bluuebunny/crossref_metadata_2025 huggingface dataset:
Heart Rate Changes and ECG Abnormalities During Epileptic Seizures: Prevalence and Definition of an Objective Clinical Sign
Authors: Zijlmans Maeike , Flanagan Danny , Gotman Jean
Published: May 2003

Summary: Purpose:To determine the prevalence of heart rate changes and ECG abnormalities during epileptic seizures and to determine the timing of heart rate changes compared to the first electrographic and clinical signs. To assess the risk factors for the occurrence of ECG abnormalities.

Methods:We analyzed retrospectively 281 seizures in 81 patients with intractable epilepsy who had prolonged video‐EEG and two‐channel ECG. The nature and timing of heart rate changes compared to the electrographic and clinical seizure onset was determined. The ictal period (including one minute preictally and three minutes postictally) was analyzed for cardiac arrhythmias, conduction and repolarization abnormalities. Risk factors for cardiac abnormalities were investigated using parametric and non‐parametric statistics.

Results:There was an increase in heart rate of at least 10 beats/minute in 73% of seizures (93% of patients) and this occurred most often around seizure onset. In 23% of seizures (49% of patients) the rate increase preceded both the electrographic and the clinical onset. ECG abnormalities were found in 26% of seizures (44% of patients). One patient had an asystole for 30 seconds. Long seizure duration increased the occurrence of ECG abnormalities. No other risk factor was found.

Conclusions:Heart rate changes occur frequently and occur around the time or even before the earliest electrographic or clinical change. The change can clarify the timing of seizure onset and the specific rate pattern may be useful for seizure diagnosis and for automatic seizure detection. ECG abnormalities occur often and repeatedly in several seizures of the same patient.
Self‐discontinuation of Antiepileptic Medication in Pregnancy: Detection by Hair Analysis
Authors: Williams John , Myson Vicki , Steward Sandra , Jones Glenda , Wilson John F. , Kerr Michael P. , Smith Philip E.M.
Published: May 2003

Summary:  Purpose: Concerns over teratogenicity of antiepileptic drugs (AEDs) during pregnancy must be balanced against the risks of seizures to the mother and developing fetus. Pharmacokinetic changes and vomiting may alter drug levels, but more important may be the patient's decision to stop medication before or during pregnancy. Compliance assessment traditionally relies either on self‐reporting or on AED plasma level monitoring; neither provides reliable information on drug‐taking behaviour over an extended interval (e.g., before, during, and after pregnancy).

Methods: We have used hair analysis to assess AED‐taking behavior in pregnant women compared with nonpregnant female controls. Twenty‐six pregnant women [mean age, 27.5 ± 6.7 (SD) years] and 13 nonpregnant female epilepsy outpatients (mean age, 31.9 ± 8.3 years) were studied. Carbamazepine (CBZ) or lamotrigine (LTG) concentrations were measured in 1‐cm hair segments, and the within‐subject variance in segmental hair concentrations of these drugs was calculated for each group. The variances of each group were then compared by using a variance ratio test.

Results: The variance of AED concentration in hair differed significantly between the pregnant and nonpregnant groups [variance ratio, 1.59 (p < 0.01)]. Four (15%) of the 26 pregnant patients had little or no AED in their proximal hair segments compared with more distal segments, apparently having discontinued their medication during pregnancy. Only one of these later disclosed having stopped her medication. One pregnant woman whose hair profile was similar to controls died suddenly at 30 weeks of gestation.

Conclusions: This study confirms the perception that pregnant women with epilepsy frequently stop or greatly reduce their prescribed medication, usually without reference or acknowledgement to their clinician.
The Effect on Vision of Associated Treatments in Patients Taking Vigabatrin: Carbamazepine Versus Valproate
Authors: Arndt Carl F. , Salle Marc , Derambure Philippe H. , Defoort‐Dhellemmes Sabine , Hache Jean‐Claude
Published: May 2003

Summary:  Purpose: To evaluate the effect on visual function of a concomitant antiepileptic drug (AED) in patients treated with vigabatrin (VGB).

Methods: Sixty‐four consecutive patients with a history of partial seizures currently treated with VGB with either carbamazepine (CBZ) or valproate (VPA) were examined with automated kinetic perimetry, static perimetry, electrooculogram (EOG), and electroretinogram (ERG). An original device based on kinetic perimetry was developed to quantify the area of perception for each isopter.

Results: Fifty‐two patients were finally included. The results showed a significant difference in patients treated with VGB‐VPA compared with patients treated with VGB‐CBZ concerning the mean defect of static perimetry and the peripheral and midperipheral isopter (III 4e and III 1a Goldmann equivalent, respectively) in kinetic perimetry. EOG and ERG results did not differ significantly between the two groups.

