bluuebunny/crossref_metadata_2025 huggingface dataset:
The Cooperative Effect Between Active Site Ionized Groups and Water Desolvation Controls the Alteration of Acid/Base Catalysis in Serine Proteases
Authors: Shokhen Michael , Khazanov Netaly , Albeck Amnon
Published: June 2007

What is the driving force that alters the catalytic function of His57 in serine proteases between general base and general acid in each step along the enzymatic reaction? The stable tetrahedral complexes (TC) of chymotrypsin with trifluoromethyl ketone transition state analogue inhibitors are topologically similar to the catalytic transition state. Therefore, they can serve as a good model to study the enzyme catalytic reaction. We used DFT quantum mechanical calculations to analyze the effect of solvation and of polar factors in the active site of chymotrypsin on the pKa of the catalytic histidine in FE (the free enzyme), EI (the noncovalent enzyme inhibitor complex), and TC. We demonstrated that the acid/base alteration is controlled by the charged groups in the active site—the catalytic Asp102 carboxylate and the oxyanion. The effect of these groups on the catalytic His is modulated by water solvation of the active site.
Impact of left ventricular ejection fraction on endothelial function in patients with coronary artery disease
Authors: Bae Jang‐Ho , Bassenge Eberhard , Kim Moo‐Hyun , Park Ki‐Rack , Kim Ki‐Young , Synn Yi‐Chul , Schwemmer Michael
Published: June 2007

Background: Endothelial dysfunction is present in patients with coronary artery disease (CAD) or with congestive heart failure.

Hypothesis: This study was performed to evaluate the impact of systolic heart function on endothelial function in patients with CAD.

Methods: The study population consisted of 283 consecutive patients (mean age 59 years, 176 men) undergoing coronary angiography. Endothelial function was assessed by measuring flow‐mediated vasodilation (FM.D) of the brachial artery.

Results: Patients (n = 236) with an ejection fraction (EF) ≥ 55% on routine echocardiogram were younger (mean age 58 vs. 62 years), showed a lower prevalence of diabetes (15 vs. 38%) and myocardial infarction (13 vs. 66%), and showed a higher FM.D (4.8 ± 2.4 vs. 4.0 ± 2.0%, p < 0.05) than patients (n = 47) with an EF < 55%. The correlation coefficient between FM.D/endothelial function and EF/systolic heart function was 0.149 (p < 0.02) in the overall study population. Multivariate analysis showed that of age, gender, frequency of diabetes mellitus, myocardial infarction, and CAD extent, EF was the only significant independent parameter correlating with FM.D in patients with CAD.

Conclusions: Compared with the other tested risk factors, EF surprisingly was the only significant independent parameter correlating with endothelial function in patients with CAD. Our results support the view that endothelial function is an independent prognostic factor in patients with CAD.
Considerations in combination therapy: Fibrinolytics plus glycoprotein IIb/IIIa receptor inhibitors in acute myocardial infarction
Authors: Manoharan Ganesh , Adgey A. A. Jennifer
Published: June 2007

The combined use of a fibrinolytic and a platelet glycoprotein (GP) IIb/IIIa receptor inhibitor to target the fibrin and platelet components of occlusive thrombi offers the potential for more rapid and complete reperfusion in patients with acute myocardial infarction (MI), although there have been concerns about the safety of this combination therapy. Data from the recent GUSTO‐V and the ASSENT‐3 trials support the use of this regimenin that the 30‐day death or non‐fatal reinfarction rate (7 days) in GUSTO‐V and death or in‐hospital reinfarction or in‐hospital refractory ischemia rate in ASSENT‐3 were reduced (p = 0.001 and p = 0.0001, respectively). The need for revascularization in both these trials was also reduced significantly. There was no increased risk of intracranial hemorrhage or stroke with the combination therapy, but an increased rate of nonintracranial severe or major bleeding was observed. At present, patients aged > 75 years should not receive combination therapy. Further studies in subgroup patient populations are warranted.
Atrial electrophysiologic abnormalities in patients with wolff‐parkinson‐white syndrome but without paroxysmal atrial fibrillation
Authors: Sakabe Koichi , Fukuda Nobuo , Nada Teru , Shinohara Hisanori , Tamura Yoshiyuki , Wakatsuki Tetsuzo , Nishikado Akiyoshi , Oki Takashi
Published: June 2007

Background: Paroxysmal atrial fibrillation (PAF) frequently occurs in patients with Wolff‐Parkinson‐White (WPW) syndrome.

Hypothesis: The purpose of this study was to analyze the atrial electrophysiologic abnormalities and vulnerability to develop atrial fibrillation (AF) in patients with WPW syndrome but with no previous history of PAF.

Methods: We investigated atrial electrophysiologic abnormalities and vulnerability to AF in patients with WPW syndrome but without PAF. An electrophysiologic study was performed in 28 patients with WPW syndrome, 23 with atrioventricular nodal reentrant tachycardia (AVNRT) and 25 with other arrhythmias (control), all of whom had no history of PAF. The following atrial excitability parameters were assessed: effective refractory period (ERP), spontaneous or paced (A1) and extrastimulated (A2) atrial electrogram widths, percent maximum atrial fragmentation (%MAF; A2/A1 × 100), wavelength index (WLI; ERP/A2), and inducibility of AF.

