bluuebunny/crossref_metadata_2025 huggingface dataset:
Diastolic Left‐to‐Right Shunting in Uncomplicated Ventricular Septal Defect
Authors: KRONZON ITZHAK , CZINER DAVID G. , TUNICK PAUL A.
Published: August 2007

The systolic left‐to‐right shunt in patients with uncomplicated ventricular septal defect is associated with a classic loud murmur, and is well described. The additional diastolic left‐to‐right shunt, always silent, is less well recognized. Left‐to‐right diastolic shunt flow is directly related to the defect size, to the diastolic pressure gradient between the left and right ventricle, and to the duration of diastole. The purpose of this study was to evaluate by Doppler echocardiography the duration, magnitude, and flow velocity characteristics of the diastolic left‐to‐right shunt. There were 30 adult patients with uncomplicated ventricular septal defects studied by color, pulsed, and continuous wave Doppler echocardiography. In each patient, the uncomplicated ventricular septal defect was visualized by two‐dimensional echocardiography and/or Doppler echocardiography, and the systolic and diastolic left‐to‐right shunt flow was identified by Doppler echocardiography. Accurate Doppler flow velocity peaks twice, in beginning and again at end diastole. The mean diastolic flow velocity was 0.5–1.5 msec (average 0.83 ± .22 msec). This flow velocity was markedly lower than the mean systolic shunt flow velocity (2.4–5.3 msec, average 3.8 ± .7 msec). The Doppler flow velocity integral was 0.17–0.64 m (average 0.36 ± 0.14), markedly smaller than the systolic flow velocity integral (0.8–1.8 m, average 1.3 ± 0.3). The diastolic left‐to‐right shunt flow was 12–41% (average 21 ± 8) of total (systolic and diastolic) shunt flow. In conclusion: Diastolic left‐to‐right shunts can be identified in all patients with uncomplicated ventricular septal defects, and analyzed in the majority of patients. A significant degree of the left to right shunting in uncomplicated ventricular septal defects occur during diastole.
Coronary Flow Velocity Reserve After Successful Balloon Angioplasty and Directional Atherectomy
Authors: HUTCHISON STUART J. , MARWAH ONKARJIT S. , POSLEY KEITH M. , KAWANISHI DAVID T. , CHANDRARATNA P. ANTHONY N.
Published: August 2007

Background: To ascertain whether transesophageal echocardiography (TEE) allows for measurement of coronary flow velocity “reserve” in patients with disease of the left anterior descending artery (LAD), and to establish the flow velocity response following angiographically successful angioplasty and atherectomy. Methods: Four groups of patients were studied: normal controls (n = 15) consisted of patients without obstructive coronary artery disease, a LAD stenosis group (n = 15) consisted of patients with > 70% stenosis, an LAD postangiographically successful balloon angioplasty group (n = 12), and an LAD postangiographically successful directional atherectomy group (n = 6). Two‐dimensional horizontal plane TEE was used to image the proximal left coronary arterial system. Pulsed Doppler recordings were made of proximal LAD flow velocities at rest, and following an infusion of 0.56 mg/kg IV dipyridamole. Results: The peak diastolic flow velocity ratio (hyperemic flow/baseline flow) for normal controls was 3.46 ± 0.48 (mean ± standard deviation), for the LAD stenosis group was 1.35 ± 0.26, for the balloon angioplasty group was 2.08 ± 0.45, and for the directional atherectomy group was 2.10 ± 0.82. Conclusions: We conclude that: (1) it is feasible to record with TEE Doppler, flow velocity and flow reserve in normals, in obstructive coronary artery disease, and following revascularization; (2) coronary flow velocity ratio (CFVR) is decreased in patients with LAD stenosis; (3) CFVR remains subnormal in patients with angiographically successful directional atherectomy and balloon angioplasty; and (4) that flow velocity ratios following directional atherectomy were not significantly different from those following balloon angioplasty.
Transesophageal Echocardiographic Assessment of Lesions of the Right Ventricular Outflow Tract and Pulmonic Valve
Authors: HUTCHISON STUART J. , ROSIN BENJAMIN L. , CURRY SUSAN , CHANDRARATNA P. ANTHONY N.
Published: August 2007

To establish the role of biplane transesophageal echocardiography (TEE) in the assessment of congenital and acquired lesions involving the right ventricular outflow tract (RVOT) and pulmonic value (PV), 28 consecutive RVOT and PV lesions in 22 consecutive patients were studied by two‐dimensional and color Doppler transthoracic echocardiograms (n = 22), horizontal (n = 22) and vertical (n = 22) plane TEEs, cardiac catheterization (n = 15), cardiac surgery (n = 6), and magnetic resonance imaging (n = 1). Sixteen patients had congenital lesions, and six had acquired lesions. Longitudinal TEE clearly imaged 25 of 28 abnormalities, transverse TEE clearly imaged 12 of 28, and transthoracic echocardiography clearly imaged 9 of 28. Two‐dimensional TEE scanning revealed the lesion or site of stenosis. Color Doppler revealed conspicuous mosaic jets in relation to a structural abnormality in most cases. Longitudinal TEE was more sensitive in the detection of small vegetations of the PV, in the depiction of PV doming in cases of valvar pulmonic stenosis, and in the display of the RVOT and PV so that the longitudinal extent of involvement of larger masses could be appreciated. However, longitudinal TEE was not able to assess the gradient of a stenosis at the RVOT or PV level in any case. Biplane TEE is helpful in the anatomic assessment of congenital and acquired lesions of the RVOT and PV in adults.
Multivariate Analysis of Left Ventricular Mass Determinants in Adults
Authors: MELTZER RICHARD S. , RINKEVICH DIANA , REISNER SHIMON A. , MOTRO MICHAEL , BECKER BRUNO , VERED ZVI
Published: August 2007

