bluuebunny/crossref_metadata_2025 huggingface dataset:
Reevaluation of digoxin‐encainide interactions using an animal model
Authors: Weinhouse E. , Tribble J. , Jarenwattananon M. , Nudel D. B.
Published: July 2009

The effects of intravenous encainide on digoxin‐induced atrial ectopic tachycardia (AET) were investigated in the rat using 3‐channel simultaneous limb‐lead electrocardiography. Pentobarbital‐anesthetized (35 mg/kg, intraperitoneal) adult male rats were given digoxin subcutaneously, 30 mg/kg. After onset of AET, rats received either saline (0.5 ml/kg) or encainide; 0.25, 0.5, 1.0, or 2.0 mg/kg intravenously in repeated doses at 15‐min intervals. At all doses, encainide converted digoxin‐induced AET to ventricular arrhythmias, prolonged recovery time, and increased mortality in comparison to saline‐treated animals. An additional group of anesthetized rats was not given digoxin. These animals received encainide (2.0 mg/kg, intravenously) in repeated doses at 15‐min intervals and developed dose‐related increases in the P‐R interval only. Blood samples were obtained by cardiac puncture from 12 additional anesthetized, digoxin‐treated rats 5 min after the fourth intravenous dose of saline (0.5 ml/kg, n=6) or encainide (1.0 mg/kg, n = 6). Serum was prepared and analyzed by affinity column‐mediated immunoassay. Digoxin levels were the same in both groups. These results suggest that encainide may exacerbate digoxin‐induced arrhythmias (proarrhythmic effect) in this species. In view of our findings of digoxin‐encainide interactions in the rat, we recommend caution if these drugs are coadministered in humans.
Release of adenosine and lactate from human hearts during atrial pacing in patients with ischemic heart disease
Authors: Haneda T. , Ichihara K. , Abiko Y. , Onodera S.
Published: July 2009

Thirty‐eight patients treated by atrial pacing were divided into three groups (Group I, patients with neither coronary stenosis nor anginal pain during pacing; Group II, patients with no coronary stenosis but having anginal pain during pacing; Group III, patients with coronary stenosis). The concentrations of adenosine and lactate were measured in the coronary sinus blood and in the arterial blood before, during, and after atrial pacing. During atrial pacing, significant levels of adenosine were released from the heart of patients in Group III, whereas significant lactate release was observed in Groups II and III. In Group II, the concentration of adenosine in coronary sinus blood appeared to increase during pacing, but not significantly. There was no significant correlation between the release of adenosine and that of lactate. A significant release of adenosine due to atrial pacing may be observed only in patients with coronary artery disease.
Neurohumoral activation in congestive heart failure: A double‐edged sword?
Authors: Mann D. L. , Cooper G.
Published: July 2009

The search for the basic mechanism(s) responsible for the progressive and frequently irreversible deterioration of left ventricular pump function in congestive heart failure has been quite extensive; nonetheless, no single explanation has been forthcoming. Indeed, given the complexity of this disease process, it is becoming increasingly unlikely that a single pathogenetic mechanism will ever be uncovered for congestive heart failure. This review will examine recent experimental and clinical evidence which suggests that excessive adrenergic stimulation of the heart is double‐edged. That is, while increased adrenergic input to the heart may initially enable the failing myocardium to function adequately for a period of months to years, continued excessive adrenergic stimulation of the heart through both local neural and circulating catecholamines may lead to frank myopathic effects on the heart, with resultant worsening of left ventricular function and the development of intractable congestive heart failure. While we do not mean to suggest that excessive sympathetic stimulation of the heart is the only, or even the major mechanism responsible for the development of irreversible congestive heart failure, the data reviewed herein do suggest that adrenergic stimulation may play a primary role in the pathogenesis of congestive heart failure.
Symptomatology and quality of life in patients with rate‐responsive pacemakers: A double‐blind, randomized, crossover study
Authors: Lau C.‐P. , Rushby J. , Leigh‐Jones M. , Tam C. Y. F. , Poloniecki J. , Ingram A. , Sutton R. , Camm A. J.
Published: July 2009

Although the hemodynamic advantages of rate‐responsive (RR) pacing are well established, the symptomatic benefits remain controversial and the effects on the quality of life have not been assessed. Sixteen patients with RR pacemakers and a mean age of 56 (range 22–77) years were involved in a double‐blind crossover study to assess their exercise capacity (treadmill testing), symptomatology, and quality of life (structured questionnaires). Pacemakers were implanted because of symptomatic heart block or sick sinus syndrome. Ventricular demand pacemakers were randomly programmed into the constant rate (VVI) or RR pacing modes for four‐week study periods. All patients exercised longer in the RR mode than in the VVI mode (570±29 vs. 437±17 s, p<0.001). Statistically significant improvements in “shortness of breath” and “energy during daily activities” as measured by a 10‐point scale were reported in the RR pacing mode by the patients and were also observed by their close relatives. Symptoms such as “chest pain” and “palpitations” were not worsened during RR pacing. Nondisease‐specific “quality of life” was studied in 11 patients using the Nottingham Health Profile which showed a trend for an improved quality of life in five of the six dimensions of perceived health, although none of the changes were statistically significant. This study suggests that RR pacing should be recommended in selected patients on symptomatic grounds.
Management of blood lipid abnormalities in coronary heart disease patients
Authors: Kuo P. T.
Published: July 2009