Conclusions: The visual impairment due to visual field constriction was more important in patients treated with VGB and VPA compared with patients treated with VGB and CBZ. The origin of this difference between the two associations could not be related to any particular retinal electrophysiologic abnormality.
Benefit of Simultaneous Recording of EEG and MEG in Dipole Localization
Authors: Yoshinaga Harumi , Nakahori Tomoyuki , Ohtsuka Yoko , Oka Eiji , Kitamura Yoshihiro , Kiriyama Hideki , Kinugasa Kazumasa , Miyamoto Keiichi , Hoshida Toru
Published: May 2003

Summary:  Purpose: In this study, we tried to show that EEG and magnetoencephalography (MEG) are clinically complementary to each other and that a combination of both technologies is useful for the precise diagnosis of epileptic focus.

Methods: We recorded EEGs and MEGs simultaneously and analyzed dipoles in seven patients with intractable localization‐related epilepsy. MEG dipoles were analyzed by using a BTI Magnes 148‐channel magnetometer. EEG dipoles were analyzed by using a realistically shaped four‐layered head model (scalp–skull–fluid–brain) built from 2.0‐mm slice magnetic resonance imaging (MRI) images.

Results: (a) In two of seven patients, MEG could not detect any epileptiform discharges, whereas EEG showed clear spikes. However, dipoles estimated from the MEG data corresponding to the early phase of EEG spikes clustered at a location close to that of the EEG‐detected dipole. (b) In two of seven patients, EEG showed only intermittent high‐voltage slow waves (HVSs) without definite spikes. However, MEG showed clear epileptiform discharges preceding these EEG‐detected HVSs. Dipoles estimated for these EEG‐detected HVSs were located at a location close to that of the MEG‐detected dipoles. (c) Based on the agreement of the results of these two techniques, surgical resection was performed in one patient with good results.

Conclusions: Dipole modeling of epileptiform activity by MEG and EEG sometimes provides information not obtainable with either modality used alone.
Long‐term Psychosocial Outcomes of Anterior Temporal Lobectomy
Authors: Jones Jana E. , Berven Norman L. , Ramirez Lincoln , Woodard Austin , Hermann Bruce P.
Published: May 2003

Summary:  Purpose: To examine the long‐term psychosocial outcomes of a consecutive series of patients who underwent anterior temporal lobectomy (ATL) compared with medically managed patients. This study focused primarily on actual long‐term changes (mean, 5 years) in life performance. There are relatively few long‐term controlled studies of actual lifetime performance changes.

Methods: The sample consisted of 61 adults who underwent ATL and 23 individuals who were evaluated for surgery but did not proceed to surgery and continued to receive medical management. Participants were interviewed 2–9 years after surgery. A structured clinical interview and review of medical records was conducted to obtain information regarding seizure frequency and psychosocial status, focusing on employment, education, driving status, financial assistance, and independent living. In addition, two questions regarding quality of life were included. Seizure frequency was evaluated for the year before the interview.

Results: Significant differences in psychosocial outcome were found between the surgery group and medical management group. Favorable psychosocial outcomes were more common among those who had surgery (46 vs. 4%). Results indicated that 68% of the surgery group exhibited improved psychosocial status compared with 5% of the medical management group. Individuals who had surgery were more likely to be driving, working full‐time, living independently, and being financially independent. Remaining seizure free was not a prerequisite for improvements in psychosocial outcomes.

Conclusions: Compared with medical management, surgery has a significant positive impact on psychosocial outcomes in terms of employment, independent living, driving, and financial independence. Additionally, a person does not necessarily have to be seizure free to achieve positive changes in psychosocial outcomes.
Use of Intraoperative Magnetic Resonance Imaging in Tailored Temporal Lobe Surgeries for Epilepsy
Authors: Buchfelder Michael , Fahlbusch Rudolf , Ganslandt Oliver , Stefan Hermann , Nimsky Christopher
Published: May 2003

Summary:  Purpose: We investigated whether intraoperative magnetic resonance imaging (MRI) was able to assess immediately the extent of a tailored temporal lobe resection for epilepsy in comparison to delayed postoperative MRI. The recently proposed concept of an individually tailored procedure, preserving tissue not involved in seizures, leads to a variety of differently shaped resections.

Methods: For intraoperative imaging we used a Magnetom Open 0.2 Tesla scanner. Fifty‐eight patients undergoing temporal lobe resections for pharmacoresistant epilepsy were investigated. Half of these were nonlesional. All patients had delayed postoperative follow‐up scans, which were compared with the intraoperative, postresection images.