Results: The ERP tended to be shorter in patients with WPW syndrome and in those with AVNRT than in the control group. The %MAF increased (154 ± 33 vs. 137 ± 23%, p < 0.05) and WLI decreased (2.7 ±0.8 vs. 3.4 ± 1.0, p<0.05) significantly in patients with WPW syndrome compared with the control group; however, these parameters in patients with AVNRT showed intermediate values. Atrial fibrillation was more inducible in patients with WPW syndrome (4/28 [14.3%]) than in those with AVNRT (4.3% [1/23]) and the control group (0/25 [0%]). With respect to patients with WPW syndrome and with and without inducible AF, the %MAF increased (195 ± 23 vs. 148 ± 30%, p<0.01) and the WLI decreased (2.2 ± 0.3 vs. 2.9 ± 0.9, p<0.05) in subjects with inducible AF.

Conclusions: Atrial electrophysiologic abnormalities, especially atrial conduction delays, are more prominent in patients with WPW syndrome, even if they had no previous history of PAF. These abnormalities may play an important role in determining the vulnerability to AF.
Elevation of the soluble thrombomodulin levels is associated with inflammation after percutaneous coronary interventions
Authors: Chao Ting‐Hsing , Li Yi‐Heng , Tsai Wei‐Chuan , Chen Jyh‐Hong , Liu Ping‐Yen , Tsai Liang‐Miin
Published: June 2007

Background: Thrombomodulin (TM) is an endothelial cell surface thrombin‐binding protein with anticoagulation ability by thrombin‐mediated activation of protein C. An increase of plasma soluble TM level is reported to be associated with severity and worse outcome of coronary artery disease.

Hypothesis: This prospective study investigated the relation of the elevated levels of plasma soluble TM and inflammatory and myonecrotic markers in patients undergoing percutaneous coronary intervention (PCI).

Methods: Plasma levels of soluble TM, C‐reactive protein (CRP), and creatine kinase and its MB isoenzyme were measured before and after PCI in 100 patients undergoing PCIs.

Results: Peak TM levels after PCIs were significantly higher thanbaseline (3.39 ± 1.63 vs. 2.90 ± 1.57 ng/ml, p< 0.001). The peak TM levels after PCIs correlated significantly with the peak CRP and MB levels, and the maximal inflation duration (r = 0.423, p<0.001; r = 0.212, p = 0.034; r = 0.307, p = 0.002, respectively).

Conclusions: Soluble TM levels increase significantly after PCI. The elevation of the soluble TM after PCI shows better correlation with inflammation than myocardial injury, indicating an endothelial origin. Measurement of soluble TM could be useful and calls for further studies on the prognostic effects of this marker in this clinical condition.
Association of genetic polymorphisms in the fibrinogen and platelet glycoprotein genes with unstable angina in Chinese patients
Authors: Yongbin Ni , Dayi Hu , Hong Yu , Cuilan Li , Wenling Liu , Hongyu Wang , Lei Li
Published: June 2007

Background: Inherited predisposition has been associated with coronary artery disease (CAD) in the white population.

Hypothesis: The objective of this study was to investigate the association between the risk of unstable angina (UA) and genetic factors believed to be associated with an increased tendency toward thrombosis (the variable number of tandem repeats [VNTR] polymorphism of the platelet glycoprotein [GP] Iba gene, P1A1/A2 of the platelet GP IIIa gene, 448G/A of the Bβ fibrinogen gene and Thr312 A1a of the Act fibrinogen gene) in Chinese patients with UA.

Methods: We performed a case/control study evaluating 69 Chinese patients (43 men, 26 women) with UA and 69 control subjects without CAD, individually matched for age and gender. The restriction fragment length polymorphism (RFLP) method was used to determine the genetic polymorphisms.

Results: The frequencies of GP Ibα C/B genotype and Bβ fibrinogen 448 A allele were higher in patients with UA (46.4 vs. 30.4%, odds ratio [OR] 1.977, 95% confidence interval [CI] 0.98‐3.97, p = 0.054, and 49.3 vs. 20.3%, OR 3.816, 95%CI 1.797‐8.103, p = 0.000, respectively). Only four subjects (two cases, two controls) with GP IIIa PlA2 allele were found, and there was no association between Act fibrinogen Thr312Ala polymorphism and UA.

Conclusions: Chinese patients with UA had increased frequencies of GP Iba C/B genotype and Bβ fibrinogen 448A allele. These data suggest that some genetic factors may influence the development of UA.
Closure of defects of the atrial septum in adults using the amplatzer device:100 consecutive patients in a single center
Authors: Purcell I. F. , Brecker S. J. , Ward D. E.
Published: June 2007

Background: Transcatheter device closure of atrial septal defects (ASD) is an alternative to surgery, but experience is limited in adults, especially in those with large (> 26 mm) defects.

Hypothesis: We investigated the safety, efficacy, and learning curve for closure of ASD and patent foramen ovale (PFO) using the Amplatzer device.

Methods: In all, 101 procedures were carried out in 100 consecutive adult patients in a single cardiac center between July 1998 and August 2002.

Results: Preprocedure diagnosis was ASD and PFO in 50 patients each. A device was deployed in 94 of 101 attempts (93%) in 94 of 100 patients (94%). Atrial septal defect device sizes were 10‐38 mm, median 24 mm, and 40% were > 26 mm. Major complications occurred in 2 of 100 patients (2%). One ASD device displaced requiring surgery within 24 h and one patient with PFO experienced pericardial tamponade; there were no deaths. Local vascular complications occurred in 4 of 100 (4%) and late complications in 4 of 100 (4%) patients. Patent foramen ovale closure was quicker (p < 0.001), required less radiation (p=0.04), and was associated with fewer local vascular complications than ASD closure (p = 0.04). Deployment of ASD devices > 26 mm was not associated with increased complications, length of procedure, or radiation compared with devices < 26 mm (all p > 0.05). Complications in the first 35 patients were more frequent than in subsequent patients:7 of 35 (20%) versus 3 of 65 (4.6%) (p = 0.04); procedure and fluoroscopy times (both p < 0.001) and radiation doses (p=0.001) were also higher.