Information obtained from clinical and laboratory research strongly supports a causal relationship between hyperlipidemia (dyslipidemia) and coronary heart disease (CHD), and provides an impetus to develop strategy for control of dyslipidemia. Some recent developments in the field may include the use of: (1) colestipol‐niacin to control hypercholesterolemia and induce regression of coronary atherosclerosis; (2) limited amounts of foods rich in stearic or oleic fatty acids to enhance the appeal of cholesterol‐lowering regimen; (3) gemfibrozil or lovastatin to inhibit cholesterol synthetic activity; and (4) gemfibrozil to raise atherosclerosis‐protective plasma high‐density lipoprotein levels. These and other newer developments will stimulate interest in research on dyslipidemia and its control to facilitate primary and secondary prevention of CHD.
Balloon angioplasty of aortic coarctation: A review
Authors: Rao P. S.
Published: July 2009

Since the initial report of balloon coarctation angioplasty in 1982, several workers used this technique in native coarctation and postoperative recoarctation. Immediate and intermediate‐term follow‐up results are generally good with a small chance for recoarctation and aneurysmal formation at the site of coarctation. The causes of recoarctation were identified and include age less than 1 year, isthmus hypoplasia, and a small coarcted aortic segment. Despite good immediate and follow‐up results, recommendations for use of balloon angioplasty as a treatment procedure of choice are clouded by the reports of development of aneurysms at the site of coarctation. We feel that balloon coarctation angioplasty is the treatment of choice in neonates and small infants, while general use of this technique in both native and postoperative coarctations in older children should await follow‐up results in larger numbers of children at selected centers.
Traumatic thrombosis of the left main coronary artery and myocardial infarction caused by Blunt Chest Trauma
Authors: Unterberg C. , Buchwald A. , Wiegand V.
Published: July 2009

We report the case of a 38‐year‐old man who, after a blunt chest trauma, developed an acute transmural myocardial infarction. Coronary arteriography revealed a thrombus in the left main artery, occlusion of the distal left anterior descending artery, and a diagonal branch caused by emboli.
Role of transmittal blood flow velocity by doppler echocardiography in the evaluation of coronary artery disease
Authors: Brunckhorst C. , Lange H. W. , Aschenberg W. , Rehpenning W. , Bleifeld W.
Published: July 2009

To determine the relation between presence and severity of coronary artery disease and diastolic filling abnormalities by Doppler echocardiography, recordings of transmitral inflow velocity were made at rest in 90 patients with coronary artery disease and 28 normals. At the time of the Doppler examination, 81 patients with coronary artery disease (90%) and 10 normals (36%) were treated with antianginal medications. No difference was found in the ratio between early (E) and late (A) diastolic filling velocity (E/A ratio) when comparing patients with greater than 70% obstruction of at least one coronary artery to age‐matched normals, regardless of the presence or absence of wall motion abnormalities. The E/A ratio was 1.3 ± 0.46 in coronary patients with normal wall motion, 1.2 ± 0.47 in coronary patients with abnormal wall motion, and 1.3 ± 0.53 in both samples of age‐matched normals. Multivariate analysis of the relation between E/A ratio and other variables showed that heart rate (F=24.46, p < 0.00001) and age (F= 19.51, p < 0.00001) were significant independent determinants of the E/A ratio, while the presence or severity of coronary artery disease, the presence of hypertension, the magnitude of wall motion abnormalities, and end‐diastolic dimension by echocardiography were not. These data suggest that transmitral inflow velocity recordings by Doppler have limited value for the recognition of coronary artery disease, since the E/A ratio is profoundly influenced by other factors, such as heart rate and age.
Beta, partial agonists to treat heart failure: Effects of xamoterol upon cardiac function and clinical status
Authors: Heng M. K.
Published: July 2009

The presence of systolic dysfunction, diastolic dysfunction, or both is an important consideration in selecting the optimal pharmacologic approach to the treatment of congestive heart failure in an individual patient. Cardiac glycosides and arterial vasodilators act only on systolic function, whereas β1‐adrenoceptor‐stimulating agents, such as β1 full and partial agonists, have both inotropic and lusitropic activity. Acute and chronic administration of xamoterol, a new β1 partial agonist, to patients with congestive heart failure has been shown to improve myocardial contractility, as indicated by increases in the peak rate of rise in left ventricular pressure, left ventricular ejection fraction, and cardiac output. Improvement in ventricular relaxation and filling, reflected by increases in the peak rate of decline in left ventricular pressure, reductions in the time constant of the decrease in isovo‐lumic pressure, improved left ventricular compliance, and increases in the atrial contribution to diastolic filling, are other beneficial effects of xamoterol on diastolic function. Exercise capacity increases in response to xamoterol therapy, while heart rate at maximum exercise declines. Relief of the signs and symptoms of congestive heart failure and improvement in functional status have also been demonstrated in xamoterol‐treated patients. The undesirable effects of β1 full agonists, such as tachycardia, arrhythmias, increased myocardial oxygen consumption, and effects on the peripheral vasculature, are not seen with xamoterol. The β1 partial agonist also causes no β‐adrenoreceptor down‐regulation, a finding that may account for its sustained effectiveness with long‐term therapy.
Ascending aortic dissection complicating syphilitic aortitis, late after aortic valve replacement
Authors: Tai Y.‐T. , Mok C.‐K. , Chow W.‐H. , Chan F.‐L. , So K.‐F.
Published: July 2009