Echocardiographic left ventricular mass (LVM) estimates are strong predictors of subsequent mortality and cardiovascular events. It is known that blood pressure (BP), weight (WT), and age are significantly correlated with LVM. We hypothesized that stroke volume (SV) measured by Doppler echocardiography would also be correlated with LVM. Two hundred and thirteen patients referred for routine echocardiography had determination of LVM, cuff BP, and Doppler SV. Those with localized LV disease, valvular disease, or cor pulmonale were excluded. In both men and women, systolic BP (SBP) was more closely correlated with LVM than was diastolic blood pressure or mean arterial pressure, and SV was more closely correlated with LVM than cardiac output or cardiac index. Stepwise regression, followed by multiple regression showed that four variables (WT, SV, SBP, and AGE) explained 32.3% of the variability in LVM in men and 48.5% of the variability in LVM in women. WT and SV were significant determinants of LVM in both men and women. Age was also significant in men and SBP was also significant in women. For both men and women, SV was more significantly correlated with LVM than was SBP. The changes in LVM associated with 1 SD increments of SV and SBP, respectively, were 8 and 5 g for men and 13 and 11 g for women. We conclude that men and women have different patterns of variables influencing LVM. Doppler echocardiographic SV is a newly described determinant of LVM that has a greater correlation with LVM than does SBP. This study reemphasizes the importance of WT as the major determinant of LVM.
Intraventricular Flow During Isovolumic Relaxation
Authors: PRICE ROBERT W. , MOODY JOE M. , RUBAL BERNARD J. , McCLURE JOHN W.
Published: August 2007

In this study, isovolumetric relaxation time (IVRT) flow velocities recorded by pulsed Doppler were induced or augmented in nine patients (aged 60 ± 20 years) with permanent pacemakers. Six subjects had evidence of IVRT flow (± 0.2 m/sec) during native rhythm, only three of whom exhibited cavity obliteration. Mean ± SD left ventricular (LV) ejection fraction and end‐diastolic and end‐systolic volumes were 60%± 5%, 104 ± 50 mL, and 39 ± 27 mL, respectively. IVRT flows were induced or augmented (P > 0.003) in all patients during paced ectopic stimulation of the right ventricle and during pacing combined with sublingual nitroglycerin (NTG; 0.4 mg). However, IVRT flows were not significantly increased with NTG alone. IVRT flow duration was prolonged < 50% by pacing (P > 0.05). These data suggest that IVRT flows may be present in patients without cavity obliteration and may be accentuated by asynchronous LV relaxation.
Echocardiographic Features of Large Posterobasal Left Ventricular Aneurysms
Authors: D'CRUZ IVAN A. , HAYES MARK , KILLAM HORACE A.W.
Published: August 2007

We describe the echocardiographic characteristics of 12 patients with left ventricular aneurysms involving posterobasal segments of the ventricular septum and of the adjacent ventricular wall. In 5, the septal as well as ventricular wall components of the aneurysm were both conspicuous; in 3 the septal but not ventricular wall component was large; and in 4 the ventricular wall part of the aneurysm was predominant. In all, the mouth (rim) of the aneurysm was wider than its fundus, thus distinguishing the posterobasal ventricular aneurysm from a pseudoaneurysm. The echographic features are striking, but are easily overlooked in standard echo planes. Aneurysmal complications (acquired ventricular septal defect, mural thrombus) can also be detected. Together with echo appearances, other consistent findings of this entity include deep, wide inferior Q waves, posteromedial papillary muscle calcification, and total or subtotal occlusion of right coronary or circumflex coronary artery.
Atrial Septal Aneurysm and Dilated Sinus of Valsalva in a Patient with Wolff‐Parkinson‐White Syndrome
Authors: WILLENS HOWARD J. , KESSLER KENNETH M.
Published: August 2007

Atrial septal aneurysm and a dilated sinus of Valsalva were noted on echocardiography in a 30‐year‐old male with Wolff‐Parkinson‐White syndrome. The relative low probability of all three coexisting by chance alone suggests the possibility of a common developmental origin.
The Role of Multiplane Transesophageal Echocardiography in Diagnosing PDA in an Adult
Authors: KRAUSS DANIEL , WEINERT LYNN , LANG ROBERTO M.
Published: August 2007

The usefulness of multiplane transesophageal echocardiography in diagnosing PDA in asymptomatic adults is described.
Transesophageal Echocardiographic Findings in Sclerosing Mediastinitis
Authors: ALAN KOVACH TODD , NANDA NAVIN C. , KIM KEE‐SIK , NATH HRUDAYA , LISTINKSY CATHERINE M. , CHUNG SANG‐MAN
Published: August 2007

We report the usefulness of transesophageal echocardiography in evaluating a patient with sclerosing mediastinitis. The technique enabled us to identify a mass obstructing the superior vena cava and right upper and lower pulmonary veins, and infiltrating and invaginating into the left atrial cavity. Transesophageal echocardiography was superior to computed tomography and transthoracic echocardiography in delineating these findings.
Usefulness of Transesophageal Echocardiography in Diagnosing and Guiding Correct Placement of a Right Ventricular Assist Device Malpositioned in the Left Atrium
Authors: SNODDY BRIAN D. , NANDA NAVIN C. , HOLMAN WILLIAM L. , KIRKLIN JAMES , CHUNG SANG‐MAN
Published: August 2007