Results: In 49 (84%) of 58 cases, intraoperative MRI depicted the resection cavity identical to delayed postoperative studies. Complete resection of the visible lesion was primarily proved in 23 of the 29 cases. In two patients with lesions and in one nonlesional case, the resection was extended after intraoperative imaging, thus increasing the rate of total resections in gliomas from 73 to 87%. In four patients, an extension into eloquent areas did not allow complete removal. In the nonlesional cases (n = 29), the extent of tailored temporal resections also could be exactly documented intraoperatively.

Conclusions: Intraoperative MRI allowed a reliable evaluation of the localization and extent of resection in epilepsy surgery within the operative procedure. Furthermore, it provided the possibility of an image‐based correction of an initially incomplete resection, particularly in lesional cases. In the majority of patients, the intraoperative images would have been able to replace delayed postoperative MRI. However, in 16%, there were postoperative changes in the resection volume.
Help‐seeking Patterns for Children with Epilepsy in Rural India: Implications for Service Delivery
Authors: Pal Deb K. , Das Tulika , Sengupta Suryanil , Chaudhury Gautam
Published: May 2003

Summary:  Purpose: Most people in the world with epilepsy are untreated with antiepileptic drugs (AEDs). In some developing countries, this is because treatment facilities are unavailable or difficult to access. It has even been suggested that indigenous health systems threaten the prospect of the global control of epilepsy with AEDs. We have investigated patterns and costs of help seeking for children with epilepsy in a region of rural India where only 12% of children with epilepsy were in treatment. Our objective was to find out (a) whom families had consulted; (b) if nonconsulting families differed in demographic or child medical factors; (c) if indigenous treatment was taken, exclusive of allopathic treatment; and (d) the direct and indirect cost of various providers.

Methods: We conducted a cross‐sectional interview study in a community‐based program for childhood epilepsy in rural West Bengal, India. We interviewed parents of 85 children aged 2 to 18 years with untreated epilepsy who had entered a clinical trial of AEDs during 1995 through 1996.

Results: Eighty percent of families had sought some help in the past: 62% with an allopathic practitioner, 44% with traditional practitioners. Primary health centres (PHCs) and quacks were not popular. Twenty‐four percent of families never sought help of any kind, and this was unassociated with sex, income, maternal literacy, or medical variables. There was evidence of both exclusivity and pluralism: 42% of families first consulting allopathic practitioners also visited traditional practitioners, whereas 30% of families first consulting traditional practitioners also went to allopathic practitioners. One visit to a physician cost a median of 9–13% of monthly income and 5–12 person‐hours; the cost of visiting indigenous providers was negligible.

Conclusions: Most families sought some form of help and were motivated to spend large amounts of money and time for allopathic treatments from qualified practitioners. The typical cost of allopathic treatment was unsustainable in the long term. Medical pluralism is common and does not adversely influence use of allopathic treatment. The phenomenon of nonconsulting merits further study. Traditional practitioners play a complementary role and might become involved in community treatment programs. Low‐cost, local treatment is essential to the public health control of epilepsy.
Dream Recall Frequency in Epilepsy Patients with Partial and Generalized Seizures: A Dream Diary Study
Authors: Bonanni Enrica , Cipolli Carlo , Iudice Alfonso , Mazzetti Michela , Murri Luigi
Published: May 2003

Summary:  Purpose: The frequency of dream recall (DR) in patients with brain diseases has proved to be indicative of the relation between sleep disturbances and the functioning of cognitive processes during sleep. In this study we attempted to ascertain whether DR frequency in patients with complex partial seizures (CPSs) is higher than that in those with generalized seizures.

Methods: DR frequency was assessed by means of a 60‐day dream diary in patients with CPSs, whose epileptic focus was in the right (n = 12) or left temporal lobe (n = 28), and with idiopathic generalized seizures (n = 21). The patients enrolled in the study were not impaired in global cognitive and memory functioning.

Results: The ability to recall dreams was established in nearly all patients with either CPSs or generalized seizures. DR frequency resulted significantly higher (about twice) in patients with CPSs, regardless of (a) the side of the epileptic focus, (b) the presence of a cerebral lesion detectable on a computed tomography (CT) scan, or (c) the occurrence of seizures in the previous day.

Conclusions: These findings indicate that overall, DR occurs in medicated epilepsy patients with CPSs more frequently than reported in previous studies. The high DR frequency observed in these patients, regardless of the side of the epileptic focus, is in agreement with the assumption that tempoparietal areas of both hemispheres are involved in the production and recall of the dream experience.
Partial Status Epilepticus in Benign Childhood Epilepsy with Centrotemporal Spikes: Are Independent Right and Left Seizures a Risk Factor?
Authors: Gregory Donna L. , Farrell Kevin , Wong Peter K.H.
Published: May 2003

Summary: Purpose:To describe an association between continuous simple partial seizures and independent right and left partial seizures in children with benign childhood epilepsy with centrotemporal spikes (BCECTS).