Conclusion: The Amplatzer device is an effective method for transcatheter closure of interatrial defects in adults, including large ASDs up to 38 mm. Major complications are uncommon. A learning curve of approximately 35 cases was suggested by the decline of complications, procedure times, and radiation exposure.
Persistent left superior vena cava draining into the coronary sinus: Report of 10 cases and literature review
Authors: Gonzalez‐Juanatey Carlos , Testa Ana , Vidan Juan , Izquierdo Ricardo , Garcia‐Castelo Alberto , Daniel Celedonio , Armesto Victor
Published: June 2007

Background: Persistent left superior vena cava (PLS VC) is the most common thoracic venous anomaly.

Hypothesis: This study examines the epidemiologic, clinical, and morphologic characteristics of a cohort of patients with PLSVC draining into the coronary sinus.

Methods: We examined the clinical and morphologic characteristics of patients with PLSVC draining into the coronary sinus diagnosed at a single referral hospital for a defined population in northwestern Spain. We designed a prospective study of the case records of all patients diagnosed with PLSVC draining into the coronary sinus at the echocardiog‐raphy laboratory of the Hospital Xeral‐Calde from January 2001 through December 2002. Patients were included if they had a PLSVC diagnosed by transthoracic echocardiogram (TTE) using an echo‐contrast enhancement and confirmed by a magnetic resonance (MR) imaging. Ten patients (6 women) fulfilled the inclusion criteria described above. All patients were adults and had associated heart disease, including a congenital heart disease in three cases.

Results: Magnetic resonance imaging examination confirmed the presence of PLSVC and the site of drainage into the coronary sinus. Absence of the right superior vena cava was observed only in three patients, in whom the main coronary sinus size was significantly increased. Absence of the left bra‐chiocephalic vein was diagnosed in five patients.

Conclusion: This study describes 10 new cases of PLSVC and supports the necessity of considering PLSVC draining into the coronary sinus in the diagnosis of patients presenting with dilated coronary sinus diagnosed by TTE. It also underlines the important role of MR imaging in the evaluation of these abnormalities. An associated heart disease must always be excluded in these patients.
Does mild pulmonary stenosis progress during childhood? a study of its natural course
Authors: Ardura Julio , Gonzalez Carmen , Andres Jesus
Published: June 2007

Background: Increase in the gradient in congenital pulmonary valvular stenosis during follow‐up is a subject of controversy and could determine the need for treatment in pediatric patients.

Hypothesis: It is postulated that a gradient < 50 mmHg shows a stable or decreasing tendency at follow‐up for congenital pulmonary valvular stenosis.

Methods: Thirty‐five patients with pulmonary stenosis, isolated and not treated, were followed for 7 years (interquartilic rank 5.7 years) at 1.5‐year intervals. Clinical and complementary tests (electrocardiogram, x‐ray, Doppler echocardiogram) were undertaken. The gradient was measured by Doppler and by using the clinical formula derived from the New England Study (Ellison). The changes observed from the initial to the final consultation were analyzed by means of the Student's t‐test, paired Wilcoxon, and Pearson correlation coefficient.

Results: No significant changes were noted on symptoms or physical examination. Signs of cardiac enlargement diminished on both ECG (R wave in V1, p < 0.0001) and x‐ray (car‐diothoracic ratio, p < 0.0007), with a decreasing gradient trend during the follow‐up period (p < 0.026) as well.

Conclusions: The gradient trend confirms the stable nature of mild pulmonary stenosis. In our study, we found that patients aged > 6 months, whose gradients were below 40 mmHg at the time of diagnosis, remained stable and required no treatment. Furthermore, the follow‐up control and clinical management of these patients may then be performed at intervals of 2 years or more.
Associations between C‐reactive protein and circulating cell adhesion molecules in patients with unstable angina undergoing coronary intervention and their clinical implication
Authors: Doo Young‐Cheoul , Han Sang‐Jin , Park Woo‐Jung , Kim Seong‐Man , Choi Seung‐Hyuk , Cho Goo‐Yeong , Hong Kyung‐Soon , Han Kyoo‐Rok , Lee Nam‐Ho , Oh Dong‐Jin , Gryu Kyu‐Hyun , Rhim Chong‐Yun , Lee Kwang‐Hwahk , Lee Yung
Published: June 2007

Background: There is growing evidence that C‐reactive protein (CRP) may have a direct role in the pathogenesis of atherosclerosis.

Hypothesis: The purpose of this study was to assess associations between CRP and adhesion molecules and to determine the prognostic value of adhesion molecules as a predictor of cardiac events in patients with unstable angina.

Methods: Fifty‐five consecutive patients (33 males, mean age 61 years) with unstable angina (Braunwald class IIb or Ib) undergoing coronary stenting were included in this study.

Results: The test for a trend toward increasing intercellular adhesion molecule (ICAM)‐1 concentrations by the 75th percentile of CRP levels at 72 h after coronary stenting was significant (p = 0.03). At 72 h after coronary stenting, CRP levels were the only determinants of ICAM‐1 concentrations by multiple linear regression analysis. An elevated level of CRP (>5.4mg/l) (oddsratio [OR] 1.5,95%confidenceinterval [CI] 1.3–3.7, p<0.05) and ICAM‐1 (>321 ng/ml) (OR 1.2, 95% CI 1.1–2.1, p < 0.05) at 72 h after coronary stenting is an independent risk factor for an adverse cardiac event.

