bluuebunny/crossref_metadata_2025 huggingface dataset:
Identification of Peptides That Inhibit the DNA Binding,trans-Activator, and DNA Replication Functions of the Human Papillomavirus Type 11 E2 Protein
Authors: Deng Su-Jun , Pearce Kenneth H. , Dixon Eric P. , Hartley Kelly A. , Stanley Thomas B. , Lobe David C. , Garvey Edward P. , Kost Thomas A. , Petty Regina L. , Rocque Warren J. , Alexander Kenneth A. , Underwood Mark R.
Published: February 2004

Peptide antagonists of the human papillomavirus type 11 (HPV-11) E2-DNA association were identified using a filamentous bacteriophage random peptide library. Synthetic peptides antagonized the E2-DNA interaction, effectively blocked E2-mediated transcriptional activation of a reporter gene in cell culture, and inhibited E1-E2-mediated HPV-11 DNA replication in vitro. These peptides may prove to be useful tools for characterizing E2 function and for exploring the effectiveness of E2-inhibitor-based treatments for HPV-associated diseases.
Jaagsiekte Sheep Retrovirus Envelope Efficiently Pseudotypes Human Immunodeficiency Virus Type 1-Based Lentiviral Vectors
Authors: Liu Shan-Lu , Halbert Christine L. , Miller A. Dusty
Published: February 2004

Jaagsiekte sheep retrovirus (JSRV) infects lung epithelial cells in sheep, and oncoretroviral vectors bearing JSRV Env can mediate transduction of human cells, suggesting that such vectors might be useful for lung-directed gene therapy. Here we show that JSRV Env can also efficiently pseudotype a human immunodeficiency virus type 1-based lentiviral vector, a more suitable vector for transduction of slowly dividing lung epithelial cells. We created several chimeric Env proteins that, unlike the parental Env, do not transform rodent fibroblasts but are still capable of pseudotyping lentiviral and oncoretroviral vectors.
Contribution of Disulfide Bridging to Epitope Expression of the Dengue Type 2 Virus Envelope Glycoprotein
Authors: Roehrig John T. , Volpe Katharine E. , Squires Jennifer , Hunt Ann R. , Davis Brent S. , Chang Gwong-Jen J.
Published: February 2004

The individual contributions of each of the six conserved disulfide (SS) bonds in the dengue 2 virus envelope (E) glycoprotein (strain 16681) to epitope expression was determined by measuring the reactivities of a panel of well-defined monoclonal antibodies (MAbs) with LLC-MK
2
cells that had been transiently transformed with plasmid vectors expressing E proteins that were mutant in their SS bonds. Three domain I (DI) epitopes (C1, C3, and C4) were affected by elimination of any SS bond and were essentially the only epitopes affected by elimination of the amino-proximal SS1 formed between Cys 3 and Cys 30. The remaining DI epitope (C2) was sensitive to only SS3-bond (Cys 74-Cys 105) and SS6-bond (Cys 302-Cys 333) elimination. Of the four DII epitopes examined, reactivities of three anti-epitope MAbs (A1, A2, and A5) were reduced by elimination of SS2 (Cys 61-Cys 121), SS3, SS4 (Cys 94-Cys 116), SS5 (Cys 185-Cys 285), or SS6. The other DII epitope examined (A3) was sensitive only to SS2- and SS3-bond elimination. The three DIII epitopes tested (B2, B3, and B4) were most sensitive to elimination of SS6. The flavivirus group epitope (A1) was less sensitive to elimination of SS3 and SS6. This result may indicate that the region proximal to the E-protein fusion motif (amino acids 98 to 110) may have important linear components. If this observation can be confirmed, peptide mimics from this region of E protein might be able to interfere with flavivirus replication.
The Influence of Diaminotoluene Isomers on the Two-Step Electroreduction of Zn(II) Ions in Acetate Buffers at Different Acidities
Authors: Dalmata Grażyna , Nosal-Wiercińska Agnieszka , Zięcina Teresa
Published: February 2004

The influence of diaminotoluene isomers on the two-step reduction of Zn(II) ions on the mercury electrode in acetate buffers at different acidities was examined. It was stated that 2,4- and 2,6-diaminotoluene inhibit the electroreduction process of Zn(II) ions, while 3,4-diaminotoluene, in dependence on pH of acetate buffer, can act as inhibitor or catalyst. The differences in activity of these isomers result mainly from their complex formation properties. The catalytic activity of 3,4-diaminotoluene is associated with removing of the coordinated water molecules from the hydration sphere of Zn(II) ions and with the formation of active complexes on the electrode surface. This reaction controls the total rate of the process. The active complexes participate in consecutive electron transfer. Both steps of electron transfer are catalysed by 3,4-diaminotoluene.
Evaluation of Two-Center Overlap Integrals Over Slater-Type Orbitals Using Fourier Transform Convolution Theorem
Authors: Özdogan Telhat
Published: February 2004

Analytical expressions are presented for two-center overlap integrals over Slater-type orbitals using Fourier transform convolution theorem. The efficiency of calculation of these expressions is compared with those of other methods and good rate of convergence and great numerical stability is obtained for wide range of quantum numbers, orbital exponents and internuclear distances.
Two Photobioelectrochemical Applications of Self-Assembled Films on Mercury
Authors: Tadini Buoninsegni Francesco , Dolfi Andrea , Guidelli Rolando
Published: February 2004

