different from that in normals. When abnormal response suggesting vasospastic angina was defined as heart rate at each stage lower than values of mean heart rate ± 1 SD in normal controls, positive test results were obtained in 15 of 45 patients (33%). The use of heart rate criteria in addition to ischemic criteria raises sensitivity from 27 to 51% (p<0.02).
Chest pain and electrocardiographic ST‐segment elevation occurring in the recovery phase after exercise in a patient with normal coronary arteries
Authors: Caplin J. L. , Banim S. O.
Published: July 2009

Exercise‐induced ST‐segment elevation usually occurs in patients with coronary artery disease. We report a case in which ST‐segment elevation occurred during the recovery phase of exercise in a patient with normal coronary arteries.
Diffuse hypoplasia of the aorta as a possible cause of cardiac hypertrophy
Authors: Hada Y. , Ikeda H. , Oku J. , Goto A. , Ohya T. , Iizuka M. , Ishii M. , Sakamoto T. , Sugimoto T.
Published: July 2009

Left ventricular hypertrophy is caused by a wide variety of cardiovascular conditions, including systemic hypertension, aortic valvular disease, and hypertrophic cardiomyopathy. This paper describes a case of diffuse hypoplasia of the aorta in left ventricular hypertrophy. This condition has not previously been well documented. We emphasize the need for evaluation of aortic dimension when systolic hypertension and vascular bruits are observed in association with myocardial hypertrophy.
Left ventricular function after elective aneurysmectomy
Authors: Lumia F. J. , Makam S. , Macmillan R. M. , Germon P. A. , Maranhao V. , Strong M. D.
Published: July 2009

Employing rest and exercise first‐pass radionuclide angiography before and 3 months after surgery, we studied patients with hemodynamically stable left ventricular aneurysm (LVA) undergoing both coronary artery bypass surgery to relieve angina pectoris and elective aneurysmectomy. There were 15 patients, 14 men and 1 woman with a mean age of 54 ± 7 years. All patients had anterior and/or apical LVA. After surgery the postexercise mean left ventricular ejection fraction (LVEF) for the whole group improved significantly (p<0.004) compared with the preoperative value, but the resting LVEF did not change. The duration of exercise improved (p< 0.01) after surgery, but not the double product. However, based upon the preoperative LVEF response to exercise, two groups were seen: Group A (n=5) had ≥5% increase in their LVEF with exercise versus Group B (n=10), who had <5% increase or a decrease in their LVEF. Postoperatively, Group A decreased their LVEF with exercise and failed to improve exercise capacity or double product. Postoperatively, Group B increased the LVEF by ≥5% as well as increasing exercise capacity (p<0.01), and double product (p<0.03). Group A had lower preoperative LVEF than Group B (p<0.01) and larger LVA. Patients with hemodynamically stable LVA who require coronary artery bypass surgery for angina should not have aneurysmectomy. The presence of hemodynamically stable LVA is not a contraindication to deriving benefit from myocardial revascularization.
Mechanism underlying the absence of ischemic changes on the exercise electrocardiogram in patients with abnormal exercise thallium‐201 imaging and coronary artery disease
Authors: Coplan N. L. , Horowitz S. F. , Hoffman D. P. , Goldman M. E. , Machac J.
Published: July 2009

Patients with coronary artery disease may have reversible abnormalities on a thallium myocardial perfusion study without simultaneous ischemic changes on the exercise electrocardiogram, but the mechanisms responsible for this disparity have not been fully elucidated. A group of 37 patients with angiographically demonstrated coronary artery disease and abnormal thallium perfusion imaging were divided into two groups on the basis of their exercise electrocardiographic ST segment response. Thirteen patients (Group A) had no significant electrocardiographic changes with exercise, while 24 patients (Group B) had ST changes consistent with ischemia during the test. There were no significant differences in clinical or angiographic characteristics between the two groups. Stress test results showed a similar mean duration of exercise in the two groups (6.2 ± 1.8 versus 6.7 ± 2.5 min, p=NS), but the patients in Group A achieved a significantly lower mean maximal heart rate (117 ± 26 versus 132 ± 21 beats/min, p<0.05) and mean maximal double product (19,650 ± 5116 versus 22,650 ± 4871, p<0.05). There was no consistent pattern of thallium perfusion abnormality noted in Group A to suggest that a particular region of electrically silent myocardium was responsible for ischemia in the absence of electrocardiographic changes. These results suggest that exercise thalliumelectrocardiogram discordance is mediated by the level of myocardial workload achieved. An abnormal perfusion scan accompanying an exercise electrocardiogram which does not demonstrate any ischemic ST change may occur when there is sufficient increase in myocardial oxygen demand to result in differential augmentation of myocardial blood flow, but insufficient imbalance of supply and demand to result in signs of ischemia on the surface electrocardiogram.
Is the blood pressure the same in both arms?
Authors: Gould B. A. , Hornung R. S. , Kleso H. A. , Altman D. G. , Raftery E. B.
Published: July 2009

It is generally believed that there are blood pressure differences between the right and left arms, but most of the validation studies have used nonsimultaneous measurements. It is important to know whether there is a difference, as methodological comparisons are often made using a different technique on each arm. We have measured the blood pressure simultaneously in both arms in 91 patients, using two observers and two cuffs to provide eight measurements in a fully balanced design. The mean difference in blood pressure between the arms (left/right) was ‐1.3 (SE 0.4)/1.1 (SE 0.3) mmHg. Mean differences of the same magnitude were found between the two observers, and between the cuffs. Thus, no systematic difference of any consequence was found, although individual patients had mean between‐arm differences in blood pressure of up to 10 mmHg. These results suggest that no significant bias is introduced in methodological comparisons that use both arms.