Conclusions: These results suggest that in patients with unstable angina undergoing coronary stenting, the measurements of inflammatory parameters, especially CRP and ICAM‐1, may be useful for identifying those at higher risk of a cardiac event, and CRP may play a direct role in promoting the inflammatory component of atherosclerosis by inducing significant expression of ICAM‐1.
Thoughts about the ventricular gradient and its current clinical use (Part I of II)
Authors: Hurst J. Willis
Published: June 2007

The concept of the ventricular gradient was conceived in the mind of Frank Wilsonin the early 1930s. Wilson, a mathematical genius, believed that the calculation of the ventricular gradient yielded information that was not otherwise obtainable. The method of analysis was not utilized by clinicians at large because the concept was not easy to understand and because the method used to compute the direction of the ventricular gradient was so time consuming that clinicians could not use it. Grant utilized the concept to create vector electrocardiography, but he believed that if his method of analysis was used, it was not often necessary to compute the direction of the ventricular gradient. He did, however, describe an easy way to compute the direction of the ventricular gradient. The current major clinical use of the ventricular gradient is to identify primary and secondary T‐wave abnormalities in an electrocardiogram showing left or right ventricular hypertrophy or left or right ventricular conduction abnormalities. In addition, the author uses the term ventricular time gradient instead of ventricular gradient in an effort to clarify the concept. Finally, the author discusses the possible clinical significance of a normally directed but shorter than normal ventricular time gradient, an attribute that has not been emphasized previously.
Continuous 12‐lead electrocardiographic ST monitoring adds prognostic information to the thrombolysis in myocardial infarction risk score in patients with non‐ST‐elevation acute coronary syndromes
Authors: Zairis Michael N. , Lyras Anastassios G. , Makrygiannis Stamatis S. , Beldekos Demetrios J. , Mainas Konstantinos A. , Patsourakos Nikolaos G. , Ampartzidou Olga S. , Adamopoulou Evdokia N. , Prekates Athanasios A. , Argyrakis Spyros K. , Foussas Stefanos G.
Published: June 2007

Background: Continuous 12‐lead electrocardiographic (ECG) ST monitoring and the Thrombolysis In Myocardial Infarction Risk Score (TIMI‐RS), both have been shown to be useful for early risk stratification in patients with non‐ST elevation acute coronary syndromes (NSTACS).

Hypothesis: Transient ST ischemic events, detected by continuous 12‐lead ECG ST monitoring, early in the course of NSTACS, may add prognostic information to the TIMI‐RS.

Methods: In all, 567 consecutive patients with a NSTACS underwent 24‐h continuous 12‐lead ECG ST monitoring. An ST ischemic event was defined as a transient ST shift in any lead of ≥ 0.10 mV compared with the reference ECG, lasting for ≥l min.

Results: The incidence of the composite of death, nonfatal myocardial infarction (or reinfarction) and recurrent ischemia by Day 14 was 22.2%. By Day 30, the incidence of the composite of death and nonfatal myocardial infarction (or reinfarction) was 14.7%. There was a significantly increased risk of 14‐day (p value for trend < 0.001) or 30‐day (p value for trend <0.001) composite endpoint with increasing of TIMI‐RS. Moreover, the occurrence of ≥ 1 ST shifts during ST monitoring was associated with a significantly increased risk of 14‐(p value < 0.001) or 30‐day (p value < 0.001) composite end‐point, and this was true throughout the groups of TIMI‐RS.

Conclusions: The present study suggests that continuous 12‐lead ECG ST monitoring, early in the course of NSTACS, may serve as an affordable tool to add prognostic information to the TIMI‐RS.
Long‐term efficacy of hybrid pharmacologic and ablation therapy in patients with pilsicainide‐induced atrial flutter
Authors: Hirao Kenzo , Okishige Kaoru , Yamamoto Naohito , Otomo Kenichiro , Azegami Kouji , Isobe Mitsuaki
Published: June 2007

Background: Combination therapy with catheter ablation of the cavo‐tricuspid isthmus and continued drug therapy, that is, “hybrid therapy,” in patients with atrial fibrillation (AF) and drug‐induced atrial flutter (AFL) is reported to be an alternative means of achieving and maintaining sinus rhythm. With respect to choosing this method among the rhythm control therapies, its long‐term efficacy and the prevalence of AFL in patients with AF are very important and have not been fully elucidated.

Hypothesis: The purpose of this study was to investigate the long‐term effectiveness of this hybrid therapy and the dose prevalence inIc drug‐induced AFL.

Methods: The subjects were 89 patients (aged 62.4 years, 72 men) with episodes of AF (paroxysmal type: 65, persistent type: 11, permanent type: 13). After 4 weeks of oral pilsicainide administration, the dose was increased in those with no documented AFL. The patients who experienced AFL with pilsicainide (Ic‐AFL) underwent ablation.

Results: Pilsicainide administration resulted in the common type AFL in 17 patients (19.1%). The pilsicainide plasma concentration in the patients with Ic‐AFL was significantly higher than in those without AFL (0.79 ± 0.41 vs. 0.51 ± 0.24 μg/ml, respectively, p < 0.01). During a 10–54 (mean 37 ± 14) month follow‐up period, sinus rhythm was maintained in 10 of 12 patients after successful ablation followed by continued antiarrhythmic drug administration.

Conclusions: Hybrid therapy with ablation and high doses of pilsicainide was useful in maintaining sinus rhythm in some selected patients with AF and drug‐induced AFL.
Cardiac sequelae in Brooklyn after the September 11 terrorist attacks
Authors: Feng Jianwei , Lenihanx Daniel J. , Johnson Marcella M. , Karri Vandana , Reddy C. V. R.
Published: June 2007

Background: Terrorism, such as the attacks on the World Trade Center (WTC) on September 11,2001, result in higher stress‐related disorders, especially in those persons in close proximity.