In this report, we describe how transesophageal echocardiography was used not only to diagnose incorrect cannula position of a right ventricular assist device in the left atrium through a patent foramen ovale, but also to guide and to confirm correct cannula placement.
Congenital Anomalies of the Aortic Arch
Authors: SNIDER A. REBECCA
Published: August 2007

Congenital anomalies of the aortic arch can occur either in isolation or in conjunction with other intracardiac defects. This review will examine congenital aortic arch anomalies as if they occur in isolation, with the awareness that intracardiac defects often coexist. The three general classes of abnormalities to be reviewed are: (1) abnormal connections between the aorta and pulmonary arterial system; (2) aortic arch obstructions; and (3) defects in the formation of the aortic arch typified by right aortic arches, vascular rings, and cervical aortic arches.
Pericardial Tamponade
Authors: KADER ALLAM ABDUL , AL‐SHAMIRI MOSTAFA , AL‐SADDIQUE AHMED , HAFEEZ M.A. , YAMANY H. , NOUH M.S.
Published: August 2007

Cardiac tamponade was manifested in a 30‐year‐old male with a 6‐month history of fever and weight loss prior to admission. Cross‐sectional echocardiography demonstrated huge pericardial effusion with a large mass in the posterior pericardial space. Pericardiocentesis revealed exudative fluid with no malignant cells. Surgery performed to determine the nature of the mass disclosed the mass originating from the posterior pericardium, invading the posterior pleural sac and adjacent structures. Histopathology identified spindle cell sarcoma. The preoperative diagnosis of the mass and its presenting features and nature are discussed.
Ultrasonic Imaging of Vascular Rings and Other Anomalies Causing Tracheobronchial Compression
Authors: MURDISON KENNETH A.
Published: August 2007

Display of aortic arch anatomy using single plane views does not readily allow for a three‐dimensional interpretation of structural relationships. A method that includes a sweep consisting of multiple contiguous frontal planes has been developed for the evaluation of the arch sidedness and number, brachiocephalic vessel pattern, upper descending thoracic aorta sidedness, ductus arteriosi site(s), and proximal pulmonary arteries. The addition of Doppler color flow mapping aids in the tracing of multiple vascular structures in complex cases, and in assessing ductus arteriosi and arch patency. Posterior angulation can display encirclement of the air‐filled trachea in cases of double aortic arch. Vascular ring segments without lumens cannot be displayed.
Quantification of Mitral and Tricuspid Regurgitation Using Jet Centerline Velocities
Authors: GRIMES RANDALL Y. , HOPMEYER JOANNE , CAPE EDWARD G. , YOGANATHAN AJIT P. , LEVINE ROBERT A.
Published: August 2007

A method for quantifying mitral and tricuspid regurgitant volume that utilizes a measure of jet orifice velocity U0 ‐ m/sec), a distal centerline velocity (Um ‐ m/sec), and the intervening distance (X ‐ cm) was recently developed; where jet flow rate (Qcal ‐ L/min) is calculated as Qcal= (UmX)2/(26.46U0). This method, however, modeled the regurgitant jet as a free jet, whereas many atrial jets are counterflowing jets because of jet opposing intra‐atrial flow fields (counterflows). This study concentrated on the feasibility of using the free jet quantification equation in the atrium where ambient flow fields may alter jet centerline velocities and reduce the accuracy of jet flow rate calculations. A 4‐cm wide chamber was used to pump counterflows of 0, 4, and 22 cm / sec against jets of 2.3, 4.8, and 6.4 m/sec originating from a 2‐mm diameter orifice. For each counterflow‐jet combination, jet centerline velocities were measured using laser Doppler anemometry. For free jets (no counterflow), flow rate was calculated with 98% mean accuracy. For all jets in counterflow, the calculation was less accurate as: (i) the ratio of jet orifice velocity to counterflow velocity decreased (U0/Uc where Uc is counterflow velocity), i.e., the counterflow was relatively more intense, and (ii) centerline measurements were made further from the orifice. But although counterflow lowered jet centerline velocities beneath free jet values, it did so only significantly in the jet's distal portion (X/D > 16, i.e., > 16 orifice diameters from the origin of the jet). Thus, the initial portion (X/D < 16) of a jet in counterflow behaved essentially as a free jet. As a result, even in significant counterflow, jet flow rate was calculated with > 93% accuracy and > 85% for jets typical of mitral and tricuspid regurgitation, respectively. Counterflow lowers jet centerline velocities beneath equivalent free jet values. This effect, however, is most significant in the distal portion of the jet. Therefore, regurgitant jets, although not classically free because of systolic atrial inflow or jet‐induced intra‐atrial swirling flows, will decay in their initial portions as free jets and thus are candidates for quantification with the centerline technique.
Spontaneous Microbubbles in Transit in the Right Cardiac Chambers
Authors: KOZLJ MIRTA , RAMOVŠ ANDREJ , ŠINKOVEC MATJAZ
Published: August 2007

We present two patients with echocardiographically detected small echoes passing through the right heart cavities, consistent with the clinical picture of thromboemboli. After anticoagulant treatment, pulmonary artery pressure fell and the echocardiographic picture of small echoes in transit disappeared. In the authors opinion, the detected echoes passing through the right heart represented microthromboemboli in transit.
Flail Aortic Valve in Systemic Lupus Erythematosus
Authors: MEHTA RAJEN K. , AGRAWAL GOPAL G. , NANDA NAVIN C. , TIRTAMAN CONNIE , PACIFICO ALBERT
Published: August 2007