Methods:Three children with BCECTS and episodes of continuous simple partial seizures are described.

Results:All three children had a history of typical rolandic seizures occurring on the right and left sides of the body on different occasions.

Conclusions:The occurrence of independent right and left rolandic seizures in children with BCECTS may be a predisposing factor for the development of partial status epilepticus.
The Role of α2‐Adrenoceptors in the Modulatory Effects of Morphine on Seizure Susceptibility in Mice
Authors: Homayoun Houman , Khavandgar Simin , Dehpour Ahmad Reza
Published: May 2003

Summary:  Purpose: To evaluate the effect of the α2‐adrenoceptor agonist clonidine and the antagonist yohimbine on the dual modulation of seizure susceptibility induced by morphine and the anticonvulsant effect of acute stress in mice.

Methods: The thresholds for the clonic seizures induced after intravenous administration of pentylenetetrazole (PTZ) or bicuculline were assessed in mice weighing 23–30 g. Acute stress was induced by restraining mice for 2 h in a restrainer.

Results: Morphine at lower doses (0.5, 1, and 3 mg/kg) increased and, at higher doses (15, 30, and 75 mg/kg), decreased the seizure threshold. Pretreatment with clonidine (0.001–0.1 mg/kg) inhibited the anticonvulsant effect of morphine, while potentiating its proconvulsant effect. Conversely, yohimbine (0.5–2 mg/kg) potentiated the anticonvulsant effect of morphine but inhibited its proconvulsant effects. Acute stress induced an anticonvulsant effect that was reversible by naloxone (1 mg/kg) or clonidine (0.05–0.1 mg/kg) or a combination of their lower doses (0.3 and 0.01 mg/kg, respectively), while being potentiated by yohimbine (1 mg/kg).

Conclusions: α2‐Adrenoceptors play a dual role in the anticonvulsant effects of morphine. The activation of these receptors also can decrease the anticonvulsant effect of acute restraint stress in mice.
EEG Features of Glut‐1 Deficiency Syndrome
Authors: Von Moers Arpad , Brockmann Knut , Wang Dong , Korenke Christoph G. , Huppke Peter , De Vivo Darryl C. , Hanefeld Folker
Published: May 2003

Summary:  Purpose: Glut‐1 deficiency syndrome (Glut‐1 DS) is caused by the deficiency of the major glucose transporter in cerebral microvessels.

Methods: We performed pre‐ and postprandial EEG recordings in two unrelated children with Glut‐1 DS with developmental delay and seizures predominantly in the morning before breakfast.

Results: Extensive epileptiform discharges observed in the fasting state were improved markedly by food intake, as documented in EEG recordings 1 and 2 h after a meal. The ratio of cerebrospinal fluid glucose to blood glucose was decreased in both children. Glut‐1 deficiency was confirmed by biochemical and molecular genetic investigations.

Conclusions: Pre‐ and postprandial EEG recordings offer a simple screening test for Glut‐1 DS.
A Hand‐Carried Personal Ultrasound Device for Rapid Evaluation of Left Ventricular Function: Use After Limited Echo Training
Authors: Lemola Kristina , Yamada Elina , Jagasia Dinesh , Kerber Richard E.
Published: May 2003

A hand‐carried personal ultrasound device (HCPUD) may be used for rapid cardiac screening by physicians with limited echo training. Our objective was to determine the accuracy of rapid HCPUD evaluation of left ventricular (LV) size and function when used by a Cardiology Fellow. Forty‐five patients underwent an HCPUD exam using a 2.4‐kg device with a 2‐ to 4‐MHz curved transducer and color power Doppler (SonoSite). The results were compared with sonographer‐performed and echocardiographer‐interpreted exams using conventional equipment. The HCPUD exam lasted 6 ± 2 minutes. There was 100% agreement between HCPUD and conventional echo on qualitative assessment of LV systolic function. Comparing the HCPUD and conventional linear measurements of left ventricular end‐diastolic dimension (LVEDD) and of interventricular septal (IVS) thickness: LVEDD is HCPUD = 0.94 conventional −0.2,

r = 0.82, P < 0.0001

; IVS is HCPUD

= 0.59

conventional

+0.6, r = 0.69, P < 0.0001

. Thus, an HCPUD can effectively be used after limited training to rapidly screen for qualitative abnormalities of LV systolic function. Quantitative measurements of smaller structures with the HCPUD are more challenging. (ECHOCARDIOGRAPHY, Volume 20, May 2003)
Automated Quantification of Left Ventricular Function by the Automated Contour Tracking Method
Authors: Sugioka Kenichi , Hozumi Takeshi , Yagi Toshikazu , Yamamuro Atsushi , Akasaka Takashi , Takeuchi Kazuhide , Homma Shunichi , Yoshida Kiyoshi , Yoshikawa Junichi
Published: May 2003