The homogeneous, defect-free surface of a hanging mercury drop electrode was used to self-assemble films apt for the investigation of two photobioelectrochemical systems. Monolayers of straight-chain C12-C18alkane-1-thiols were anchored to a hanging mercury drop electrode and a film of chlorophyll was self-assembled on the top of them. The dependence of the photocurrents generated by illumination of the chlorophyll film with red light, on the thickness of the alkane-1-thiol monolayer and the applied potential is discussed. The photocurrents of purple membrane fragments, adsorbed on a mixed hexadecane-1-thiol/ dioleoylphosphatidylcholine bilayer self-assembled on mercury, were investigated in the presence of sodium perchlorate, chloride and acetate. The effect of the anions on the kinetics of the light-driven proton transport by bacteriorhodopsin has been determined.
Luminescent Terbium Complexes with Polymer Ligands
Authors: Výprachtický Drahomír , Cimrová Věra , Kukla Stanislav , Machová Luďka
Published: February 2004

Alternating and statistical copolymers of 9-vinylcarbazole with diethyl fumarate (1), diethyl maleate (2), methacrylic acid (3), maleic anhydride (4), or maleic acid (5) were synthesized and characterized. These copolymers were tested as polymer ligands, that might be able to suppress the environmental vibronic quenching of a lanthanide ion and, simultaneously, to function as energy donors in the ligand-to-metal energy transfer processes. Time-resolved luminescence of a series of [Tb(III)-ligand] complexes in common and deuterated solvents revealed that the complexing properties of copolymers 3 or 5 are stronger than those of 1 or 2. Consequently, the strong binding affinity decreases the ligand-metal (donor-acceptor) distance and gives rise to an efficient ligand-to-metal energy transfer. Thus, the intensities of the long-lived emission (5D4→7F6, 5D4→7F5, 5D4→7F4, 5D4→7F3) of the [Tb(III)-3], [Tb(III)-5], and [Tb(III)-1] or [Tb(III)-2] complexes were found to be eight times, five times, and less than twice that of uncomplexed Tb3+, respectively.
Synthesis of New Chiral 1,2-Disubstituted Ferrocenes
Authors: Fleischer Ivana , Toma Štefan
Published: February 2004

Synthesis of six chiral 1,2-disubstituted ferrocene derivatives is described starting from (S)-{[2-(methoxymethyl)pyrrolidin-1-yl]methyl}ferrocene (2) and {[N-((1R,2S)-methoxy-1-methyl-2-phenethyl)-N-methylamino]methyl}ferrocene (3). Oxidation of the (N-substituted aminomethyl)ferrocenes with active MnO2 furnished the corresponding 2-substituted ferrocenecarbaldehydes.
New Alkali Metal and Tetramethylammonium Tetrafluoroarsenates(III), Their Vibrational Spectra and Crystal Structure of Cesium Tetrafluoroarsenate(III)
Authors: Klampfer Peter , Benkič Primož , Lesar Antonija , Volavšek Bogdan , Ponikvar Maja , Jesih Adolf
Published: February 2004

The title compounds were synthesised by the reaction of alkali metal and tetramethylammonium fluorides with liquid AsF3. Crystal structure of CsAsF4 was determined. Raman and infrared spectra of the title compounds were analysed.
Reaction of Zirconacyclopentadienes with Ethynylferrocenes
Authors: Dufková Lenka , Matsumura Hiroshi , Nečas David , Štěpnička Petr , Uhlík Filip , Kotora Martin
Published: February 2004

Various zirconacyclopentadienes fully substituted at the metallacycle react with ethynylferrocene in the presence of [NiBr2(PPh3)2] or with methyl or ethyl 3-ferrocenylpropynoates in the presence of CuCl to give penta- and hexasubstituted phenylferrocenes, respectively. X-Ray diffraction analysis showed that the cyclopentadienyl and benzene rings in (5,8-diphenyl-1,2,3,4-tetrahydronapthalen-6-yl)ferrocene are rotated by as much as 51°.
New Ligands for Enantioselective Recognition of Chiral Carboxylates Based on 1,1'-Binaphthalene-2,2'-diamine
Authors: Stibor Ivan , Holakovský Roman , Mustafina Asiya R. , Lhoták Pavel
Published: February 2004

Simple bis(arylureido)binaphthalenes and (arylamido)binaphthalenes have been synthesized in both racemic as well as optically active forms. One of these compounds has been found to complex chiral anions with modest enantioselectivity.
Inclusion Complexation of Carbethopendecinium Bromide with Some α- and β-Cyclodextrins Studied by Potentiometry with Membrane Electrodes
Authors: Kopecký František , Vojteková Mária , Kováčová Silvia , Juríčeková Monika
Published: February 2004

Inclusion complexation of an antimicrobial quaternary ammonium salt, carbethopendecinium bromide (SBr, Septonex), with five cyclodextrins was investigated potentiometrically using the prepared membrane electrodes selective to the surface-active carbethopendecinium cations (S+). Relatively strong complexation of the S+ cations with native α-cyclodextrin (α-CD), β-cyclodextrin (β-CD), and their random-substituted derivatives, namely hydroxypropyl-α-cyclodextrin (HP-α-CD), methyl-β-cyclodextrin (M-β-CD), and hydroxypropyl-β-cyclodextrin (HP-β-CD), was evidenced in dilute aqueous solution. In the region where the potentiometrically determined concentration of the free S+ cations remained lower than the critical micelle concentration (cmc) of SBr by a factor of ca ten, formation of the 1:1 complexes with the complexation constants K11 ≈ 104-105 was evaluated by two respective methods, based on a modified linear and a non-linear regression. Deviations from the 1:1 complexation were observed when concentration of the free S+ cations approached cmc of SBr more closely and also in solutions with large excess of α-CD. Comparison of K11 values corroborated the inclusion of the n-C14H29 alkyl chain of the carbethopendecinium cation as the mechanism of its complexation with cyclodextrins. The well-soluble native α-CD with good complex-forming capability towards S+ cations may be especially suitable for possible blocking the undesirable residues of carbethopendecinium bromide.
Reactivity of p-Substituted Benzaldoximes in the Cleavage of p-Nitrophenyl Acetate: Kinetics and Mechanism
Authors: Pícha Jan , Cibulka Radek , Hampl František , Liška František , Pařík Patrik , Pytela Oldřich
Published: February 2004