A 54‐year‐old man underwent aortic valve replacement for syphilitic aortic regurgitation. Eight years later, he was admitted with sudden precordial discomfort and symptoms of superior vena caval obstruction. Ascending aortic dissection was diagnosed by echocardiography and computed tomography of the thorax. The patient succumbed rapidly after admission. Postmortem findings and histological features were compatible with syphilitic aortitis, without significant atherosclerosis. This case report adds to the sparse literature on aortic dissection complicating syphilitic aortitis, and illustrates that, at certain stages of the disease process, syphilitic aortitis can lead to such a degree of mechanical instability of the aortic wall as to predispose to dissection.
Right Ventricular Infarction
Authors: Williams J. F.
Published: July 2009

Right ventricular infarction commonly occurs in association with acute inferior left ventricular infarction, but is uncommon when infarction involves other areas of the left ventricle. Evidence of right ventricular infarction often can be detected by physical examination, electrocardiography, echocardiography, or radionuclide ventriculography. However, hetnodynamically signifcant infarction (i. e., hypotension or shock) is much less frequent, occurring in approximately 10% of patients with other evidence of right ventricular infarction. Right ventricular infarction increases ventricular stiffness, thereby impeding diastolic filling. This results in hemodynamic changes similar to those found in constrictive pericarditis: elevated systemic venous pressure, a Y descent greater than the X descent, and an inspiratory increase in venous pressure. The increase in venous pressure generally equals or even exceeds left atrial pressure. When hypotension or shock occurs, expansion of vascular volume is generally employed as initial therapy. in nonresponders, dobutamine or similar inotropic agents may be helpful. The prognosis during the acute phases is guarded, but, in survivors, prognosis is favorable and generally related to the extent of left ventricular involvement.
Acute anterior myocardial infarction: Streptokinase prevents ventricular thrombosis independently of its effect on infarct size
Authors: Destro G. , Barbieri E. , Bicego D. , Zanolla L. , Franceschini L. , Zardini P.
Published: July 2009

Left ventricular thrombosis (LVT) is a frequent complication after acute anterior myocardial infarction (AMI). The purpose of this study is to evaluate whether streptokinase (SK) therapy prevents LVT, and whether this effect is due to the preservation of left ventricular function or to the fibrinolytic action of the drug. Sixty‐five patients who underwent a left ventricular angiography within 2 months after a first AMI were studied. Twenty‐eight patients (SK group) received SK 1, 500,000 U i.v. administered over 60 min within 6 h from the onset of symptoms. A lower incidence of LVT was found in the SK group (p=0.0003). We divided patients into two classes according to the value of akinetic‐dyskinetic area (AD): the first group with a lower value of AD, the second group with a higher value of AD. In both groups, a reduced incidence of LVT was associated with SK therapy (p=0.014, p=0.015, respectively). Early infusion of SK during AMI seems to prevent the development of LVT, with an effect partly independent from its action on infarct size for small to large myocardial infarction.
Left ventricular aneurysm: Clinical and hemodynamic data
Authors: Mariotti R. , Petronio A. S. , Robiglio L. , Balbarini A. , Mariani M.
Published: July 2009

Clinical and hemodynamic data of 30 patients with left ventricular aneurysm (27 men, 3 women, mean age 54.9 years) were compared with those of 30 patients with previous myocardial infarction and segmental hypo‐or akinesis (28 men, 2 women, mean age 51 years). In each group, 10 patients were affected by one‐, two‐, or three‐vessel disease. A semiquantitative evaluation of collateral coronary circulation showed no significant differences between the two groups. Mean end‐diastolic volume was higher in patients with left ventricular aneurysm (p < .025, < .05, and < .001 in 1‐, 2‐, and 3‐vessel disease, respectively) and ejection fraction was lower only in patients with one‐, (p < .001) and two‐ (p < .05) vessel disease in comparison with patients without left ventricular aneurysm. No significant difference was evidenced in basal or isometric exercise end‐diastolic pressure. The incidence of thrombosis detected by ventriculography was higher in patients with left ventricular aneurysm (33.3 vs. 6.6%). The mean duration of follow‐up was 20.7 months in patients with left ventricular aneurysm and 20.6 in the control group. No significant difference was found either in mortality or in reinfarction rate as far as incidence and severity of angina. The incidence of congestive heart failure was more evident, but not significant in patients with left ventricular aneurysm. One embolic episode was present in one patient with aneurysm and intraventricular thrombosis. Left ventricular performance is influenced by an aneurysm when a limited coronary compromise is present (one‐ and two‐vessel disease) while it is not affected in the case of a coexisting three‐vessel disease.
Interval versus continuous exercise training after coronary bypass surgery: A comparison of training‐induced acute reactions with respect to the effectiveness of the exercise methods
Authors: Meyer K. , Lehmann M. , Sünder G. , Keul J. , Weidemann H.
Published: July 2009