The automated contour tracking (ACT) method has been developed for the automated measurement of area volume using the energy minimization method without tracing a region of interest. The purpose of this study was to compare the ACT method and left ventriculography (LVG) for the measurement of left ventricular (LV) function in the clinical setting. An apical four‐chamber view was visualized by two‐dimensional echocardiography and recorded for off‐line analysis in 14 patients with high‐quality images who underwent LVG. The ACT method automatically traces the endocardial border from the recorded images and calculates LV volumes (end‐diastole and end‐systole) and ejection fraction (EF). Both ACT and LVG were compared by linear regression analysis for the measurement of EF. EF determined by the ACT method agreed well with that by LVG (

r = 0.96, y = 0.94x + 4.6

, standard error of the estimate = 3.9%). The mean difference between the ACT and LVG was –

1.4%± 7.3%.

In conclusion, the ACT method is reliable for noninvasive estimation of EF in high‐quality images. This suggests that this new technique may be useful in the automated quantification of LV function. (ECHOCARDIOGRAPHY, Volume 20, May 2003)
Influence of Perindopril on Left Ventricular Global Performance During the Early Phase of Inferior Acute Myocardial Infarction: Assessment by Tei Index
Authors: Nearchou Nearchos S. , Tsakiris Alexandros K. , Lolaka Maria D. , Zarcos Ilias , Skoufas Dimitrios P. , Skoufas Panagiotis D.
Published: May 2003

The beneficial effect of angiotensin‐converting enzyme inhibitors (ACE inhibitors) on left ventricular (LV) function in patients with acute myocardial infarction (AMI) is widely known. However, controversy exists about their efficacy on patients with small infarcts and preserved LV systolic function. The aim of the present study was to detect the influence of the ACE‐I perindopril on the global LV performance in patients with pure inferior AMI (AMI‐I) using a Doppler‐derived index (DI) that combines systolic and diastolic time intervals (Tei index). Our study included 40 patients with first AMI‐I, mean age 60 years ± 9.06 years (SD) and 24 age‐ and gender‐matched normal patients who constituted the control group (COG). Patients were randomized into two groups to receive the conventional treatment of AMI‐I (GCT) or the above therapy plus P (GP). Complete Doppler echocardiography (systolic and diastolic parameters), DI, and systolic blood pressure (SBP) were measured on the

8.07 ± 1.16

(SD) post‐infarct day. The same examination was performed to COG. The DI was significantly lower in healthy patients

(0.45 ± 0.23)

compared with the value in patients of either GP

(0.56 ± 0.03; P = 0.023)

or GCT

(0.78 ± 0.05; P = 0.000)
. Moreover DI was higher in patients of GCT compared with that of GP(P = 0.000). In addition, perindopril administration decreased isovolumic relaxation time(IRT; 120.00 ± 4.23 vs. 139.00 ± 6.74; P = 0.006)and increased significantly ejection time (ET;274.25 ± 7.35 vs. 253.50 ± 7.68; P = 0.042). SBP in patients of GP was similar to that of GCT(120.5 ± 2.85 mmHg vs. 112.5 ± 3.49 mmHg; P = NS). Conclusions: Global LV function (DI) is impaired in patients with AMI‐I. Administration of perindopril has a favorable impact on LV performance in patients with AMI‐I, achieved through improvement of the diastolic function (IRT), which indirectly improves LV systolic function (ET, DI). This beneficial influence of perindopril is the result of the direct tissue effect of the drug and not its hemodynamic action. (ECHOCARDIOGRAPHY, Volume 20, May 2003)
Right Ventricular Myocardial Adaptation to Different Training Protocols in Top‐Level Athletes
Authors: D'Andrea Antonello , Caso Pio , Sarubbi Berardo , Limongelli Giuseppe , Liccardo Biagio , Cice Gennaro , D'Andrea Luigi , Scherillo Marino , Cotrufo Maurizio , Calabrò Raffaele
Published: May 2003