Hypothesis: Cardiac events resulting from the September 11,2001 tragedy have not been detailed near the WTC.

Methods: Patients admitted to the Telemetry and Coronary Care Units at New York Methodist Hospital 4 miles from the WTC 60 days prior to and after the September 11 attacks were analyzed. In all, 1,653 admissions were reviewed: 427 records pre 9/11/2001 and 422, 393, and 411 records in the post‐9/11/2001, pre‐9/11/2000, and post‐9/11/2000 data sets, respectively. Patients were categorized based on diagnosis: acute myocardial infarction (MI), unstable angina (UA), tachyarrhythmia (TA), and others (including syncope and congestive heart failure).

Results: There was a significant difference in the proportion of the various cardiac diagnoses post 9/11/01 (p = 0.008 by chi‐square analysis). Compared with pre 9/11/2001, there were significantly more patients with acute MI (15.5 vs. 11.2%) and TA(19.9vs. 13.6%)but fewer with UA(39.6vs. 47.3%)after the terrorist attacks. The distribution of cardiac events during a similar period of time in 2000 revealed no such pattern.

Conclusions: There was a significant increase in acute MI and TA and a smaller increase in UA after the September 11 attacks. The difference did not appear to be due to temporal variation. It appears that stress likely contributed to an increase in TA by itself or with ischemia, resulting in progression of UA to acute MI.
Amount of left ventricular hypertrophy determines the plasma N‐terminal pro‐brain natriuretic peptide level in patients with hypertrophic cardiomyopathy and normal left ventricular ejection fraction
Authors: Kim Seon Woon , Park Seung Woo , Lim Seong‐Hoon , Kwon Sung Uk , Hoi Yu Jeong , Park Man Ki , Lee Sang‐Chol , Lee Sang Hoon , Park Jeong Euy , Jeon Eun‐Seok
Published: June 2007

Background: N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) is increased in patients with hypertrophic cardiomyopathy (HCM); however, the determinants of NT‐proBNP level have not been clarified in HCM.

Hypothesis: This study was performed to determine the relationship between NT‐proBNP levels and various echocardiographic variables of patients with HCM and normal left ventricular ejection fraction (LVEF).

Methods: We assessed plasma NT‐proBNP levels and echocardiographic variables of 36 patients (19 men, 58 ± 14 years) with HCM and an LVEF of ≥ 55%. Echocardiographic variables measured were LV wall thickness, end‐diastolic LV internal dimension (LVIDd) and volume (LVEDV), LV mass, and LV mass index (LV mass/body surface area, LVMI). Left ventricular outflow tract pressure gradient, transmitral E and A velocities, deceleration time (DT) of the transmitral E wave, and septal annular E' velocity were measured by Doppler technique. The relationship between echocardiographic variables and plasma NT‐proBNP level was analyzed.

Results: The plasma NT‐proBNP level was 775.2 ± 994.2 pg/ml (range 33.1‐729.0 pg/ml). It showed positive correlations with LV end‐diastolic septal thickness (r = 0.39, p = 0.010) and LVMI (r = 0.27, p = 0.050), while it revealed negative correlations with LVIDd (r = −0.44, p = 0.004), LVEDV (r= −0.44, p = 0.004) and DT(r= −0.31, p = 0.034). The NT‐proBNP level was higher in the patients with than in those without LV diastolic dysfunction (p = 0.03 3) and was independently related to LVIDd (p = 0.001), LVMI (p = 0.006) and DT (p = 0.031) by multivariate analysis.

Conclusion: In patients with HCM and normal LVEF, the amount of LV hypertrophy and LV diastolic dysfunction may exert a significant role in determining plasma NT‐proBNP level.
Young adults born small for gestational age: Is reduced baroreceptor sensitivity a risk factor for hypertension?
Authors: Pozza R. Dalla , Bechtold S. , Putzker S. , Bonfig W. , Netz H. , Schwarz H. P.
Published: June 2007

Background: Adults born small for gestational age (SGA) are at increased risk for the metabolic syndrome and cardiovascular disease.

Hypothesis: Impaired short‐term blood pressure regulation may contribute to the development of hypertension in patients born SGA.

Methods: In all, 43 patients born SGA (18 female, age 19.4 ± 0.3 years) were evaluated by beat‐to‐beat blood pressure and heart rate registration during rest and mental and orthostatic stress. The study group was divided into Group 1 with normal resting blood pressure (n = 32) and Group 2 with slightly elevated blood pressure (n = 11). Baroreceptor sensitivity (BRS) was calculated. Fasting insulin as well as lipid levels were correlated with hemodynamic parameters.

Results: Eleven of the 43 study patients (25%) had a slightly elevated resting systolic blood pressure (SBP) rising during mental and orthostatic stress. Body mass index (BMI) and fasting insulin levels correlated strongly with SBP in Group 2. Baroreceptor sensitivity was lower in Group 2 at rest (p<0.05).

Conclusions: Three components of metabolic syndrome (elevated BP, high BMI, elevated insulin levels) correlate strongly in young adolescents born SGA; BRS is reduced in prehypertensive patients. Close follow‐up is warranted during adult life as they are predisposed for developing a metabolic syndrome with elevated cardiovascular risk.
Serial analysis of troponin I levels in patients with ischemic and nonischemic dilated cardiomyopathy
Authors: Nellessen Ulrich , Goder Stephan , Schobre Robertus , Abawi Miriam , Hecker Hartmut , Tschöke Sigrid
Published: June 2007

Background: Ongoing myocardial cell damage forms the basis for progression of chronic heart failure. Evidence is accumulating that progressive loss of cardiac myocytes is associated with the release of cardiac troponin I (cTnI).