In order to improve endurance by exercise on a bicycle ergometer, both the interval method (I) (exertion and recovery phases alternate each minute) and the continuous method (constant exertion) can be employed. We examined the effects of both methods on the following parameters: heart rate, blood pressure, rate‐pressure product, glucose, lactate, and catecholamine levels, and physical performance. Two groups of nine male patients were trained daily on a bicycle ergometer for 3.5 weeks. These patients had undergone coronary bypass surgery 24 and/or 26 days before the training started. The training heart rate was set at 86% of the individual maximum heart rate. In the last week of training, the exercise intensity in both patient groups, following either I or C regimen, was 20:121 W and 83 W respectively. The exercise training lasted 20 minutes with the following findings: (1) there were no significant differences in blood pressure, rate‐pressure product, rates of glucose and catecholamines, and (2) there was a significantly higher rate of lactate in the second ten minutes of the I training. Before and after the training period, the patients were subjected to a multistage bicycle ergometer exercise test (sitting). The following results obtained after the training favor the I method: (1) patients' physical performance increased ( + 0.63 vs. + 0.26 W/kg; p < 0.001); (2) heart rate was lower at rest ( ‐ 9 vs. ‐ 4 beats/min; p < 0.04) and at 75 W ( ‐ 12 vs. ‐ 2 beats/min; p < 0.02); (3) rate‐pressure product was lower at rest ( ‐ 1675 vs. ‐ 291; p < 0.04) and at 75 W ( ‐ 2810 vs. ‐ 735; p < 0.05); (4) rate of lactate was lower at 75 W ( ‐ 0.83 vs. ‐ 0.33 mmol/1; p < 0.04); (5) catecholamines were not lowered by I or C training, and no differences between the two groups could be observed. Exercise training according to the I method involves both the aerobic and anaerobic capacity of the organism, whereas exercise training according to the C method involves only oxidative capacity. After coronary bypass surgery, the I method is better suited to increase physical performance and is more effective in economizing the cardiac function.
Syntheses of three stable isotope‐labeled ethylcyclopropanes
Authors: Baldwin John E. , O'Neil Edward J.
Published: July 2009

Three stable isotope‐labeled ethylcyclopropanes have been synthesized in preparation for a mechanistic study of its fragmentation to methane and butadiene. Two tactical innovations have been used to deal with practical synthetic challenges posed by the very limited solubility of methylmagnesium iodide in tetrahydrofuran and the high volatility and high tendency to form aerosols characteristic of ethylcyclopropane. Copyright © 2009 John Wiley & Sons, Ltd.
Identification of species formed after pyridine adsorption on iron, cobalt, nickel and silver electrodes by SERS and theoretical calculations
Authors: Andrade Gustavo F. S. , Temperini Marcia L. A.
Published: July 2009

The adsorption of pyridine (py) on Fe, Co, Ni and Ag electrodes was studied using surface‐enhanced Raman scattering (SERS) to gain insight into the nature of the adsorbed species. The wavenumber values and relative intensities of the SERS bands were compared to the normal Raman spectrum of the chemically prepared transition metal complexes. Raman spectra of model clusters M4(py) (four metal atoms bonded to one py moiety) and M4(α‐pyridil) where M = Ag, Fe, Co or Ni were calculated by density functional theory (DFT) and used to interpret the experimental SERS results. The similarity of the calculated M4(py) spectra with the experimental SERS spectra confirm the molecular adsorption of py on the surface of the metallic electrodes. All these results exclude the formation of adsorbed α‐pyridil species, as suggested previously. Copyright © 2009 John Wiley & Sons, Ltd.
Raman spectroscopic study of the multi‐anion mineral dixenite CuMn2+14Fe3+(AsO3)5(SiO4)2(AsO4)(OH)6
Authors: Bahfenne Silmarilly , Frost Ray L.
Published: July 2009

The mixed anion mineral dixenite has been studied by Raman spectroscopy, complemented with infrared spectroscopy. The Raman spectrum of dixenite shows bands at 839 and 813 cm−1 assigned to the (AsO3)3− symmetric and antisymmetric stretching modes. The most intense Raman band of dixenite is the band at 526 cm−1 and is assigned to the ν2 AsO33− bending mode. DFT calculations enabled the calculation of the position of AsO22− symmetric stretching mode at 839 cm−1, the antisymmetric stretching mode at 813 cm−1, and the deformation mode at 449 cm−1. The Raman bands at 1026 and 1057 cm−1 are assigned to the SiO42− symmetric stretching vibrations and those at 1349 and 1386 cm−1 to the SiO42− antisymmetric stretching vibrations. Both Raman and infrared spectra indicate the presence of water in the structure of dixenite. This brings into question the commonly accepted formula of dixenite as CuMn2+14Fe3+(AsO3)5(SiO4)2(AsO4)(OH)6. The formula may be better written as CuMn2+14Fe3+(AsO3)5(SiO4)2(AsO4)(OH)6·xH2O. Copyright © 2009 John Wiley & Sons, Ltd.
Numerical integration over arbitrary polygonal domains based on Schwarz–Christoffel conformal mapping
Authors: Natarajan Sundararajan , Bordas Stéphane , Roy Mahapatra D.
Published: July 2009

This paper presents a new numerical integration technique on arbitrary polygonal domains. The polygonal domain is mapped conformally to the unit disk using Schwarz–Christoffel mapping and a midpoint quadrature rule defined on this unit disk is used. This method eliminates the need for a two‐level isoparametric mapping usually required. Moreover, the positivity of the Jacobian is guaranteed. Numerical results presented for a few benchmark problems in the context of polygonal finite elements show that the proposed method yields accurate results. Copyright © 2009 John Wiley & Sons, Ltd.
Scale effect on flow and thermal boundaries in micro‐/nano‐channel flow using molecular dynamics–continuum hybrid simulation method
Authors: Sun Jie , He Ya‐Ling , Tao Wen‐Quan
Published: July 2009