This case report describes a patient with systemic lupus erythematosus who demonstrated by trans‐esophageal echocardiography (TEE) a flail right coronary cusp of the aortic valve causing severe aortic regurgitation. This finding was confirmed at surgery, which showed near detachment of the right coronary leaflet near the commissure. Destruction of areas of the aortic valve has been reported in one previous case report in the absence of infective endocarditis or a traumatic process. This is the second case to our knowledge and the first to describe identification by TEE.
Is a Full Digital Echocardiography Laboratory Feasible for Routine Daily Use?
Authors: MOBAREK SAMEH K. , GILLILAND YVONNE E. , BERNAL ALBERTO , MURGO JOSEPH P. , CHEIRIF JORGE
Published: August 2007

To determine the feasibility and accuracy of digital echocardiography for routine interpretation of two‐dimensional and Doppler echocardiography, we studied 93 consecutive patients chosen at random from our daily workload. The parameters studied included cavity sizes, biventricular regional and global systolic and diastolic function, valvular structure and function, and presence or absence of pericardial disease. The results were first interpreted using quad screen, digital format cine loops. These results were then compared with the results obtained from reviewing the video‐tape images. Seventy‐nine patients (87%) showed complete concordance between the digital system and video tape. Among the 1156 echocardiographic parameters/measurements examined in all patients, a 99% concordance rate (normal vs abnormal) was found. Disagreements between the digital system and video tape in the patients undergoing two‐dimensional/Doppler exams included mitral valve prolapse in 3, mild valvular insufficiency in 5, a small pleural effusion in 2, and a wall‐motion abnormality in 3 patients. In conclusion, the use of digital technology for evaluation of routine echocardiograms appears to compare favorably with the interpretation of images using the conventional video tape.
Microembolism in Cerebral Angiography
Authors: MARKUS HUGH
Published: August 2007

Using transcranial Doppler monitoring of middle cerebral artery blood flow velocity, a number of studies have detected transient high intensity embolic signals during cerebral angiography. These are particularly frequent during contrast injection, but also sometimes occur at the time of catheter and wire manipulations and following saline flushes. These embolic signals appear to be asymptomatic, although a correlation with subtle neurological damage, by neuropsychological evaluation for example, has not been made. Experimental studies in flow models and animal models suggest that the majority of these signals represent air emboli. These are most commonly introduced at the time the contrast is drawn up and at the time of contrast injection. The former can be reduced by allowing the contrast to stand prior to injection. The latter appears to be due to cavitation bubbles and can be reduced by reducing the speed of injection. Using current transcranial Doppler machines, it is impossible to be certain whether some of the embolic signals, particularly at times other than contrast injection, may be due to particulate, rather than air, emboli, but technological improvements may allow this distinction to be made in the future.
Doppler Microembolic Signals for Diagnosis of Ulcerated Carotid Artery Plaques
Authors: SPENCER MERRILL P.
Published: August 2007

Background: Finding the pathological meaning of Doppler microembolic signals is important to developing the clinical applications of this new technology. Methods: Two hundred eighty‐four plaques, removed at carotid endarterectomy, were examined by the surgeon and pathologist for evidence of ulceration. The ipsilateral middle cerebral artery was monitored, with 2‐MHz pulsed Doppler, preoperatively and during surgical mobilization of the carotid arteries. Associated Doppler embolic signals representing formed element emboli (FEE) were sought for 15–273 (mean 60) minutes. The embolization rate was calculated in FEE/hour. Results: Preoperatively, 21% of patients demonstrated FEEs. During surgical mobilization of the carotid arteries, 51% demonstrated FEEs. A 79% prevalence of plaque ulceration was found. Analysis demonstrated 61% sensitivity and specificity, and an 86% positive predictive value. The positive predictive value increased progressively with higher FEE rates, up to 100% for patients with > 60 FEE/hour. Conclusions: FEEs detected in the middle cerebral artery ipsilateral to carotid artery stenosis are diagnostic of plaque ulceration or luminal thrombus formation. Other embolic sources may be ruled out by monitoring the contralateral carotid artery system and the ipsilateral carotid arteries. There is no significant relationship between the number and prevalence of FEEs and the severity of stenosis or preoperative symptoms. Postoperative cerebral complications of stroke were associated with more FEEs than were postoperative transient ischemic attacks.
Sense of Coherence, Spirituality, Stress and Quality of Life in Chronic Illness
Authors: Delgado Cheryl
Published: August 2007

Purpose

: To investigate the relationship between sense of coherence and spirituality and their association with perceptions of stress, and quality of life.

Methods

: Questionnaires mailed to nonhospitalized patients with chronic obstructive pulmonary disease. Data analyses included descriptive statistics, Pearson's correlations, multiple regressions, and ANOVA.

Results

: High sense of coherence (SOC) and spirituality were correlated with low stress and high quality of life (QoL). Neither SOC nor spirituality related significantly to objective symptom severity. In regression analyses 73.2% of the variance in QoL was explained by SOC, the FEV1/FVC ratio, and functional ability.

Conclusions

: Psychosocial factors are important in patients' cognitive interpretations of illness. SOC and spirituality may buffer stress in the context of chronic illness.
Nonadherence With Diet and Fluid Restrictions and Perceived Social Support in Patients Receiving Hemodialysis
Authors: Kara Belguzar , Caglar Kayser , Kilic Selim
Published: August 2007

Purpose

: To describe nonadherence with diet and fluid restrictions and the level of perceived social support in hemodialysis patients.

Design

: Descriptive survey. The data were obtained from 160 patients in three hemodialysis centers in Turkey between March 2006 and May 2006. Descriptive statistics, reliability analysis, correlations, and logistic regression analysis were conducted.