Hypothesis: This study sought to determine whether levels of cTnI are of prognostic value for risk stratification of patients with chronic heart failure.

Methods: Release of cTnI was measured by conventional enzyme immunoassay following serum ultrafiltration in 58 consecutive patients hospitalized for chronic heart failure and 31 healthy volunteers serving as control group. Determination of serum levels was performed every 2 weeks over a time interval of 3 months. According to the results of coronary angiography, patients were divided into Group D showing normal coronary arteries (n = 33, ejection fraction 27 ± 6.1%) and Group I showing severe coronary heart disease (n = 25, ejection fraction 28.8 ± 7.8%). Survival of patients was evaluated after a mean time interval of 3 years.

Results: The mean cTnI serum level over all measurements was 0.66 ± 1.8 ng/ml in patients versus 0.11 ± 0.48 ng/ml in volunteers. At all six points of analysis, the mean cTnI serum level was significantly different (p < 0.001) between patients and volunteers. There was no significant difference between patients with and without coronary heart disease following hospital discharge, however, troponin release was significantly different between survivors and nonsurvivors (n = 27) (0.56 ng/ml vs. 0.84 ng/ml; p < 0.05).

Conclusion: Permanent cTnI release is a common finding in patients with chronic heart failure and a strong prognosticator. In this setting, coronary morphology seems to play a minor role for disease progression.
Implantable cardioverter defibrillator implant‐explant‐implant case study: Addressing the psychological adjustment to multiple shocks
Authors: Kovacs Adrienne H. , Eigofsky Suzannef , Goff J. Sean , Saidi Arwa S. , Curtis Anne B. , Conti Jamie B. , Sears Samuel F.
Published: June 2007

This case study details the multidisciplinary approach to a patient who underwent implantable cardioverter defibrillator (ICD) explantation for psychological reasons. The patient was unable to manage the stress associated with multiple shocks. He had a class I indicationfor an ICD but initially refused to undergo reimplantation. Treatment included the provision of comprehensive medical, nursing, and psychological care, with emphasis on patient autonomy and respect forthe patient's experience.
The physiologic basis for the management of ventricular assist devices
Authors: Mudge Gilbert H. , Fang James C. , Smith Colleen , Couper Gregory
Published: June 2007

Mechanical ventricular assist devices are now approved as destination therapy for terminal heart failure. It is the purpose of this review to discuss the physiology of this technology that is considered in outpatient care. The currently available pulsatile devices are solely dependent of preload volume and, when placed in the automatic mode, can maintain physiologic cardiac outputs with exercise. However, because of their dependence on preload volume, there are unique physiologic consequences; device bradycardia represents volume depletion, device tachycardia reflects volume overload. The differential diagnosis of left ventricular assist device dysfunction includes native right ventricular failure, native left ventricular recovery, or other technical considerations. The management of biventricular mechanical support as well as arrhythmia management and the role of echocardiographic assessment in this unique patient population will be discussed. Expertise in outpatient management of such devices is now a requisite for subspecialists in heart failure. In the future, technical innovations may simplify management for professionals, patients, and their families.
Coronary artery aneurysm: A review
Authors: Pahlavan Payam S. , Niroomand Feraydoon
Published: June 2007

Coronary artery ectasia (CAE) is found in 0.3–5% of patients undergoing coronary angiography. Atherosclerosis is the main cause, followed by Kawasaki disease and infectious emboli. The exact pathogenesis has not been diagnosed as yet, but an inflammatory process is underlying. Symptoms, if present, are usually related to myocardial ischemia. Angiography is the mainstay for diagnosis. The prognosis is generally favorable. Thromboembolic complications are rare with antiplatelet therapy, and spontaneous rupture generally is rare but occurs more commonly in Kawasaki disease. Management varies from antithrombotic therapy to surgical ligation. Controlling coronary heart disease risk factors sharply affects the prognosis in patients with CAE.
Predischarge low‐dose dobutamine test and prediction of left ventricular function at 1 year in patients with a first anterior myocardial infarction
Authors: Figueras Jaume , Ortadellas Josefa C. , Missorici Mario , Astell Joan C. , Soler Jordi Soler
Published: June 2007

Background: It is unclear whether spontaneous improvement in contractility following acute myocardial infarction (AMI) is related to severity of predischarge systolic dysfunction and can be predicted by isotopic ventriculography with a low‐dose dobutamine test (DBT).

Hypothesis: Spontaneous improvement in contractility would be similar in patients with more preserved and those with depressed ventricular function, and a DBT test could predict it.

Methods: Left ventricular ejection fraction (LVEF), regional contractility score (RCS), and left ventricular end‐diastolic volume index (EDVI) at predischarge, during DBT, and at 1 year were analyzed in 43 patients with a first anterior ST‐ele‐vation AMI.

Results: Changes produced by DBT in patients with LVEF <40%, RCS >3, or EDVI >70 ml/m2 were smaller than in those observed at 1 year (LVEF: 30 ± 5‐35 ± 7%, p < 0.001, vs. 39 ± 10%, p = 0.005; RCS: 4.9 ± 1.4‐4.6 ± 2.0, NS, vs. 3.4 ± 2.0, p<0.02; EDVI: 92 ± 14‐86 ± 22, NS, vs. 78 ± 23 ml/m2, p < 0.03). In contrast, in patients with EF > 40%, RCS < 3 or EDVI < 70 ml/m2, changes with DBT tended to be greater than those observed at 1 year (LVEF: 52 ± 8‐57 ± 11%, p< 0.004 vs. 55 ± 11%, p< 0.04); RCS: 1.1 ± 0.9‐0.8 ± 0.8, NS, vs. 1.1 ± 1.1, NS; and EDVI: 51 ± 9‐47 ± 11, p < 0.005, vs. 54 ± 13 ml/m2, NS).