The molecular dynamics (MD)–continuum hybrid simulation method has been developed in two aspects in the present work: (1) The energy equation has been combined into the coupling method in order to obtain the hybrid temperature profile and (2) the coupling method has been improved by the local linearization to obtain a smoother parametric profile. The developed method is primarily validated by analytical solutions and full MD results. Then, it is employed to study the scale effect on the flow and thermal boundaries in micro‐/nano‐channel flow. The hybrid velocity and temperature profiles are obtained with the channel height (H) ranging from 60σ to 2014σ and the solid–liquid coupling (β) ranging from 0.1 to 50. Scale effect has shown strong influence on the boundaries. Obvious slip characteristics can be found in the profiles, i.e. velocity slip and temperature jump, when H is small and β is large. However, the results also show that the profiles can be well predicted to converge to the macroscale non‐slip/non‐jump analytical solutions when H is large enough, where the effect of β can be omitted and the slip characteristics disappear. Correlations of relative slip length, relative temperature jump and pressure gradient with H are fitted from the simulation results. Copyright © 2009 John Wiley & Sons, Ltd.
Analysis of three‐dimensional fracture mechanics problems: A two‐scale approach using coarse‐generalized FEM meshes
Authors: Kim D.‐J. , Pereira J. P. , Duarte C. A.
Published: July 2009

This paper presents a generalized finite element method (GFEM) based on the solution of interdependent global (structural) and local (crack)‐scale problems. The local problems focus on the resolution of fine‐scale features of the solution in the vicinity of three‐dimensional cracks, while the global problem addresses the macro‐scale structural behavior. The local solutions are embedded into the solution space for the global problem using the partition of unity method. The local problems are accurately solved using an hp‐GFEM and thus the proposed method does not rely on analytical solutions. The proposed methodology enables accurate modeling of three‐dimensional cracks on meshes with elements that are orders of magnitude larger than the process zone along crack fronts. The boundary conditions for the local problems are provided by the coarse global mesh solution and can be of Dirichlet, Neumann or Cauchy type. The effect of the type of local boundary conditions on the performance of the proposed GFEM is analyzed. Several three‐dimensional fracture mechanics problems aimed at investigating the accuracy of the method and its computational performance, both in terms of problem size and CPU time, are presented. Copyright © 2009 John Wiley & Sons, Ltd.
Psychometric testing of the Perception of Pregnancy Risk Questionnaire
Authors: Heaman Maureen I. , Gupton Annette L.
Published: July 2009

Pregnant women's perception of risk may influence their health behaviors during pregnancy; however, no validated instrument exists to measure those perceptions. The purpose of this study was to refine a new instrument, the Perception of Pregnancy Risk Questionnaire (PPRQ), and conduct psychometric assessment of the final 9‐item version. Reliability and validity were assessed using a sample of 199 women in the third trimester of pregnancy. Exploratory factor analysis resulted in a two‐factor solution. Evidence of construct validity was demonstrated using the known‐groups technique and through convergent validity. Ratings of pregnancy risk correlated with state anxiety level, providing evidence of concurrent validity. The PPRQ had high internal consistency reliability and excellent test–retest reliability. © 2009 Wiley Periodicals, Inc. Res Nurs Health 32:493–503, 2009
Cell selectivity‐membrane phospholipids relationship of the antimicrobial effects shown by pleurocidin enantiomeric peptides
Authors: Lee Juneyoung , Park Cana , Park Seong‐Cheol , Woo Eun‐Rhan , Park Yoonkyung , Hahm Kyung‐Soo , Lee Dong Gun
Published: July 2009

Previously, we investigated the antimicrobial properties of pleurocidin (Ple) enantiomers. Our studies showed that the L‐enantiomer exhibited about a 2–16 fold more potent activity against bacterial strains as compared to that of the D–enantiomer. However, fungal strains were about two–fold more susceptible to the D–enantiomer than to the L‐enantiomer. In this study, confocal laser scanning microscopy indicates that the Ple enantiomers internalize into the cell surface. The present results also suggest that they could be characterized by a membrane–active mechanism. To further elucidate their selective membranolytic activities, we conducted a fluorescence analysis. A study with 1,6–diphenyl–1,3,5–hexatriene, a hydrophobic molecule, showed that the L–and the D–enantiomer exert more potent antibacterial or antifungal activity than their opposite enantiomer, respectively. Furthermore, we synthesized liposomes by using representative phospholipids consisting of bacterial or fungal membranes. Our results show that the L‐enantiomer causes significant dye leakage from negatively charged liposomes (PG/CL; 58:42, PC/PG; 1:1, w/w) which mimic bacterial membranes such as Staphylococcus aureus. Conversely, the D–enantiomer has more potent leakage effects against fungal liposomes (PC/PE/PI/ergosterol; 5:4:1:2, w/w/w/w, PC/ergosterol; 10:1, w/w). In summary, these results suggest that the selective antimicrobial effects of the Ple enantiomers against bacterial and fungal cells may be due to the different lipid compositions of prokaryotes and eukaryotes. Copyright © 2009 European Peptide Society and John Wiley & Sons, Ltd.
Prenatal diagnosis of cardiac rhabdomyomas: incidence of associated cerebral lesions of tuberous sclerosis complex
Authors: Saada J. , Hadj Rabia S. , Fermont L. , Le Bidois J. , Bernades‐Stein L. , Martinovic J. , Sonigo P. , Dumez Y. , Bonnet D. , Benachi A.
Published: July 2009

Objectives

To determine the prevalence of specific cerebral lesions of tuberous sclerosis complex (TSC) and neurological outcome in cases diagnosed prenatally with cardiac rhabdomyomas.

Methods

We reviewed all fetuses diagnosed prenatally with cardiac rhabdomyomas which had undergone detailed ultrasound evaluation and cerebral magnetic resonance imaging (MRI) and which were recorded in the database of a single institution covering the period January 1992 to December 2005.