Objective: The aim of this study was to analyze right ventricular (RV) myocardial function in competitive athletes with left ventricular (LV) hypertrophy induced by either endurance or strength training. Methods: Standard Doppler echo, maximal electrocardiogram (ECG) ergometric test, and pulsed tissue Doppler (TD) of LV mitral annulus and of RV tricuspid annulus were performed in 32 competitive endurance athletes (long‐distance swimmers; ATE) and in 26 strength‐trained athletes (short‐distance swimmers; ATS), all males. By use of TD, the following parameters of myocardial function were assessed: systolic peak velocities (Sm), precontraction time, contraction time, early (Em) and late (Am) diastolic velocities, Em/Am ratio, and relaxation time. Results: The two groups were comparable for age, but ATS at rest exhibited higher heart rate, systolic blood pressure, and body surface area. LV mass index did not significantly differ between the two groups. However, ATS characterized increased wall thickness and relative wall thickness, whereas LV stroke volume and both LV and RV end‐diastolic diameters were greater in ATE. All transmitral and transtricuspid Doppler indexes were higher in ATE, with increased E/A ratios. TD analysis demonstrated in ATE higher Em and Em/Am ratio as well as longer relaxation time both at mitral and at tricuspid annulus level. In the overall population, distinct multiple linear regression models evidenced independent positive association between RV peak Em velocity and LV end‐diastolic diameter (P < 0.001) as well as independent direct correlation of the same RV peak Em velocity with both LV stroke volume and maximal workload achieved by bicycle ergometer (both P < 0.001). Conclusions: Right ventricular early diastolic myocardial function is positively influenced by preload increase in athletes, and represents an independent determinant of cardiac performance during physical effort. Therefore, pulsed TD may be taken into account to distinguish different cardiac adaptation to either endurance or strength sport activities, and eventually to quantify RV adaptation degree to long‐term training. (ECHOCARDIOGRAPHY, Volume 20, May 2003)
Integrated Backscatter During Harmonic and Fundamental Frequency Imaging—Effect of Depth, Mechanical Index, and Tissue Anisotropy: Implications for Myocardial Tissue Characterization
Authors: Beaver Timothy A. , Jansujwicz Alan , Arbuckle Brenda E. , D'Sa Alwyn , Palac Robert T.
Published: May 2003

Objective: To explore the potential advantages of tissue harmonic imaging (THI) versus fundamental frequency imaging (FFI) when applied to tissue characterization. Methods: A Philips Medical Systems Sonos 5500 echocardiograph equipped with a broadband transducer (S4) and an on‐line quantitative analysis software package (Acoustic Densitometry) was used for imaging. The effect of mechanical index (MI), imaging depth, and anisotropy on relative backscatter amplitude was evaluated. Results: This study demonstrated that imaging with tissue harmonics generated relatively greater backscatter values at clinically relevant imaging depths and instrument settings referenced to FFI. This effect was dependent on MI setting. A direct relationship between backscatter amplitude and MI was demonstrated. Additionally, tissue anisotropy had similar effects on integrated backscatter amplitude during both THI and FFI. However, relative backscatter values at each fiber orientation are greater during THI at similar instrument settings when referenced to FFI. Conclusion: Tissue harmonic imaging may offer advantages over FFI for myocardial tissue characterization. (ECHOCARDIOGRAPHY, Volume 20, May 2003)
Detection of a Pseudonormal Mitral Inflow Pattern: An Echocardiographic and Tissue Doppler Study
Authors: Poerner Tudor C. , Goebel Björn , Unglaub Petra , Sueselbeck Tim , Strotmann Jörg M. , Pfleger Stefan , Borggrefe Martin , Haase Karl K.
Published: May 2003

Objective: The aim of this study was to assess the ability of several echocardiographic and tissue Doppler imaging (TDI) derived parameters to improve the noninvasive diagnosis of a pseudonormal mitral inflow pattern. Methods: Ninety‐eight consecutive patients with age‐related normal transmitral Doppler profile underwent echocardiography including TDI and measurement of left ventricular end‐diastolic pressure (LVEDP) using fluid‐filled catheters. Peak transmitral velocities were determined at rest (E, A) and during the strain phase of a Valsalva maneuver. The difference in duration between the pulmonary venous retrograde velocity and the transmitral A‐velocity (PVR–A) was calculated from pulsed Doppler recordings. Propagation velocity of the early mitral inflow (VP) was determined by color M‐mode. Early diastolic peak mitral annulus velocities (E′) and the early diastolic transmyocardial velocity gradient of the posterior basal wall (MVG) were obtained by TDI. Results: Fifty‐two patients presented with normal diastolic function (group I: LVEDP

9.5 ± 3 mm Hg

, E/A

1.1 ± 0.19

), while pseudonormalization, defined as LVEDP 15 mm Hg and E/A > 0.9, was found in 46 patients (group II: LVEDP

23 ± 7 mm Hg

, E/A

1.43 ± 0.83

). The coefficient of linear correlation (r) and the area under ROC – curve (AUC) to predict LVEDP values 15 mm Hg were maximal for the index PVR–A (