Conclusions: Among patients with a first anterior AMI, spontaneous improvement in contractility at 1 year was greatest in those with a more depressed ventricular function or a dilated ventricle, but its magnitude was underestimated by a predischarge DBT test.
The efficacy of fractionated radiotherapy and stereotactic radiosurgery for pituitary adenomas
Authors: Kong Doo‐Sik , Lee Jung‐Il , Lim Do Hoon , Kim Kwang Won , Shin Hyung Jin , Nam Do‐Hyun , Park Kwan , Kim Jong Hyun
Published: June 2007

BACKGROUND.

The objective of this retrospective cohort study was to define the efficacy and safety of fractionated radiotherapy (FRT) and stereotactic radiosurgery (SRS) for the treatment of patients with pituitary adenoma.

METHODS.

Between January 1995 and April 2006, 125 consecutive patients with pituitary adenomas (54 hormone‐secreting adenomas and 71 nonsecretory adenomas) received FRT or underwent SRS. Sixty‐four patients received FRT, for which the mean total dose was 50.4 grays (Gy) (range, 48–54 Gy), and 61 patients underwent gamma‐knife SRS with mean marginal dose of 25.1 Gy (range, 9–30 Gy).

RESULTS.

After mean follow up of 36.7 months, the tumor volume was increased in only 4 patients (3.2%). The overall actuarial progression‐free survival rate was 99% at 2 years and 97% at 4 years. No difference was observed between the FRT group and the SRS group in the control of tumor growth. Based on the endocrinologic results in the patients who had secretory adenomas, the overall hormone complete remission rate was 26.2% at 2 years and 76.3% at 4 years. The median time to complete remission was 26 months in the SRS group and 63 months in the FRT group (P = .0068). Hypopituitarism developed as a delayed complication in 11.5% of patients at a median of 84 months.

CONCLUSIONS.

Both FRT and SRS were efficient treatment modalities for the control of tumor growth in patients with pituitary adenomas. The current results indicated that single‐dose radiosurgery more promptly produces an effect on the hypersecretion of pituitary hormones and may be recommended over FRT for suitable patients. Cancer 2007. © 2007 American Cancer Society.
Correspondence Between CIELAB and CIELUV Color Differences
Authors: Ohta Noboru
Published: June 2007

The CIE presently recommends two uniform color spaces, the CIE 1976 (L*u*v*)‐space (CIELUV) and the CIE 1976 (L*a*b*)‐space (CIELAB). With each of these spaces is associated a color‐difference formula. Color differences calculated by one formula cannot readily be converted to color differences calculated by the other formula. A conversion factor such as ρ = ΔEuv*/ΔEab* cannot be determined uniquely. However, for any given location in color space, it is possible to determine a range, ρmin ⩽ ρ ⩽ ρmax, within which ρ must lie. Lines of constant ρmin and ρmax can be plotted in (L*a*b*)‐space which indicate the range of ρ in (L*u*v*)‐space.
Fine color metric (FCM)
Authors: Friele L. F. C.
Published: June 2007

Optimal discrimination ellipsoids were calculated from the data on color differences of commercial importance, available in the studies by Davidson and Friede, Kuehni, Metropolitan Section AATCC, Morley, Munn and Billmeyer, and Robinson, and in the new VVVR data. The analysis led to an improved uniform color space and a color‐difference formula, the merits of which are compared to those of the CIELUV and the CIELAB formulas. The CIE formulas break down for saturataed red and blue colors. The new color‐difference formula presents a fair approach to the ultimate aim, that visually equal color differences should be rated with equal numerical value throughout color space.
Colorimetry of fluorescent materials: visual evaluation of fluorescent whites
Authors: Swenholt Bonnie K. , Grum Franc , Witzel Robert F.
Published: June 2007

This paper documents studies of the Subcommittee for Problem 18, Colorimetry of Fluorescent Materials, of the Inter‐Society Color Council. Visual judgments were made of the relative whiteness of fluorescent white papers, plastics, and textiles. The data were analyzed statistically and were found to support the validity of the Grum, Witzel, and Stensby whiteness formula.
Computer color matching with the aid of visual techniques
Authors: Winey Ray K.
Published: June 2007

A method for simplifying and speeding up computer color matching is described. The colorist uses the computer in an interrupt‐conversational mode to utilize the direction of metameric mismatch in order to reduce the number of colorant combinations which must be examined to provide an acceptable match.
A colorimetric comparison of colour reproductions
Authors: Chalmers A. N.
Published: June 2007

This article describes a methodology used to enable a meaningful comparison of the colour reproduction characteristics of a pair of colour photographic media, on the basis of an instrumental determination of the colour differences between sets of coloured test surfaces and their photographic reproductions. A figure of merit is proposed which can serve as a measure of the relative colour fidelity of the media being compared. This approach should yield a valid comparison between any two or more media having essentially the same display format and being subject to similar sets of controls and constraints.
The Concept of Colourfulness and its Use for Deriving Grids for Assessing Colour Appearance
Authors: Pointer M. R.
Published: June 2007

A technique of subjective magnitude estimation has been used to assess a set of pseudosurface colours, each having a luminance factor of 0.2. Three adaptation conditions corresponding to daylights D65 and D50 and tungsten light SA were used. The experimental technique and data analysis represent an improvement on that previously reported. The concept of colourfulness, as opposed to chroma or saturation, has been introduced with considerable success. The loci of constant hue and colourfulness were derived in u',v' chromaticity space and the results compared with predictions obtained using the Bartleson adaptation equations.
Determining Pigment Optical Properties for Use in the Mie and Many‐Flux Theories
Authors: Billmeyer Fred W. , Chassaigne Patrick G. , Dubois Jean F.
Published: June 2007