Results

Fifty‐one fetuses were included in the study. MRI was performed at a mean ± SD gestational age of 30 ± 3 gestational weeks and showed specific lesions of TSC in 49% of cases. Termination of pregnancy was chosen by the parents in 26 cases. Neurological development was studied in 20 cases, follow‐up lasting 4.8 ± 2.9 years. Neurodevelopmental events occurred during the follow‐up period in 45% of cases. Neurological complications occurred in 67% of patients who had cerebral lesions at MRI and in 33% of patients with normal MRI results. There was no significant difference between the two groups of patients (P = 0.2).

Conclusion

In fetuses with cardiac rhabdomyomas detailed ultrasound examination and third‐trimester cerebral MRI are able to diagnose most TSC cerebral lesions, but fail to determine neurological outcome. Copyright © 2009 ISUOG. Published by John Wiley & Sons, Ltd.
UV plumage color is an honest signal of quality in male budgerigars
Authors: Griggio Matteo , Zanollo Valeria , Hoi Herbert
Published: July 2009

Elaborate and colorful feathers are important traits in female mate choice in birds. Plumage coloration can result from pigments deposited in feathers such as carotenoids and melanins, or can be caused by nano‐scale reflective tissues (structurally based coloration), usually producing ultraviolet (UV) coloration. Structural colorations remain the least studied of the three most important feather colorations. Previous studies have found a female preference for UV color in the budgerigar, Melopsittacus undulatus, but it is not clear what information this ornament conveys, nor what is the possible cost associated with its production. We investigated possible correlations between immune response and plumage color of wild‐type (green) male budgerigars. In particular we measured the wing web swelling resulting from injection of phytohaemagglutinin (PHA). We did not detect any correlation between the sedimentation rate and morphological and color variables. We found that UV chroma is the best predictor for the cutaneous immune activity. Indeed, male budgerigars with high UV reflectance in the breast feathers showed stronger immune responses. These results are consistent with the idea that UV colors are special signals conveying information about a bird's condition.
Tolerability of Ramipril 10 mg Daily in High‐risk Cardiovascular Patients in Taiwan: Experience from Kaohsiung Medical University Chung‐Ho Memorial Hospital
Authors: Chu Chih‐Sheng , Cheng Kai‐Hung , Lee Kun‐Tai , Lin Tsung‐Hsien , Lee Shuo‐Tsan , Su Ho‐Ming , Voon Wen‐Choi , Sheu Sheng‐Hsiung , Lai Wen‐Ter
Published: July 2009

The Heart Outcomes Prevention Evaluation (HOPE) study demonstrated that the angiotensin‐converting enzyme inhibitor, ramipril, significantly reduces mortality, myocardial infarction and stroke in high‐risk cardiovascular patients, beyond the benefits from blood pressure lowering. The tolerability of ramipril 10 mg/day has been an important concern when applying these results. Following the same criteria as the HOPE study, we investigated the adverse effects profile and tolerability of 10 mg ramipril in high‐risk patients at our institution. In total, 92 patients with high cardiovascular risk were eligible for this study. Initially, ramipril was prescribed 2.5 mg orally once daily, and then titrated up to 5.0, 7.5, and 10.0 mg/day at 1‐month intervals. The target maintenance dose was 10 mg/day. All adverse events were recorded during at least 3 months of follow‐up. After 4‐6 months of the titration protocol, only 18 patients (25.3%) reached and remained on ramipril 10 mg/day; 11 (15.5%), 22 (30.9%), and 20 patients (28.2%) remained on 2.5, 5.0, and 7.5 mg/day, respectively. Twenty‐one patients (22.6%) had at least one adverse event. Twelve patients (13.0%) stopped treatment because of adverse effects. A total of 23 episodes of adverse events were reported, including cough (15.1%), dizziness (6.0%), and hypotension (2.4%). Ramipril was relatively well tolerated in our study population. However, only one‐quarter of our patients reached the target maintenance dose of 10 mg/day. Dry cough, dizziness, and hypotension were the major side effects. About 15% of our patients discontinued ramipril treatment, which is comparable with previous reports.
Effect of Age on Allergen Responses of Allergic Patients in Southern Taiwan
Authors: Chiang Wen , Tsai Inn‐Feng , Tsai Wen‐Chan , Chen Bai‐Hsiun
Published: July 2009

To survey airborne and food allergen patterns in southern Taiwan and to analyze the effect of age on response to different allergens, we tested samples from 4,411 allergic patients at Kaohsiung Medical University Hospital using the MAST‐CLA test (new Taiwan panel). A total of 2,212 (50.1%) samples showed a positive response. We grouped allergic patients into five age groups. Milk and egg white were the main food allergens in the younger groups (< 3 years old and 3‐6 years old). Shrimp, crab, and shellfish were the main allergens in the groups aged 7‐12, 13‐18, and more than 18 years. Among airborne allergens, house dust and mites Dermatophagoides farinae and D. pteronyssinus were the main allergens in all age groups, whereas the frequency of response to cockroach allergen was low in the group aged less than 3 years, but increased in the other age groups. There was a sharp increase in the frequency of response to airborne allergens after 3 years old and a sharp decrease in response to food allergens. Among subjects allergic to both airborne and food allergens, there was a positive MAST‐CLA rate of 19.9% to 26% (all five age groups, no significant difference). When we compared our results with those from Taipei Veterans General Hospital in northern Taiwan, there were significant differences for yeast, peanut, feather mix, dog dander, cockroach, D. farinae and D. pteronyssinus allergens (p < 0.01). These differences were probably caused by differences in patient location, patient age, disease patterns and allergen panels.
Antibiotic Susceptibility Pattern of Anovaginal Isolates of Streptococcus agalactiae from Pregnant Women in Their Late Third Trimester
Authors: Fu Jung‐Chung , Lin Duei‐Pong , Huang Wei‐Jen , Huang Chung‐Sien , Yang Chi‐Fei
Published: July 2009