Eleven p-substituted benzaldoximes (p-XC6H4CH=NOH, where X = H, CH3, CF3, F, Cl, Br, OCH3, N(CH3)2, COOCH3, CN, NO2) have been synthesized and their dissociation constants determined in 10% (v/v) aqueous dioxane at 35 °C. Under the same conditions, the pseudo-first order rate constants kobs of their reactions with p-nitrophenyl acetate (PNPA) were measured at pH values from 7.8 to 10.8 and at concentrations coxime ranging from 0 to 4.00 × 10-3 mol l-1. The kinetic model and mechanism of the said reaction was proposed by means of mathematical statistical modelling of the dependences of kobs on pH and coxime. The mechanism involves a pre-equilibrium (k-1/k1) in which PNPA forms a tetrahedral intermediate (THI) with the deprotonated form of oxime. In the given medium, THI is in equilibrium with the non-reactive conjugated acid THIH (dissociation constant Ka,THIH) which is stabilized by intramolecular hydrogen bond. Depending on pH, the rate-limiting step consists either in formation of THI from educts (pH < pKa,oxime) or in its spontaneous (k2) and oxime-catalyzed (k3, general acid catalysis) decomposition to products (pH > pKa,oxime). Evaluation of substituent effects on dissociation constants (Ka,oxime) of the oximes showed that there is no direct conjugation between the substituent and the reaction centre (the found reaction constant ρ(Ka,oxime) = 0.91). The transmission coefficient of the transfer of these effects through C=N-O grouping corresponds approximately to one bond. The reaction constants in the Hammett equation obtained from the regression model are: ρ(k-1Ka,THIH/k1) = 1.29, ρ(k2Ka,THIH) = 0.20 and ρ(k3Ka,THIH) = 0.67. These reaction constants have been discussed with the regard to the reaction mechanism suggested.
Preparation of Diethyl 1-(Alkyl/Aryl-2-amino-4-oxo-4,5-dihydropyrrol-3-yl)phosphonates
Authors: Tverdokhlebov Anton V. , Tolmachev Andrey A. , Volovenko Yulian M.
Published: February 2004

The title compounds were prepared starting from diethyl (cyanomethyl)phosphonate by C-acylation with chloroacetyl chloride and subsequent amination with primary amines.
Non-Cottrell Behavior of the Dopamine Redox Reaction Observed on the Carbon Fibre Microelectrode by the Double-Step Voltcoulometry
Authors: Gmucová Katarína , Orlický Jozef , Pavlásek Juraj
Published: February 2004

The redox reaction of the neurotransmitter dopamine at the carbon fibre microelectrode was studied by several electrochemical methods. It was found that under conditions usual in a living body, the diffusion current fullfils, within experimental errors, the behavior theoretically predicted by the Cottrell equation. Nevertheless, attention should be paid to the fact that unsupported or weakly supported conditions give rise to a non-Cottrell response of diffusion current. Moreover, similar changes were observed if the dopamine concentration was either lower such as several units of μmol l-1, or about 100 μmol l-1 or higher. The non-Cottrell behavior of diffusion current involves the nonlinearity of the dopamine calibration curve obtained by pulse techniques. The present work is aimed at pointing out that such behavior of the measured data could lead to misinterpretation of the obtained dopamine concentration. Similar features could be also achieved for the other catecholamines.
1,3-Dipolar Cycloaddition Reactions of 4-Halophenylphthalazinium Ylides to Activated Alkenes and Alkynes
Authors: Caprosu Maria C. , Zbancioc Gheorghita N. , Moldoveanu Costel C. , Mangalagiu Ionel I.
Published: February 2004

For the first time in the benzodiazinium ylide series cycloaddition of (4-halophenyl) substituted ylides to activated alkenes and alkynes was studied. The ability of these ylides to react with acrylonitrile, N-phenylmaleimide, ethyl propiolate and dimethyl acetylenedicarboxylate was investigated. The stereochemistry and regiochemistry involved in these reactions are also discussed. Two new salts and ten new azabicyclic compounds have been obtained.
Synthesis of Purine Nucleoside Analogues Derived from Carbocyclic 5-C-(Hydroxymethyl)hexopyranoses
Authors: Hřebabecký Hubert , Masojídková Milena , Holý Antonín
Published: February 2004

(1R,2R,3R,4S)-3-(Benzyloxy)-5,5-bis(hydroxymethyl)cyclohexane-1,2,4-triol (1) was converted to (3aS,4R,5S,7aR)-4-(benzyloxy)-2-oxo-6,6-bis[(trityloxy)methyl]hexahydro-2λ4-1,3,2-benzodioxathiol-5-ol (3) and subsequently to (3aS,4R,5S,7aR)-4-(benzyloxy)-2,2-dioxo-6,6-bis[(trityloxy)methyl]hexahydro-2λ4-1,3,2-benzodioxathiol-5-yl benzoate (4). Treatment of sulfate 4 with adenine and DBU afforded, after deprotection, 7 and 22 in low yields. Reaction of sulfite 3 with lithium azide gave (1R,2R,3S,6S)-6-azido-2-(benzyloxy)-4,4-bis[(trityloxy)methyl]-cyclohexane-1,3-diol (10) and (1S,4R,5S,6S)-5-azido-6-(benzyloxy)-2,2-bis[(trityloxy)methyl]-cyclohexane-1,4-diol (11) which were, after separation, reduced with LAH to (1R,2R,3S,6S)-6-amino-2-(benzyloxy)-4,4-bis[(trityloxy)methyl]cyclohexane-1,3-diol (9) and (1S,4R,5S,6S)-5-amino-6-(benzyloxy)-2,2-bis[(trityloxy)methyl]cyclohexane-1,4-diol (12). Amino derivatives 9 and 12 were transformed to (1R,2R,3S,6S)-6-(6-amino-9H-purin-9-yl)-4,4-bis(hydroxymethyl)cyclohexane-1,2,3-triol (7), (1R,2R,3S,6S)-6-[6-(cyclopropylamino)-9H-purin-9-yl]-4,4- bis(hydroxymethyl)cyclohexane-1,2,3-triol (16), (1S,2S,3S,4R)-3-[6-(cyclopropylamino)-9H-purin-9-yl]-6,6-bis(hydroxymethyl)cyclohexane-1,2,4-triol (20), (1S,2S,3S,4R)-3-(6-amino-9H-purin-9-yl)-6,6-bis(hydroxymethyl)cyclohexane-1,2,4-triol (22), and 2-amino-9-[(1S,2R,3R,4S)- 2,3,4-trihydroxy-5,5-bis(hydroxymethyl)cyclohexyl]-9H-purin-6(1H)-one (27).
Synthesis of 4,6-Disubstituted-2-(1H-indol-3-yl)benzothiazoles
Authors: Záletová Janka , Dzurilla Milan , Kutschy Peter , Pazdera Pavel , Kováčik Vladimír , Aldölfi Juraj , Bekešová Slávka
Published: February 2004