Methods

: Data were collected by using a personal data form, the Dialysis Diet and Fluid Nonadherence Questionnaire, and the Multidimensional Scale of Perceived Social Support.

Results

: Most patients showed nonadherence with diet and fluid restrictions. Family members were important providers of social support for patients. Significant factors affecting fluid nonadherence included age, marital status, and family and friend support. Marital status and family support were also the main variables affecting diet nonadherence.

Conclusions

: The results of this study showed that nonadherence was more common among younger, married patients, and those with lower levels of perceived social support.
Immunohistochemical and ultrastructural characteristics of interstitial cells of Cajal in the rabbit duodenum. Presence of a single cilium
Authors: Junquera Concepción , Martínez‐Ciriano Carmen , Castiella Tomás , Serrano Pedro , Azanza María Jesús , Ramón y Cajal Junquera Santiago
Published: August 2007

Santiago Ramón y Cajal discovered a new type of cell related to the myenteric plexus and also to the smooth muscle cells of the circular muscle layer of the intestine. Based on their morphology, relationships and staining characteristics, he considered these cells as primitive neurons. One century later, despite major improvements in cell biology, the interstitial cells of Cajal (ICCs) are still controversial for many researchers. The aim of study was to perform an immunohistochemical and ultrastructural characterization of the ICCs in the rabbit duo‐denum. We have found interstitial cells that are positive for c‐Kit, CD34 and nestin and are also positive for Ki67 protein, tightly associated with somatic cell proliferation. By means of electron microscopy, we describe ICCs around enteric ganglia. They present triangular or spindle forms and a very voluminous nucleus with scarce per‐inuclear chromatin surrounded by a thin perinuclear cytoplasm that expands with long cytoplasmic processes. ICC processes penetrate among the smooth muscle cells and couple with the processes of other ICCs located in the connective tissue of the circular muscle layer and establish a three‐dimensional network. Intercellular con‐tacts by means of gap‐like junctions are frequent. ICCs also establish gap‐like junctions with smooth muscle cells. We also observe a population of interstitial cells of stellate morphology in the connective tissue that sur‐rounds the muscle bundles in the circular muscle layer, usually close to nervous trunks. These cells establish different types of contacts with the muscle cells around them. In addition, the presence of a single cilium show‐ing a structure 9 + 0 in an ICC is demonstrated for the first time. In conclusion, we report positive staining c‐kit, CD34, nestin and Ki 67. ICCs fulfilled the usual transmission electron microscopy (TEM) criteria. A new ultrastructural characteristic of at least some ICCs is demonstrated: the presence of a single cilium. Some populations of ICCs in the rabbit duodenum present certain immunohistochemical and ultrastructural characteristics that often are present in progenitor cells.
Proteomic identification of nitrated brain proteins in amnestic mild cognitive impairment: a regional study
Authors: Sultana Rukhsana , Reed Tanea , Perluigi Marzia , Coccia Rafaella , Pierce William M. , Butterfield D. Allan
Published: August 2007

Oxidative stress is an imbalance between the level of antioxidants and oxidants in a cell. Oxidative stress has been shown in brain of subjects with mild cognitive impairment (MCI) as well Alzheimer's disease (AD). MCI is considered as a transition phase between control and AD. The focus of the current study was to identify nitrated proteins in the hippocampus and inferior parietal lobule (IPL) brain regions of subjects with amnestic MCI using proteomics. The identified nitrated proteins in MCI brain were compared to those previously reported to be nitrated and oxidatively modified in AD brain, a comparison that might provide an invaluable insight into the progression of the disease.
Concepts of scaffold‐based tissue engineering—the rationale to use solid free‐form fabrication techniques
Authors: Hutmacher D.W. , Cool S.
Published: August 2007

Introduction

Scaffolds for bone engineering fabricated by solid free‐form fabrication

Scaffolds combined with growth factors and other biologically active molecules

Accelerated bone repair with growth factors, HS and HS‐like molecules

Conclusion

A paradigm shift is taking place in orthopaedic and reconstructive surgery from using medical devices and tissue grafts to a tissue engineering approach that uses biodegradable scaffolds combined with cells or biological molecules to repair and/or regenerate tissues. One of the potential benefits offered by solid free‐form fabrication technology (SFF) is the ability to create scaffolds with highly reproducible architecture and compositional variation across the entire scaffold, due to its tightly controlled computer‐driven fabrication. In this review, we define scaffold properties and attempt to provide some broad criteria and constraints for scaffold design in bone engineering.We also discuss the application‐specific modifications driven by surgeon's requirements in vitro and/or in vivo. Next, we review the current use of SFF techniques in scaffold fabrication in the context of their clinical use in bone regeneration. Lastly, we comment on future developments in our groups, such as the functionalization of novel composite scaffolds with combinations of growth factors; and more specifically the promising area of heparan sulphate polysaccaride immobilization within the bone tissue engineering arena.
Programming the genome in embryonic and somatic stem cells
Authors: Collas Philippe , Noer Agate , Timoskainen Sanna
Published: August 2007

Introduction

Epigenetic makeup of embryonic stem cells: keeping chromatin loose

The epigenetic makeup of mesenchymal stem cells reflects restricted differentiation potential

Linking DNA methylation to histone modifications, chromatin packaging and (re)organization of the nuclear compartment

Perspectives: towards remodelling the stem cell epigenome?