Group B streptococcus (GBS) neonatal sepsis is a serious disease causing newborn mortality and long‐term neurologic sequelae. The Centers for Disease Control and Prevention (CDC) recommend third‐trimester GBS screening and intrapartum antibiotic prophylaxis for high‐risk women. The aim of our study was to identify colonized pregnant women and assess the prevalence of GBS in pregnancy and the susceptibility pattern of GBS in southern Taiwan. We performed the study at the Department of Obstetrics and Gynecology, Kaohsiung Women and Children' Hospital, between January and December 2002. Distal vaginal and anorectal swabs were obtained from pregnant women at 35 or more weeks' gestation. Swabs were used to inoculate selected medium, which was subcultured onto sheep' blood agar after 24 hours. Sensitivity to azithromycin, clindamycin, erythromycin, ofloxacin, penicillin G, tetracycline, trimethoprim/sulfamethoxazole, and vancomycin was tested using the disc diffusion method. Of the 374 pregnant women enrolled in the study, 56 (15%) had positive cultures for GBS. Antibiotic susceptibility was as follows: azithromycin 44.6%, clindamycin 66.1%, erythromycin 70.5%, ofloxacin 70.5%, penicillin G 60.7%, tetracycline 39.3%, trimethoprim/sulfamethoxazole 35.7%, and vancomycin 100%. The CDC recommend penicillin as the first choice for intrapartum prophylaxis, with erythromycin and clindamycin as alternatives for penicillin‐allergic patients. There has been increasing resistance to these antibiotics among GBS. Third‐trimester GBS screening and susceptibility testing for pregnant women should be considered.
Parental Stress and Related Factors in Parents of Children with Cerebral Palsy
Authors: Wang Hui‐Yi , Jong Yuh‐Jyh
Published: July 2009

Children with cerebral palsy display prominent motor dysfunction associated with other developmental disorders. Parenting a child with cerebral palsy presents a number of challenges and stresses. The first purpose of this study was to compare parental stress in parents of children with cerebral palsy to that in parents of children with typical development. The second purpose was to analyze the correlations between parental stress and parents' characteristics, the child's characteristics, the child's earliest age when rehabilitation was first commenced, and weekly frequency of rehabilitation for the child. A convenience sample of 63 parents of children with cerebral palsy (mean age of children, 4.3 ± 1.8 years) was recruited. Forty parents of children with typical development were recruited as a comparison group. All parents filled out the Chinese version of the Parenting Stress Index (PSI), which consists of child domain and parent domain scales. The scores reported by parents of children with cerebral palsy in the child domain, parent domain, and PSI total scale were significantly higher than those for parents in the comparison group. The child domain score was significantly correlated to the child's age and severity of motor disability. A significant correlation was also found between the parent domain score and the child's earliest age of commencing rehabilitation. The PSI total scale score was significantly associated with both the child's severity of motor disability and age of commencing rehabilitation. Clinical professionals should be concerned about parental stress in parents of children with cerebral palsy and provide resources to support such parents. We suggest some strategies to reduce parental stress by strengthening parents' child‐care skills.
Ureteral Metastasis from Prostatic Carcinoma with an Associated Ureteral Stone: A Case Report
Authors: Liu Chia‐Chu , Wu Wen‐Jeng , Chou Yii‐Her , Huang Chun‐Hsiung , Chai Chee‐Yin
Published: July 2009

Ureteral metastasis is rare, and only a few cases of ureteral metastasis from prostatic carcinoma have been reported. We present a case of ureteral metastasis from prostatic carcinoma that was also associated with a ureteral stone. To our knowledge, this is the second case with a ureteral stone at the site of the metastatic lesion.
Relationship Between Post‐stroke Depression and Lesion Location: A Meta‐Analysis
Authors: Yu Lifa , Liu Ching‐Kuan , Chen Jew‐Wu , Wang Shing‐Yaw , Wu Yu‐Hsin , Yu Shenq‐Horng
Published: July 2009

Our understanding of the relationship between the neuroanatomic loci of brain damage and the incidence of post‐stroke depression (PSD) is not complete. Many studies have investigated this relationship and the evidence is conflicting. With the purpose of gaining a consistent, strong, and credible conclusion on the relationship between PSD and the loci of brain damage, a meta‐analysis was used in this study to systematically reanalyze the findings of related studies and to investigate the sources of heterogeneity among study results. The key words “stroke or cerebrovascular” and “depression or mood or affective” were entered into the MEDLINE, PsycINFO, and EMBASE databases to search for relevant studies. The references cited in the studies found were also used to locate additional studies. For each eligible study, the important study characteristics were recorded, and the effect sizes of the relationship between PSD and lesion location were computed. Furthermore, we conducted subgroup analyses to explore the heterogeneity among study results. A total of 3,668 patients participating in 52 studies were included in this meta‐analysis. There was a weak relationship between PSD and right hemisphere lesion. The major sources of heterogeneous study results included systematic exclusion of patients with language dysfunction and use of different assessors and instruments for diagnosing depression. Future efforts should aim to enhance standards for reporting studies, improve assessment tools for assessing depression of aphasic patients, and adopt appropriate study methodologies for investigating the relationship between PSD and lesion location.
Applying Theory of Planned Behavior to Predict Nurses' Intention and Volunteering to Care for Sars Patients in Southern Taiwan
Authors: Ko Nai‐Ying , Feng Ming‐Chu , Chiu Dan‐Ying , Wu Mei‐Hsin , Feng Jui‐Ying , Pan Shung‐Mei
Published: July 2009