A new four-step synthesis of substituted 2-(1H-indol-3-yl)benzothiazoles is described, using N3-phenyl-1H-indole-3-carbothioamides as key intermediates. The structure of the obtained products was determined by IR, 1H, 13C NMR and MS spectral methods.
Association of endothelial constitutive nitric oxide synthase gene polymorphism with acute coronary syndrome in Koreans
Authors: Park K-W , You K-H , Oh S , Chae I-H , Kim H-S , Oh B-H , Lee M-M , Park Y-B
Published: February 2004

Objective: To examine the effects of two polymorphisms of the endothelial constitutive nitric oxide synthase (ecNOS) gene, 4a/4b(A:B) located in intron 4 and Glu298Asp(G:T) located in exon 7, on the development of acute coronary syndromes (ACS).

Methods: 164 patients with ACS and 142 control participants were investigated for genotype and conventional risk factors. Genotype was determined by polymerase chain reaction and restriction fragment length polymorphism analysis.

Results: Genotype and allele frequencies of the A:B polymorphism in the ACS group (0.15:0.85 for AA+AB:BB, 0.09:0.91 for A:B) differed from those in the control group (0.26:0.74 for AA+AB:BB, 0.15:0.85 for A:B). However, genotype and allele frequencies of the G:T polymorphism in the ACS group (0.22:0.78 for TT+TG:GG, 0.11:0.89 for T:G) were similar to those in the control group (0.17:0.83 for TT+TG:GG, 0.09:0.91 for T:G). Multiple logistic regression analysis showed that the non-BB (AA+AB) and the non-BB+GG genotypes were significant protective factors against ACS (odds ratios 0.49 and 0.34, 95% confidence intervals 0.26 to 0.93 and 0.14 to 0.83, respectively). In addition, linear association analysis showed that the percentage of ACS patients was significantly lower in the genotype group non-BB+GG than in the genotype group BB+non-GG (39.6% v 62.7%, p  =  0.01).

Conclusions: The non-BB genotype of the ecNOS 4a/4b gene polymorphism is a protective factor against the development of ACS. The GG genotype of the ecNOS Glu298Asp polymorphism exerts a benefit in addition to the non-BB genotype in the Korean population.
Relation between left ventricular contractile reserve during low dose dobutamine echocardiography and plasma concentrations of natriuretic peptides
Authors: Schinkel A F L , Vourvouri E C , Bax J J , Boomsma F , Bountioukos M , Rizzello V , Biagini E , Agricola E , Elhendy A , Roelandt J R T C , Poldermans D
Published: February 2004

Background: In ischaemic cardiomyopathy, raised plasma concentrations of natriuretic peptides are associated with a poor long term prognosis, while the presence of contractile reserve is a favourable sign.

Objective: To assess the relation between plasma natriuretic peptides and contractile reserve.

Design: Prospective observational study.

Setting: Tertiary referral centre.

Patients: 66 consecutive patients undergoing low dose dobutamine stress echocardiography to evaluate contractile reserve in regions with contractile dysfunction at rest, divided into two groups: group 1, 31 patients with ischaemic cardiomyopathy (left ventricular ejection fraction ⩽ 40%) and heart failure symptoms; group 2, 35 patients with normal left ventricular function.

Main outcome measures: Plasma atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP), measured using immunoradiometric assays. Contractile reserve was defined as an improvement in segmental wall motion score during infusion of low dose dobutamine.

Results: Plasma ANP and BNP concentrations were higher in group 1 than in group 2 (mean (SD): ANP, 17.8 (32.8) v 7.2 (9.7), p < 0.005; BNP, 24.4 (69.0) v 5.0 (14.3) pmol/l, respectively; p < 0.001). In group 1, the presence of contractile reserve was inversely related to ANP and BNP levels; however, patients with contractile reserve had lower ANP and BNP concentrations than patients without contractile reserve (ANP, 14.2 (9.1) v 24.2 (44.2), p < 0.05; BNP, 20.2 (25.5) v 37.5 (93.8) pmol/l, respectively; p < 0.05).

Conclusions: Plasma natriuretic peptide concentrations are raised in patients with left ventricular dysfunction, but in the presence of preserved myocardial contractile reserve, relatively low levels of ANP and BNP are present.
Aberrant tendinous chords with tethering of the tricuspid leaflets: a congenital anomaly causing severe tricuspid regurgitation
Authors: Kobza R , Kurz D J , Oechslin E N , Prêtre R , Zuber M , Vogt P , Jenni R
Published: February 2004

Objective: To define the entity of tricuspid regurgitation caused by tethering of the tricuspid valve leaflets by aberrant tendinous chords.

Design: Retrospective study.

Setting: Tertiary care centre (university teaching hospital).