In opposition to terminally differentiated cells, stem cells can self‐renew and give rise to multiple cell types. Embryonic stem cells retain the ability of the inner cell mass of blastocysts to differentiate into all cell types of the body and have acquired in culture unlimited self‐renewal capacity. Somatic stem cells are found in many adult tissues, have an extensive but finite lifespan and can differentiate into a more restricted array of cell types. A growing body of evidence indicates that multi‐lineage differentiation ability of stem cells can be defined by the potential for expression of lineage‐specification genes. Gene expression, or as emphasized here, potential for gene expression, is largely controlled by epigenetic modifications of DNA and chromatin on genomic regulatory and coding regions. These modifications modulate chromatin organization not only on specific genes but also at the level of the whole nucleus; they can also affect timing of DNA replication. This review highlights how mechanisms by which genes are poised for transcription in undifferentiated stem cells are being uncovered through primarily the mapping of DNA methylation, histone modifications and transcription factor binding throughout the genome. The combinatorial association of epigenetic marks on developmentally regulated and lineage‐specifying genes in undifferentiated cells seems to define a pluripotent state.
NEED OF A GENERAL PSYCHOLOGICAL THEORY COMMON TO NEUROPSYCHIATRY, PSYCHOLOGY AND THE SOCIAL SCIENCES
Authors: SMTTT JARL WAGNER
Published: August 2007

Karl Bühler in “Die Krise der Psychologie”: Es ist, wenn nieht alles täuscht, keine Zerfalls‐, sondern eine Aufbaukrise, ein embarras de richesse, wie er das Aushoten zu einem umfas‐senden Gemeinschaftswerke begleiten kann. Ge‐lingt es, eine Konkordanz herzustellen, dann dürfen wir Grosses von der Zukunft erwarten. Kritisch ist ja nicht nur die Lage in der Psychologie, sondern auch die in anderen Geisteswis‐sensehaften und in der Biologie: ich denke mir, unsere nächsten Nachbaren, z. B. die Soziologen und die Psychiater, dürften nicht nur aus altruistischen Gründen an dern, was uns hier be‐schäftigen soil, Interesse nehmen.
BOOKS
Authors: Olivarius Bent de Fine , Dalbj M. A. , Nimb Mogens , Remvig Jargen
Published: August 2007

Brain's Diseases of the Nervous System. 7th edit. Revised by the late Lord Brain and John N. Walton.

Helmut Künkel: Die Periodik der paroxysmalen Dysrhythmie im Elektroencephalogramm.

WHO Expert Committee on Drug Dependence. Sixteenth Report. World Health Organization Technical Report Series.

Psychiatry and the Deaf Child (1969). Edited for the National Deaf Children's Society by J. H. Kahn, M. D.
REPRODUCTION IN FEMALE PSYCHIATRIC PATIENTS: SEVERITY OF MENTAL DISTURBANCE NEAR REPRODUCTION AND RATES OF OBSTETRIC COMPLICATIONS
Authors: McNeil T. F. , Persson‐Blennow I. , Kaij L.
Published: August 2007

The relationship was studied between degree of active maternal mental disturbance near reproduction and the total number of obstetric complications during 169 reproductions for 99 female psychiatric patients. The primary source of information on active mental disturbance was the psychiatric records of the patients. Degree of disturbance was rated on a seven‐point general psychopathology scale, both for the 10 months prior to delivery and for the first 10 months postpartum. Degree of active maternal mental disturbance during pregnancy was unrelated to total number of obstetric complications. Degree of active maternal mental disturbance postpartum was slightly negatively related to total number of obstetric complications. The current data did not support the psychosomatic hypothesis of a relationship between maternal mental disturbance and somatic complications, nor did the data support the hypothesis that obstetric complications are the intermediating link between severity of psychiatric disturbance in mothers and increased risk for disturbance in their offspring.
THE EFFECTS OF LITHIUM CARBONATE ON SERUM GASTRIN IN PSYCHIATRIC PATIENTS
Authors: Sathananthan G. , Shopsin B. , Petersson B.
Published: August 2007

Indications that gastrin is produced in the pancreatic A1 cells and that there is a lithium‐related increase in A1 cell nuclei in guinea pigs are background factors leading up to this study. The effect of lithium treatment on the gastrin level in serum was tested on four patients with different psychiatric diagnoses. All the patients showed normal serum values during the first 3 weeks of the treatment period. Possible reasons for the relatively unelevated levels of serum gastrin (non‐detectable to 300 pg gastrin/ml serum) are discussed. The effects of catecholamines on gastrin release is also mentioned as a lead in the study of the relationships between lithium, amines, gastrin and carbohydrate metabolism.
A CUMULATIVE NATIONAL PSYCHIATRIC REGISTER: ITS STRUCTURE AND APPLICATION
Authors: Dupont A. , Videbech Th. , Weeke A.
Published: August 2007

The Danish Central Psychiatric Register is a cumulative register comprising all psychiatric in‐patient institutions (about 12,000 beds and about 40,000 admissions per year). The system of manual files and an EDP registration is described. Its development, method of operation and function, some applications and results are presented.
COMPARISON OF FRONTOPARIETAL AND TEMPOROPARIETAL UNILATERAL ELECTROCONVULSIVE THERAPY
Authors: Widepalm K. , 'Elia G.d
Published: August 2007

An intraindividual, double‐blind, cross‐over comparison of the anterograde effect on memory of unilateral non‐dominant frontoparietal (FP) and temporoparietal (TP) ECT was performed in connection with the second and third treatments of ECT‐series. Treatment technique was standardized and seizure duration was measured by means of EEG. Memory functions were examined 3 and 6 hours after treatments by means of parallel memory tests, and three operationally defined memory variables, immediate and delayed reproduction, and their difference, forgetting, were scored.