Severe acute respiratory syndrome (SARS) spread worldwide after an outbreak in Guangdong Province, China, in mid‐November 2002. Health care workers were at highest risk of infection. The purpose of this study, which was based on Ajzen's theory of planned behavior (TPB), was to determine the extent to which personal attitudes, subjective norms, and perceived control influence nurses' intention and volunteering to care for SARS patients. After the SARS outbreak, a total of 750 staff nurses (response rate 90%) at one hospital completed a questionnaire assessing their intention to provide care to SARS patients. Overall, 42.7% of nurses had a positive intention to provide care to SARS patients, and 25.4% of nurses would volunteer to care for SARS patients. Four factors explaining 35% of the variance in nurses' intention to care for SARS patients were self‐efficacy (β = 0.39, p < 0.001), attitude (β = 0.25, p < 0.001), years of working in the study hospital (β = −0.15, p < 0.001), and receiving resources from the hospital (β = 0.13, p < 0.001). Two factors explaining 15% of the variance in nurses' volunteering to care for SARS patients were intention (β = 0.31, p < 0.001) and attitude (β = 0.15, p < 0.001). The final model shows that the variables of the TPB contributed significantly to the explanation of a portion of variance in nurses' intention and volunteering to care for SARS patients. The results are helpful for human resources managers facing a new contagious disease.
Acute Idiopathic Syringomyelia: A Case Report
Authors: Chen June‐Kai , Chen Chia‐Hsiu , Lee Chia‐Ling , Huang Mao‐Hsiung , Chen Tien‐Wen , Weng Ming‐Cheng
Published: July 2009

There have been isolated reports in the literature of the natural history and less than complete knowledge of the epidemiology and pathophysiology of syringomyelia. This article describes a clinically acute‐onset abnormal patient with localized dilatation of the central canal of the spinal cord who had no evidence of present or prior Chiari's malformation, trauma, infection, tumor, or other predisposing pathologic condition. It is suggested that this distinct condition be labeled “acute idiopathic syringomyelia”.
Interdisciplinary Management of Dental Implant Patient: A Case Report
Authors: Chen Chun‐Ming , Huang I‐Yueh , Yang Chia‐Fu , Shen Yee‐Shyong , Chen Chung‐Ho , Tseng Yu‐Chuan , Lee Huey‐Er
Published: July 2009

Maxillary molars can over‐erupt when their antagonists are lost and there are no replacements. When the opposing molars severely extrude into the edentulous space, it is difficult to replace the missing teeth with either fixed or removable prostheses. We present the following case report, providing a solution for this type of problem. A two‐stage posterior subapical osteotomy was used to reestablish the intermaxillary space. Following orthodontic treatment and implant placement, the patient regained occlusal harmony and normal masticatory function.
Comparison of Quality of Life for People with Schizophrenia and Mental Health of Caregivers Between Community‐Based and Hospital‐based Services
Authors: Tzeng Dong‐Sheng , Lung For‐Wey , Chang Yong‐Yuan
Published: July 2009

This study is a comparison of the quality of life and family stress levels in community‐based and hospital‐based services for people with schizophrenia. Fiscal considerations of the health insurance industry in Taiwan require the evaluation of a community support program versus the traditional, hospital‐centered program for reform of mental health policy concerning schizophrenia. The study involved 52 schizophrenic patients, 27 in a community‐based program and 25 in a hospital‐based treatment model, and was conducted from January to December 2001 in the psychiatric department of a general teaching hospital in southern Taiwan. Outcomes were determined using the World Health Organization quality of life questionnaire (WHOQoL‐BREF, Taiwan version), Brief Psychiatric Rating Scale (BPRS), General Health Questionnaire (Chinese version), rate of loss to follow‐up, job conditions, and social function. Comparisons of quality of life and caregiver mental health between the two groups were accomplished using descriptive analysis, independent sample t test, and the generalized estimating equation‐I. No significant differences between the two groups were found in quality of life or family mental stress according to the General Health Questionnaire after controlling for sex, age, disease duration, full IQ, and total BPRS score. Long disease duration predicted a hospital setting, while a high IQ was predictive of a community setting. We found no decrease in quality of life for schizophrenic patients in a hospital‐based program and no increase in family mental stress among the community‐based group. To improve patients' quality of life and the mental health of caregivers in both services, it is important to ameliorate severe symptoms associated with schizophrenia.
A Case of Subarachnoid Hemorrhage With Persistent Shock and Transient ST Elevation Simulating Acute Myocardial Infarction
Authors: Lee Hsiang‐Chun , Yen Hsueh‐Wei , Lu Ye‐Hsu , Lee Kun‐Tai , Voon Wen‐Chol , Lai Wen‐Ter , Sheu Sheng‐Hsiung
Published: July 2009

Electrocardiographic changes in neurovascular disease are not rare. Patients with subarachnoid hemorrhage have electrocardiographic (ECG) abnormalities that may mimic ischemic heart disease and acute myocardial infarction. Outflow of catecholamines in the early stage of subarachnoid hemorrhage contributes to elevated blood pressure in most patients. Hypotension is a rare presentation in subarachnoid hemorrhage. We report a case of subarachnoid hemorrhage with transient ST elevation and intractable shock simulating acute myocardial infarction, and review the mechanism of ECG changes in subarachnoid hemorrhage.