Patients: 10 patients with unexplained severe tricuspid regurgitation.

Methods: The last 13 500 echocardiographic studies from our facility were reviewed to identify patients with severe unexplained tricuspid regurgitation. Tethering was defined by the presence of aberrant tendinous chords to the tricuspid valve leaflets limiting the mobility of the tricuspid leaflet and resulting in incomplete coaptation and apical displacement of the regurgitant jet origin. Aberrant tendinous chords were defined as those inserting at the clear zone of the tricuspid leaflet and not originating from the papillary muscle. Patients fulfilling the diagnostic criteria for Ebstein’s anomaly were excluded.

Results: 10 patients with aberrant tendinous chords tethering one or more tricuspid valve leaflets were identified. There were short non-aberrant tendinous chords in seven patients, five of whom also had right ventricular or tricuspid annulus dilatation.

Conclusions: Tethering of the tricuspid valve leaflets by aberrant tendinous chords can be the sole mechanism of congenital tricuspid regurgitation. It is often associated with short non-aberrant tendinous chords, which may develop secondary to right ventricular or tricuspid annulus dilatation. Awareness of tethering as a cause of tricuspid regurgitation may be important in planning reconstructive surgery.
Prognostic relations between inflammatory markers and mortality in diabetic patients with non-ST elevation acute coronary syndrome
Authors: Sanchez P L , Morinigo J L , Pabon P , Martin F , Piedra I , Palacios I F , Martin-Luengo C
Published: February 2004

Objective: To determine the differences in the inflammatory status between diabetic and non-diabetic patients and to evaluate the usefulness of C reactive protein, fibrinogen, and leucocyte count as predictors of death in diabetic patients with unstable coronary disease.

Design: Nested case-control comparisons of the inflammatory status between diabetic and non-diabetic patients. Prospective cohort analysis of C reactive protein concentration, fibrinogen concentration, and leucocyte count as predictors of cardiovascular death in diabetic patients.

Setting: Coronary care unit in Spain.

Participants: 83 diabetic patients with non-ST elevation acute coronary syndrome and 83 sex and aged matched patients selected from 361 non-diabetic patients with non-ST elevation acute coronary syndrome.

Main outcome measures: Plasma concentrations of C reactive protein and fibrinogen, and leucocyte count. Investigators contacted patients to assess clinical events.

Results: Concentrations of C reactive protein and fibrinogen, and leucocyte count on admission were higher in diabetic than in non-diabetic patients (7 mg/l v 5 mg/l, p  =  0.020; 3.34 g/l v 2.90 g/l, p  =  0.013; and 8.8 × 109/l v 7.8 × 109/l, p  =  0.040). Among diabetic patients, these values were also higher in those who died during the 22 month follow up (13 mg/l v 6 mg/l, p  =  0.001; 3.95 g/l v 3.05 g/l, p < 0.001; and 11.4 × 109/l v 8.4 × 109/l, p  =  0.005). After adjustment for confounding factors, diabetic patients in the highest tertile of C reactive protein had a hazard ratio for cardiovascular death of 4.51 (95% confidence interval (CI) 1.62 to 12.55). Similar hazard ratios were for fibrinogen 3.74 (95% CI 1.32 to 10.62) and for leucocyte count 3.64 (95% CI 1.37 to 9.68).

Conclusions: Inflammation appears more evident in diabetic than in non-diabetic patients with acute coronary syndrome. C reactive protein concentration, fibrinogen concentration, and leucocyte count constitute independent predictors of cardiovascular death in diabetics with unstable coronary disease.
Recent insights into human coronary collateral development
Authors: Fujita M , Tambara K
Published: February 2004

Enhancement of coronary collateral function is an intriguing approach to the preservation of ischaemic myocardium. Coronary collateral development consists of collateral recruitment and collateral growth. Collateral growth encompasses proliferation of capillaries in the ischaemic area (angiogenesis) and maturation of pre-existing collateral vessels (arteriogenesis), with the latter being more relevant in humans. Therefore, treatment intended directly for arteriogenesis of collateral vessels appears to be more effective. Promotion of coronary collateral growth has many attractive features, particularly in patients with angina who are not indicated for percutaneous coronary intervention or coronary artery bypass grafting surgery. A complete elucidation of the remaining practical and mechanistic questions of arteriogenesis may lead to a new remedy capable of developing collateral vessels more effectively.
Cost of an emerging epidemic: an economic analysis of atrial fibrillation in the UK
Authors: Stewart S , Murphy N , Walker A , McGuire A , McMurray J J V
Published: February 2004

Objective: To evaluate the cost of atrial fibrillation (AF) to health and social services in the UK in 1995 and, based on epidemiological trends, to project this estimate to 2000.

Design, setting, and main outcome measures: Contemporary estimates of health care activity related to AF were applied to the whole population of the UK on an age and sex specific basis for the year 1995. The activities considered (and costs calculated) were hospital admissions, outpatient consultations, general practice consultations, and drug treatment (including the cost of monitoring anticoagulant treatment). By adjusting for the progressive aging of the British population and related increases in hospital admissions, the cost of AF was also projected to the year 2000.

Results: There were 534 000 people with AF in the UK during 1995. The “direct” cost of health care for these patients was £244 million (~€350 million) or 0.62% of total National Health Service (NHS) expenditure. Hospitalisations and drug prescriptions accounted for 50% and 20% of this expenditure, respectively. Long term nursing home care after hospital admission cost an additional £46.4 million (~€66 million). The direct cost of AF rose to £459 million (~€655 million) in 2000, equivalent to 0.97% of total NHS expenditure based on 1995 figures. Nursing home costs rose to £111 million (~€160 million).