AUC = 0.92, r = 0.77

), followed by

E/E′ (AUC = 0.80, r = 0.46), MVG (AUC = 0.65, r = 0.33)

and

E/VP (AUC = 0.69, r = 0.30), P < 0.01

, whereas the decrease in E/A ratio during Valsalva maneuver failed to reach significance. Similar results were observed when echocardiographic parameters were used to estimate the left ventricular diastolic pressure before atrial contraction. Conclusions: PVR–A enabled the most accurate estimation of LVEDP. TDI‐derived indices E/E′ and MVG are also reliable alternatives superior to the classical Valsalva maneuver to detect a pseudonormal transmitral Doppler profile. (ECHOCARDIOGRAPHY, Volume 20, May 2003)
Anatomical M‐Mode: An Old–New Technique
Authors: Carerj Scipione , Micari Antonio , Trono Antonio , Giordano Guido , Cerrito Marco , Zito Concetta , Luzza Francesco , Coglitore Sebastiano , Arrigo Francesco , Oreto Giuseppe
Published: May 2003

The M‐mode (motion mode) technique has improved the diagnostic possibilities of echocardiography due to its high temporal resolution. The use of a two‐dimensional (2D) image as a basis for M‐mode analysis at a defined line, independent of the transducer orientation, namely the anatomic M‐mode (AMM), has been proposed from the beginning of 2D echocardiography. For several years, however, this could not be accomplished due to several reasons including the limited digital memory, the relatively rough pixels of 2D images, and the low temporal resolution of the screen. The AMM has been improved by the “fully digital” machines. These are able to provide a series of digital data (direction, position, and timing) relative to any single echo received from any point of the tissue. AMM analysis, thus, can be performed in any direction, as a “normal” monodimensional echocardiogram. With respect to traditional M‐mode, AMM permits a more detailed analysis of cardiac chambers diameters obtained by linear measurements, regional wall motion of the left ventricle (both at rest and during stress), and location of accessory pathways. In particular, the assessment of left ventricular regional wall motion represents the most important goal of this new technique, which results in marked reduction or even elimination of the limitations due to the subjective character of wall motion evaluation with 2D echocardiography. (ECHOCARDIOGRAPHY, Volume 20, May 2003)
Mobile Components Associated With Rapidly Developing Mitral Annulus Calcification in Patients With Chronic Renal Failure: Review of Mobile Elements Associated With Mitral Annulus Calcification
Authors: Willens Howard J. , Ferreira Alexandre C. , Gallagher Anthony J. , Morytko John A.
Published: May 2003

Mitral annulus calcification may directly cause cerebrovascular accidents by serving as a source of calcific or thrombotic emboli. This hypothesis has been supported by recent reports of mobile components associated with mitral annulus calcification detected by echocardiography. Cardiovascular calcifications, including mitral annulus calcification, are common in end‐stage renal disease and may develop and progress over a short period of time. We report two patients with mobile components associated with mitral annulus calcification and end‐stage renal disease. Serial echocardiography documented that the mitral annulus calcification in these two patients had developed rapidly. Follow‐up echocardiography in one patient demonstrated resolution of the mobile elements. (ECHOCARDIOGRAPHY, Volume 20, May 2003)
Eosinophilic Heart: Marked Left Ventricular Wall Thickening and Myocardial Dysfunction Improving With Corticosteroid Therapy
Authors: Adsett Michael , West Malcolm J. , Galbraith Andrew , Duhig Edwina , Lange Aleksandra , Palka Przemyslaw
Published: May 2003

We report a case of a 34‐year‐old male with acute severe heart failure associated with marked concentric left ventricular wall thickening and biopsy evidence of eosinophilic myocardial infiltrate. This appears to be an unusual description of this degree of concentric myocardial thickening in eosinophilic myocarditis coupled with Doppler tissue echocardiography. Following high‐dose corticosteroid treatment, wall thickness, systolic and diastolic left ventricular function normalized and the patient experienced a dramatic clinical improvement. (ECHOCARDIOGRAPHY, Volume 20, May 2003)
Pulmonary Artery Dissection: Echocardiographic Findings and Diagnosis
Authors: Areco Daniel , Pizzano Nelson
Published: May 2003

Pulmonary artery dissection is a rare but life‐threatening event, predisposing to sudden cardiac death or cardiogenic shock. It is often associated with underlying congenital disorders predisposing to pulmonary hypertension. Rarely, it is diagnosed by echocardiography or other image techniques. We present a case report of a pulmonary artery dissection, diagnosed primarily by echocardiography. The patient died soon after refusing any interventional approach after a short period under medication. (ECHOCARDIOGRAPHY, Volume 20, May 2003)
Noncompaction of the Ventricular Myocardium: Report of Two Cases With Bicuspid Aortic Valve Demonstrating Poor Prognosis and With Prominent Right Ventricular Involvement
Authors: Cavusoglu Yuksel , Ata Necmi , Timuralp Bilgin , Gorenek Bulent , Goktekin Omer , Kudaiberdieva Gulmira , Unalir Ahmet
Published: May 2003