The duration of the electrical stimulation (with constant intensity) necessary to evoke generalized seizure was similar in the two methods. The duration of seizure activity was significantly shorter after FP‐ECT. In spite of this difference, the anterograde effect on the memory variables was closely similar in the two treatments.

The shorter duration of seizure activity after FP‐ECT indicates that a maximal seizure is more difficult to obtain with frontal electrode position. The lack of difference in anterograde effect between TP‐ECT and FP‐ECT indicates that little further reduction of memory impairment can be expected with new unilateral electrode positions.
LONG‐TERM TREATMENT OF PSYCHIATRIC PATIENTS WITH CLOPENTHIXOL: ANALYSIS OF LABORATORY TESTS WITH A VIEW TO LONG‐TERM THERAPY
Authors: Ravn V. Hansen, J. , Rud C.
Published: August 2007

For the purpose of investigating the effects of long‐term therapy with clopenthixol in terms of measurable laboratory parameters, 57 female patients who had been treated with clopenthixol alone from 3 to 9 years were examined. Twenty‐six patients had psychiatric diseases only 31 had concomitant somatic diseases. Several parametric and non‐parametric statistical methods (especially Spearman's Rho) were used to study the relationships between the measured values, in particular variations within the range between the two groups. Age, dose and duration of treatment were variables along with laboratory tests.

There were no indications that long‐term treatment with clopenthixol exerts a nephrotoxic, hepatotoxic, or haematotoxic effect. Changes did seem to occur in certain parameters, predominantly within the range of normal, especially as concerns thymol turbidity values and total leucocyte count.
A DOUBLE‐BLIND CLINICAL EVALUATION OF PENFLURIDOL (R 16 341) AS A MAINTENANCE THERAPY IN SCHIZOPHRENIA
Authors: Vandecasteele A. J. A. , Vereecken J. L. Th. M.
Published: August 2007

Twenty‐one female schizophrenics (age range 34–74 years) were included in a clinical study assessing the effectiveness of penfluridol as a basic maintenance therapy. At the start of the study, the patients, all of whom had been successfully maintained on penfluridol for at least 6 months, were divided into two comparable groups. Group I (ten patients) received penfluridol and Group II(II patients) placebo under double‐blind conditions for 6 months. Patients were evaluated using a 36‐item questionnaire, which was completed before and after 1, 3, 4 and 6 months of treatment.

When at any time during the study a patient deteriorated, haloperidol in individually adjusted doses was added to her treatment regimen. By the end of the study, eight of the 11 placebo patients received additional haloperidol, whereas only three of the penfluridol patients did.

Evaluation of the scores on the rating scale showed no significant differences between the two treatment groups. The trial confirmed previously gained experience that penfluridol is a very suitable drug for the maintenance therapy of chronic schizophrenic patients.
MIND AND ULCER
Authors: Viskuml K.
Published: August 2007

Among 2,619 patients admitted to a medical department for duodenal ulcer, gastric ulcer and ulcer dyspepsia without ulcer demonstrable by x‐ray, admissions to psychiatric departments were investigated. A total of 20.4 % of the patients had at some time during their lifetime been admitted, but no significant differences were observed in percentage among the three ulcer groups or the sexes.

The incidence of psychoses was close to the expected, whereas neuroses among women and neuroses and psychopathy among men were far in excess of the expected. Among those operated on, the percentage of persons admitted to a psychiatric department was greater than among unoperated patients and their number of admissions per 100 observation years were significantly greater than for unoperated patients, within well‐defined observation periods. For patients operated on, only men with duodenal ulcer had significantly more admissions per 100 observation years in the postoperative than in the preoperative period. The course of the disease was more severe for patients with duodenal and gastric ulcer admitted to a psychiatric department than for those not admitted, but the subjective status at the time of the follow‐up did not differ between the two groups. Among men, there were a number of heavy drinkers, especially among those operated on.
EEG IN UNILATERAL AND BILATERAL ELECTROCONVULSIVE THERAPY
Authors: Strömgren L. Sand , Juul‐Jensen P.
Published: August 2007

The investigation concerned 100 patients with endogenous depression treated with ECT, 52 unilaterally on the non‐dominant hemisphere, and 48 bilaterally. A double‐blind investigation of the therapeutic effect and the effect on memory and on EEG was carried out. With unilateral treatment, mainly diffuse and same‐sided EEG changes appeared, while with bilateral treatment mainly diffuse and left‐sided changes occurred. Bilateral treatment led to significantly more EEG changes than did unilateral treatment. For both groups there was a tendency to greater changes after the last than after the sixth treatment.

At termination of treatment, a significantly better therapeutic effect was found in cases where EEG changes appeared, especially severe EEG changes. This applied to the total material but not to the groups of unilaterals and bilaterals taken separately.

In the entire material after the first six treatments, the greatest representation of patients with unchanged and imparied memory was found in cases with deteriorated EEG compared to cases with no EEG deterioration. After the entire series of ECT, this correlation no longer was present. After separation of the patients into unilaterals and bilaterals it was not present at any of the stages.

In the bilateral group, ECT treatment gave more frequent and stronger EEG changes among the older than among the younger patients. For the unilateral group, there was no comparable difference.

The number of weak seizures was significantly greater among the unilaterals than among the bilaterals. The therapeutic effect was not correlated to the number of weak seizures, but the number of weak seizures was positively correlated to the number of treatments applied.