Conclusions: AF is an extremely costly public health problem.
Aortic pressure–area relation in Marfan patients with and without β blocking agents: a new non-invasive approach
Authors: Nollen G J , Westerhof B E , Groenink M , Osnabrugge A , van der Wall E E , Mulder B J M
Published: February 2004

Objective: To investigate the heterogeneous response to β blockade in patients with Marfan syndrome by non-invasive assessment of the aortic pressure–area curve.

Design and patients: 25 patients with the Marfan syndrome who used β blocking agents (mean (SD) age, 29 (10) years; 20 men, five women), seven without β blockade (34 (14) years; five men, two women), and 10 controls (29 (5) years; seven men, three women) underwent magnetic resonance imaging and non-invasive continuous blood pressure measurement. Pressure–area curves were constructed at the level of the descending thoracic aorta. A transition point was defined as the pressure at which the pressure–area relation deviated from its elastic (linear) to the collagen (exponential) course.

Setting: Tertiary referral centre for adult congenital heart disease.

Results: In six patients (five with and one without β blockade), a transition point in the pressure–area curve was observed, indicating that the load bearing component was not only elastin but also collagen. In the remaining 26 Marfan patients and in the control subjects a linear pressure–area relation was observed.

Conclusions: This new non-invasive method to derive aortic pressure–area curves showed that most patients with Marfan syndrome have a similar pressure–area curve to controls with similar blood pressures. Five patients on β blockade showed a transition point in the pressure–area curve which could play a crucial role in the heterogeneous response to β blocker treatment in Marfan patients. Patients with a transition at low blood pressures may not benefit from β blocking agents.
Risk factors for non-fatal myocardial infarction in young South Asian adults
Authors: Ismail J , Jafar T H , Jafary F H , White F , Faruqui A M , Chaturvedi N
Published: February 2004

Objective: To determine the risk factors for premature myocardial infarction among young South Asians.

Design and setting: Case–control study in a hospital admitting unselected patients with non-fatal acute myocardial infarction.

Methods and subjects: Risk factor assessment was done in 193 subjects aged 15–45 years with a first acute myocardial infarct, and in 193 age, sex, and neighbourhood matched population based controls.

Results: The mean (SD) age of the subjects was 39 (4.9) years and 326 (84.5%) were male. Current smoking (odds ratio (OR) 3.82, 95% confidence interval (CI) 1.47 to 9.94), use of ghee (hydrogenated vegetable oil) in cooking (OR 3.91, 95% CI 1.52 to 10.03), raised fasting blood glucose (OR 3.32, 95% CI 1.21 to 8.62), raised serum cholesterol (OR 1.67, 95% CI 1.14 to 2.45 for each 1.0 mmol/l increase), low income (OR 5.05, 95% CI 1.71 to 14.96), paternal history of cardiovascular disease (OR 4.84, 95% CI 1.42 to 16.53), and parental consanguinity (OR 3.80, 95% CI 1.13 to 1.75) were all independent risk factors for acute myocardial infarction in young adults. Formal education versus no education had an independently protective effect on acute myocardial infarction (OR 0.04, 95% CI 0.01 to 0.35).

Conclusions: Tobacco use, ghee intake, raised fasting glucose, high cholesterol, paternal history of cardiovascular disease, low income, and low level of education are associated with premature acute myocardial infarction in South Asians. The association of parental consanguinity with acute myocardial infarction is reported for the first time and deserves further study.
Insulin induced increase in coronary flow reserve is abolished by dexamethasone in young men with uncomplicated type 1 diabetes
Authors: Laine H , Sundell J , Nuutila P , Raitakari O T , Luotolahti M , Rönnemaa T , Elomaa T , Koskinen P , Knuuti J
Published: February 2004

Objective: To examine the role of the sympathetic nervous system in regulating insulin’s action on coronary perfusion in uncomplicated type 1 diabetes by blocking centrally mediated sympathetic activity with dexamethasone.

Methods: Positron emission tomography and oxygen 15 labelled water were used to quantify myocardial blood flow basally and during adenosine infusion with or without simultaneous euglycaemic physiological hyperinsulinaemia in nine non-smoking men with type 1 diabetes and 12 healthy non-diabetic men. Each patient was studied both with and without previous dexamethasone treatment for two days (2 mg/day).

Results: Insulin increased coronary flow reserve in diabetic (from 4.3 (0.7) to 5.1 (0.6), p < 0.05) and non-diabetic (from 4.3 (0.3) to 5.4 (0.4), p < 0.05) patients. In contrast to non-diabetic patients dexamethasone pretreatment abolished the insulin induced increase in coronary flow reserve in diabetic patients (p < 0.05) leading to lower coronary flow reserve in diabetic than in non-diabetic patients (3.9 (0.6) v 7.1 (0.9), p < 0.05).

Conclusions: These results show that insulin’s ability to modulate coronary perfusion is sustained in young patients with type 1 diabetes without microvascular complications or autonomic neuropathy. Dexamethasone treatment abolished the insulin induced increase in coronary flow reserve in diabetic patients but not in healthy study participants, suggesting that sympathetic activation plays an important part in regulating insulin’s effects on myocardial perfusion in patients with type 1 diabetes.
Sex differences in the expression of haemorheological determinants in individuals with atherothrombotic risk factors and in apparently healthy people
Authors: Zeltser D , Rogowski O , Berliner S , Mardi T , Justo D , Serov J , Rozenblat M , Avitzour D , Shapira I
Published: February 2004

Background: Increased red cell aggregation can be detrimental, leading to slow capillary blood flow and tissue hypoxaemia. Sex differences in the degree of erythrocyte adhesiveness/aggregation in the peripheral blood have not been clearly shown.

Objectives: To determine whether there are sex differences in the expression of erythrocyte adhesiveness/aggregation in the peripheral blood in individuals with atherothrombotic risk factors and in apparently healthy people.

Methods: From a cohort of 965 participants in the Tel Aviv Medical Centre inflammation survey, 192 pairs of different sex were matched for age, body mass index, hip and waist circumferences, cardiovascular risk factors, and the intake of active cardiovascular drugs.