Normalized phase functions p(ϑ), the angular dependence of light scattering, were determined experimentally for diluted aqueous dispersions of iron‐oxide pigments. The best means of representing p(ϑ) through a series of Legendre polynomials was studied. From the Legendre coefficients it was possible to calculate by the Mie theory both the complex refractive index of the pigment and the single‐scattering absorption and scattering coefficients. The latter coefficients were used in the many‐flux theory to calculate the reflectance of a paint film made from the pigment. Reasonable agreement was obtained with the experimental value of reflectance of a paint film prepared from the same, but undiluted, dispersion.
New products for color
Authors: Stanziola Ralph
Published: June 2007

For some time we have contemplated the inclusion of a “new products” column of interest to the color community. With the appointment of Ralph Stanziola as Special Editor for Industrial Applications, we are pleased to initiate this feature. No reply card, just a name and telephone number if you are interested. We encourage manufacturers to send information on new products for color to Ralph Stanziola at the address given next to the table of contents.—F.W.B.
A standards program for color control
Authors: Fairman Hugh S.
Published: June 2007

Manufacturers of colored products in multiplant environments must establish color‐control programs which revolve around physical standards. The preparation of a set of such standards is discussed, and a program to be followed in the preparation and use of such a set is proposed, using a paint system as an example.
Advances in color‐difference formulas
Authors: Kuehni Rolf G.
Published: June 2007

Unit ovals in the CIE chromaticity diagram are used to compare and evaluate new developments in color‐difference formulas since the 1976 CIE recommendations.
A new colour‐perception lantern
Authors: Holmes J. G. , Wright W. D.
Published: June 2007

A new colour‐perception lantern shows red, green, and white lights which are within current international chromaticity limits for signal lights in all forms of transport, at three levels of luminous intensity. The light source, filters, and power supply have long‐life characteristics and the whole lantern is intended to be maintenance‐free. The operator's functions are simple and clear, and a fixed routine is proposed for the colour‐perception test. There are two models, Type A approved for the British Armed Services and for Civil Aviation, and Type B approved for the Merchant Navy.
Effects of GABA antagonists on spectral responses of horizontal cells in the carp retina
Authors: Shimoda Yukio , Miyachi Ei‐Ichi , Watanabe Shu‐Ichi , Murakami Motohito
Published: June 2007

Previous experiments have shown that, in the carp retina, a GABA‐mediated feedback from horizontal cells to cones is involved in neural mechanisms of color opponency. In this article, we investigated effects of GABA antagonists, picrotoxin and bicuculline, on spectral responses of horizontal cells. These chemicals caused selective suppression of responses to long wavelength, probably because the feedback was blocked. In particular, a biphasic spectral response curve in the H2 cell turned into almost monophasic. The presence of feedback in the carp retina was further supported by the fact that depolarizing synaptic potentials were detected in cones at the center, when horizontal cells were hyperpolarized by a peripheral annulus illumination.
Spectral properties of the second‐order neurons in the dace retina
Authors: Hashimoto Yoko , Abe Machiko , Inokuchi Mie
Published: June 2007

Spectral properties of the horizontal cells and the bipolar cells in the dace retina were studied under mesopic and/or photopic conditions. Four types of horizontal cells were identified: two L types (L1 and L2) and two C types (RB and RGB). The L1 cell has its spectral peak at about 590 nm, and the L2 cell peaks at about 630 nm. The wavelength at which a maximum hyperpolarization of the RB cell is produced is around 460 nm, and a subpeak is seen around the green‐yellow spectral region. The maximum hyperpolarizing response of the RGB cell appears at 400 nm, and it depolarizes over a wide spectral range (460–660 nm). The high sensitivity to blue light of C‐type horizontal cells is most characteristic in the dace. The bipolar cells are classified into two groups, non‐color‐coded cells and color‐coded cells, by the spectral properties of the center response. The non‐color‐coded cells have broad spectral sensitivities, although the spectral maxima are different in the center and the surround in some cells. It is clear from the spectral response curves that there are no large impingements of blue cones in the non‐color‐coded bipolar cells as compared with the horizontal cells. Spectral properties of the color‐coded cells are not yet fully analyzed.
Proposed standards for the NBS retroreflection MAP
Authors: Eckerle Kenneth L. , Hsia Jack J.
Published: June 2007

A proposed Measurement Assurance Program (MAP) service for retroreflectance is under development at the National Bureau of Standards. A package for the MAP consists of high‐ and low‐intensity bead‐sheeting retroreflectors, a prismatic retroreflector, and seven colored glass filters. The retroreflectors are being measured using the NBS reference retroreflectometer. The glass filter measurements are based on spectral data obtained using a high‐accuracy reference spectrophotometer. The luminous transmittances are calcúlated from the spectral transmittances using CIE Illuminant A and a CIE V(λ)‐type detector, and can be used to check the combined spectral distribution of source and responsivity of the receiver. Computations are mentioned which show that if a color‐correction filter is not chosen carefully, large errors may result. Preliminary results for pressure and temperature effects on two types of retroreflectors indicate small changes. Temperatures used were nominally 15, 25, and 32°C. Pressures used were nominally 0.85, 1.0, and 1.25 bars. Results showing the sensitivity of the coefficient of luminous intensity (C.I.L.) of the retroreflectors to various geometrical parameters are described. These parameters include the observation angle α, the entrance angles β1 and β2, the source and receiver apertures δ, and the rotation angle ϵ.