It was concluded that the therapeutic effect of ECT is positively correlated to the incidence and degree of EEG changes, while the positive correlation between therapeutic effect and age observed in previous investigations did not appear to have a consistent relationship to the appearance of EEG changes. The EEG findings support the contention that unilateral treatment may be considered to have a gentler action on the brain. The importance of obtaining sufficiently strong universal seizures is emphasised, since the treatment otherwise can be less effective unless a greater number of treatments are applied.
CARDIAC ARRHYTHMIA AND BEHAVIOUR IN AUTISTIC CHILDREN
Authors: Hutt C. , Forrest S. J. , Richer J.
Published: August 2007

The behaviour and heart rate of autistic children were simultaneously videorecorded in a standard situation. Normal children of two age‐groups were also studied. It was found that the heart rate of the autists was characteristically highly variable and more so than that of normal children of the same age or younger. This variability (arrhythmia) however, was behaviour‐dependent in all children involvement in a task resulting in suppression of the arrhythmia. It was at a maximum in the autists during the performance of stereotyped behaviours. The functional implications of these behaviour‐heart rate associations are discussed.
A LONG‐TERM FOLLOW‐UP STUDY OF SCHIZOPHRENIA: PSYCHIATRIC COURSE OF ILLNESS AND PROGNOSIS
Authors: Huber G. , Gross G. , Schüttler R.
Published: August 2007

A systematic psychiatric follow‐up study of 502 schizophrenics was carried out using the same well‐defined criteria to evaluate the patients throughout the investigation. After an average course of disease of 22.4 years, 22.1 % of the patients showed complete psychopathological remission, 43.2 % had non‐characteristic types of remission and 34.7 % suffered from characteristic schizophrenic deficiency syndromes. At the time of the last follow‐up investigation, 86.7 % of the patients were living at home, while 13.3 % were permanently hospitalized. Of the entire sample, 55.9 % were found to be socially recovered. Higher education, psychoreactive provocation, depressive traits, perception of delusions, catatonic agitation, non‐characteristic thought disorders and symptoms of depersonalizati on at the onset of the illness tended to carry with them a favorable prognosis. On the other hand, low intelligence, abnormal primary personality, premorbid disturbances in social behavior, broken homes, prolonged prodromal stages, pneumoence‐phalographically measurable atrophic or dysplastic changes in the brain ventricles as well as somatic and auditory hallucinations and predominance of hebephrenic symptoms at the onset of the illness tended to lead to an unfavorable Prognosis. The principle of the basic reversibility of typical schizophrenic symptoms and the extensive irreversibility of the non‐characteristic defect is important for the psychopathological and social long‐term prognosis.
SJÖBRING PERSONALITY DIMENSIONS: NORMS FOR SOME AMERICAN POPULATIONS
Authors: Barrett J. E.
Published: August 2007

An American version of the MNT Inventory (Sjöbring personality dimensions) was administered to three separate groups of American subjects. Normative data on the Sjöbring dimensions, including correlational data between the dimensions, was reported for these groups and compared to published normative data from prior studies in Sweden and in the United Kingdom.

For the American groups, the correlations between dimensions were negligible or very small, in accord with Sjöbring theory. There were similar patterns to the scale scores and to the correlational data for the American groups and comparable Swedish groups.

The results suggest that the American version of the MNT inventory is a valid tool for obtaining Sjöbring dimension scores on American subjects.
A DOUBLE‐BLIND TRIAL OF MAPROTILINE (LUDIOMIL®) AND AMITRIPTYLINE IN DEPRESSED OUTPATIENTS
Authors: Weissman M. M. , Lieb J. , Prusoff B. , Bothwell S.
Published: August 2007

The results of a double‐blind trial of a tetracyclic antidepressant, maprotiline (Ludiomil®) and a conventional tricyclic, amitriptyline (Elavil®), in 67 ambulatory depressives are reported. hamilton's Rating Scale for Depression was the main outcome criterion.

No statistically significant differences were found between the drugs in onset of action, efficacy, side effects or predictors of response. Patients on either drug showed a significant reduction in symptoms after 1 week of treatment and at the end of the trial. Both drugs were tolerated well. A review of double‐blind comparisons of maprotiline and tricyclic antidepressants, spanning 13 countries, and including over 900 patients, both ambulatory and inpatient, shows essentially similar results. The main outcome criterion in all these studies was manifest psychopathology assessed on the Hamilton Rating Scale for Depression by the treating physician. The absence of additional types of outcome criteria or assessment techniques, which may have detected differences in motor activity or drive as originally postulated, may have obscured results which were expected to be subtle.
A TWO‐GENE MODEL FOR SCHIZOPHRENIA WITH THE POSSIBILITY TO DETECT CARRIERS OF THE MODIFIER GENE
Authors: Maricq H. R.
Published: August 2007

A two‐gene model for the hereditary transmission of schizophrenia is presented involving two pairs of autosomal alleles Ss and Pp. It is hypothesized that the recessive gene can produce schizophrenia in homozygous state with a penetrance of .40. In the presence of the gene P schizophrenia can occur in the heterozygote Ss, resulting in a more serious form of the disease and having a manifestation rate of .70. The population frequencies best fitting the available data are estimated to be approximately .03 for P and .07 or .08 for s. It is also hypothesized that the reproductive fitness is .80 in manifest schizophrenics with genotype ss pp and .50 in overt schizophrenics carrying the modifier gene P. The model is proposed to cover only the so‐called “process” or “nuclear” type of schizophrenia. The remaining schizophrenics of “reactive” and other types may belong to different genotypes or consist in phenocopies.

The model is discussed in relation to literature observations and our own previous studies. The possibilities for increased fitness of non‐schizophrenic carriers of P and s are also discussed.