Results: Women had an enhanced degree of red cell aggregation (p < 0.0005) as well as increased concentrations of inflammation sensitive proteins including fibrinogen and C reactive protein. Women had a lower haemoglobin concentration than men, but this did not affect the degree of erythrocyte adhesiveness/aggregation.

Conclusions: The significant increase in red blood cell adhesiveness/aggregation in the peripheral blood of women with atherothrombosis could be relevant to the more eventful course that some women experience during and following acute ischaemic disease.
Haemochromatosis gene mutations and risk of coronary heart disease: a west of Scotland coronary prevention study (WOSCOPS) substudy
Authors: Gunn I R , Maxwell F K , Gaffney D , McMahon A D , Packard C J
Published: February 2004

Objectives: To measure the frequency of genotypes of the HFE (haemochromatosis) gene in patients recruited to the west of Scotland coronary prevention study (WOSCOPS), and relate them to the subsequent occurrence of coronary clinical events.

Design: Nested case–control study, drawing samples of DNA from the biological bank of a cohort study.

Patients: Men aged 45–64 years in 1989, with moderate hypercholesterolaemia and no evidence of coronary heart disease at baseline.

Interventions: Follow up for a mean period of 4.9 years. Typing for C282Y and H63D mutations of the HFE gene in 482 subjects with a subsequent coronary event and 1104 without an event.

Results: The C282Y mutation was present in 81 of 482 cases (16.8%) and 182 of 1104 controls (16.5%). Comparing the prevalence of gene mutations in the cases and controls, there were no significant differences. The hazard ratio for C282Y heterozygotes was 1.03 (95% confidence interval (CI) 0.77 to 1.36) and for C282Y/H63D compound heterozygotes 1.04 (95% CI 0.50 to 2.14). Prespecified subgroup analyses of the pravastatin, placebo, smoking, and non-smoking groups showed no significant differences between cases and controls. Repeating the analyses after adjusting for possible confounding factors produced no change in the results.

Conclusions: In a population of moderately hypercholesterolaemic middle aged Scottish men who did not have any evidence of coronary heart disease at baseline, the presence of a C282Y mutation in the HFE gene did not predict the occurrence of coronary events over a mean follow up of 4.9 years.
Response of very small (2 mm) porcine coronary arteries to balloon angioplasty and stent implantation
Authors: Morton A C , Arnold N D , Crossman D C , Gunn J
Published: February 2004

Objective: To investigate the response of very small coronary arteries to stent deployment and balloon angioplasty.

Setting: Normal porcine coronary arteries.

Methods: 24 pigs underwent intervention to two main coronary arteries, in segments 2.0 mm in diameter, with balloons whose diameter was 2.5 mm at standard pressure. Twelve arteries received a BiodivYsio small vessel (SV) stent; 12 an NIR SV stent; 12 standard BiodivYsio stent, and 12 balloon only. The arteries were harvested at 28 days, fixed, embedded in plastic, and cut and ground in cross section. The injury score and histomorphometry were assessed.

Results: The BiodivYsio SV stent was associated with 20% less injury (p  =  0.16), a 30% larger lumen (p  =  0.13), and a 25% smaller neointima (p  =  0.03) than the NIR SV stent, despite identical oversize. The standard BiodivYsio stent exhibited less recoil but 29% greater injury (p  =  0.01), 59% more neointima (p  =  0.00), and 18% less lumen (p  =  0.27) than the BiodivYsio SV. Of all interventions, balloon only was associated with little injury, little neointima, major vessel shrinkage, and the largest lumen.

Conclusion: Despite uniform oversize dilatation, both injury and response varied widely in very small porcine coronary arteries, depending on whether a stent or balloon was used, the stent design, and the number and/or thickness of struts. The response to different stent designs is considerable and is related to the degree of injury.
Congenital coronary artery anomaly simulating an acute aortic dissection
Authors: De Luca L , Bovenzi F , de Luca I
Published: February 2004

In this rare case, a patient had an anomalous right coronary artery originating from the left sinus of Valsalva coursing between the great vessels. He presented with symptoms and computed tomograms suggestive of an acute aortic dissection.
Haemorrhagic peritonitis as a late complication of echocardiography guided pericardiocentesis
Authors: Luckraz H , Kitchlu S , Youhana A
Published: February 2004

Clinically significant pericardial effusion is an uncommon complication after cardiac surgery. Pericardiocentesis can be performed either through a mini-sternotomy or under echocardiography guidance. Echocardiography guidance is a relatively safe procedure and it avoids the need for another general anaesthetic. However, in this post cardiac surgical patient echocardiography guided pericardiocentesis was complicated several days later by haemorrhagic peritonitis.
Diagnostic and prognostic evaluation of left ventricular systolic heart failure by plasma N-terminal pro-brain natriuretic peptide concentrations in a large sample of the general population
Authors: Groenning B A , Raymond I , Hildebrandt P R , Nilsson J C , Baumann M , Pedersen F
Published: February 2004

Objective: To evaluate N-terminal pro-brain natriuretic peptide (NT-proBNP) as a diagnostic and prognostic marker for systolic heart failure in the general population.

Design: Study participants, randomly selected to be representative of the background population, filled in a heart failure questionnaire and underwent pulse and blood pressure measurements, electrocardiography, echocardiography, and blood sampling and were followed up for a median (range) period of 805 (60−1171) days.

Setting: Participants were recruited from four randomly selected general practitioners and were examined in a Copenhagen university hospital.

Patients: 382 women and 290 men in four age groups (50−59 (n  =  174); 60−69 (n  =  204); 70−79 (n  =  174); ⩾ 80 years (n  =  120)).

Main outcome measures: Value of NT-proBNP in evaluating patients with symptoms of heart failure and impaired left ventricular (LV) systolic function; prognostic value of NT-proBNP for mortality and hospital admissions.

Results: In 38 (5.6%) participants LV ejection fraction (LVEF) was ⩽ 40%. NT-proBNP identified patients with symptoms of heart failure and LVEF ⩽ 40% with a sensitivity of 0.92, a specificity of 0.86, positive and negative predictive values of 0.11 and 1.00, and area under the curve of 0.94. NT-proBNP was the strongest independent predictor of mortality (hazard ratio (HR)  =  5.70, p < 0.0001), hospital admissions for heart failure (HR  =  13.83, p < 0.0001), and other cardiac admissions (HR  =  3.69, p < 0.0001). Mortality (26 v 6, p  =  0.0003), heart failure admissions (18 v 2, p  =  0.0002), and admissions for other cardiac causes (44 v 13, p < 0.0001) were significantly higher in patients with NT-proBNP above the study median (32.5 pmol/l).

Conclusions: Measurement of NT-proBNP may be useful as a screening tool for systolic heart failure in the general population.
Acute myocardial infarction probably caused by paradoxical embolus in a pregnant woman
Authors: Agostoni P , Gasparini G , Destro G
Published: February 2004

A 19 year old pregnant woman presented to the coronary care unit with an acute anterior myocardial infarction. She was treated with primary percutaneous transluminal coronary angioplasty of the proximal left anterior descending coronary artery. Ultrasound examination showed patent foramen ovale (PFO) and atrial septal aneurysm. The patient was a heterozygote carrier of factor V Leiden. Despite the lack of a clear clue, it was considered that the pathophysiological cause of this infarction was a paradoxical embolus in the left coronary artery. Pregnancy and factor V Leiden carriership are associated with increased risk of venous thromboembolism and the association between PFO and atrial septal aneurysm is a strong risk factor for systemic embolisation.
Evidence for “lumen sealing” with sirolimus eluting stents in the treatment of complex coronary artery dissection
Authors: Wong E M , Pawsey C , Lowe H C
Published: February 2004

Immediate and two month angiographic and intravascular ultrasound examination of sirolimus eluting stents deployed for complex coronary dissection is presented. The findings support the hypothesis that this novel treatment option is both effective and safe.
Clopidogrel induced urticarial rash in a patient with left main stem percutaneous coronary intervention: management issues
Authors: Khambekar S K , Kovac J , Gershlick A H
Published: February 2004

Clopidogrel, an ideal treatment for prevention of subacute stent thrombosis, may not be feasible to use in every patient. Ticlopidine (plus aspirin) is a very good alternative, although the risks of life threatening neutropenia should mandate regular monitoring of blood counts. It is proposed that patients undergoing angioplasty and stenting should carry a warning card in an effort to make the public and general practitioners aware that antiplatelet treatment after angioplasty plays an important part in ensuring successful outcome.
Massive pulmonary haemorrhage complicating the treatment of acute coronary syndrome
Authors: Gill D S , Ng K , Ng K-S
Published: February 2004

Antiplatelet medications such as clopidogrel and tirofiban (glycoprotien IIb/IIIa inhibitors) are associated with a reduction in mortality and morbidity and are therefore recommended in the treatment of acute coronary syndromes. Massive pulmonary haemorrhage is a rare complication of both clopidogrel and tirofiban. Pulmonary haemorrhage may easily be mistaken for acute pulmonary oedema, a condition commonly seen in patients with acute coronary syndrome. Physicians need to be aware of this diagnostic dilemma because early treatment increases the chances of patient survival.
The politics of preventable deaths: local spending, income inequality, and premature mortality in US cities
Authors: Ronzio C R , Pamuk E , Squires G D
Published: February 2004

Objective:To examine the association between (1) local political party, (2) urban policies, measured by spending on local programmes, and (3) income inequality with premature mortality in large US cities.

Design:Cross sectional ecological study.

Outcome measures:All cause death rates and death rates attributable to preventable or immediate causes for people under age 75.

Predictor measures:Income inequality, city spending, and social factors.

Setting:All central cities in the US with population equal to or greater than 100 000.

Results:Income inequality is the most significant social variable associated with preventable or immediate death rates, and the relation is very strong: a unit increase in the Gini coefficient is associated with 37% higher death rates. Spending on police is associated with 23% higher preventable death rates compared with 14% lower death rates in cities with high spending on roads.

Conclusions:Cities with high income inequality and poverty are so far unable to reduce their mortality through local expenditures on public goods, regardless of the mayoral party. Longitudinal data are necessary to determine if city spending on social programmes reduces mortality over time.
Evaluation of methodologies for small area life expectancy estimation
Authors: Eayres D , Williams E S
Published: February 2004

Study objective:To evaluate methods for calculating life expectancy in small areas, for example, English electoral wards.

Design:The Monte Carlo method was used to simulate the distribution of life expectancy (and its standard error) estimates for 10 alternative life table models. The models were combinations of Chiang or Silcocks methodology, 5 or 10 year age intervals, and a final age interval of 85+, 90+, or 95+.

Setting:A hypothetical small area experiencing the population age structure and age specific mortality rates of English men 1998–2000.

Participants:Routine mortality and population statistics for England.

Main results:Silcocks and Chiang based models gave similar estimates of life expectancy and its standard error. For all models, life expectancy was increasingly overestimated as the simulated population size decreased. The degree of overestimation depended largely on the final age interval chosen. Life expectancy estimates of small populations are normally distributed. The standard error estimates are normally distributed for large populations but become increasingly skewed as the population size decreases. Substitution methods to compensate for the effect of zero death counts on the standard error estimate did not improve the estimate.

Conclusions:It is recommended that a population years at risk of 5000 is a reasonable point above which life expectancy calculations can be performed with reasonable confidence. Implications are discussed. Within the UK, the Chiang methodology and a five year life table to 85+ is recommended, with no adjustments to age specific death counts of zero.