Noncompaction of the ventricular myocardium is a rare, unclassified cardiomyopathy due to an arrest of myocardial morphogenesis. The characteristic echocardiographic findings consist of multiple, prominent myocardial trabeculations and deep intertrabecular spaces communicating with the left ventricular (LV) cavity. The disease typically involves the LV myocardium, but right ventricular (RV) involvement is not uncommon. The clinical manifestations include heart failure (HF) signs, ventricular arrhythmias and cardioembolic events. Noncompacted myocardium may occur as an isolated cardiac lesion, as well as it can be in association with congenital anomalies. We describe two illustrative cases of noncompaction of the ventricular myocardium, a 19‐year‐old male with bicuspid aortic valve and progressive worsening of HF, and a 61‐year‐old male with marked RV involvement in addition to LV apical involvement, both with the typical clinical and echocardiographic features of the disease. (ECHOCARDIOGRAPHY, Volume 20, May 2003)
Contrast Transesophageal Echocardiographic Detection of a Pulmonary Arteriovenous Malformation Draining Into Left Lower Pulmonary Vein
Authors: Ahmed Sujood , Nanda Navin C. , Nekkanti Rajasekhar , Yousif Abdalla M.
Published: May 2003

We report the identification of a pulmonary arteriovenous malformation draining into the left lower pulmonary vein by contrast two‐dimensional transesophageal echocardiography in an adult with no evidence of hereditary hemorrhagic telangiectasia. To our knowledge, this has not been reported previously. This study also emphasizes the importance of transesophageal echocardiographic examination of the left lower pulmonary vein in the detection of a pulmonary arteriovenous malformation. (ECHOCARDIOGRAPHY, Volume 20, May 2003)
Transesophageal Echocardiographic Identification of Bilateral Vertebral Artery Ostial Stenosis
Authors: Ahmed Sujood , Nekkanti Rajasekhar , Nanda Navin C. , Gomez Camilo R.
Published: May 2003

We describe the usefulness of transesophageal echocardiography in correctly diagnosing severe ostial stenosis of both the left and right vertebral arteries in an adult patient. Although transesophageal echocardiography has been previously used to identify left vertebral artery stenosis, to our knowledge this study represents the first demonstration of its usefulness in detecting bilateral vertebral artery ostial stenosis. (ECHOCARDIOGRAPHY, Volume 20, May 2003)
Magnetic microstructure of Fe84Nb7B9 alloys observed by electron holography
Authors: Gao Youhui , Shindo Daisuke , Bitoh Teruo , Makino Akihiro
Published: May 2003

The microstructure, magnetic properties and magnetic structure of crystallized Fe84Nb7B9 samples are studied in this article. It is found that the size of the body-centered-cubic Fe crystallites is independent of the annealing temperature. The volume fraction of the amorphous phase decreases with an increase in annealing temperature and iron boride precipitates form at temperatures over 973 K. Excellent soft magnetic properties are obtained in the sample annealed at 923 K which has large uniform domains with smooth and straight walls, whereas precipitates of Fe boride in the sample annealed at 973 K degrade the magnetic softness. Their magnetization processes are pure magnetization rotation dominated by uniaxial anisotropy. The thick amorphous phase matrix and strong internal stray field in the sample annealed at 773 K lead to a magnetic ripple structure. The domain wall movement is strongly pinned by anisotropy fluctuations. The longitudinal wavelength of the magnetic ripples increases with a decrease in temperature, and disappears at temperatures below 230 K.
Quantum Monte Carlo simulation of two-dimensional S=1/2 antiferromagnets with very weak easy-plane anisotropy
Authors: Cuccoli Alessandro , Roscilde Tommaso , Tognetti Valerio , Vaia Ruggero , Verrucchi Paola
Published: May 2003

We study the critical and thermodynamic properties of an S=1/2 two-dimensional quantum XXZ antiferromagnet with weak easy-plane anisotropy using the continuous-time quantum Monte Carlo method based on the loop-cluster algorithm. A detailed finite-size scaling analysis reveals that the model displays a finite temperature Berezinskii–Kosterlitz–Thouless (BKT) transition for anisotropy as small as 10−3, the dominant isotropic coupling. For larger anisotropy (10−2) we single out relevant features of anisotropic behavior that anticipate the BKT transition. Implications for experimental observation of a BKT phase in real magnets are discussed.
Microstructure, microchemistry, and magnetic properties of melt-spun Sm(Co,Fe,Cu,Zr)z magnets
Authors: Yan A. , Gutfleisch O. , Handstein A. , Gemming T. , Müller K.-H.
Published: May 2003

The evolution of the microstructure, microchemistry, and magnetic properties during slow cooling of melt-spun Sm(Co,Fe,Cu,Zr)z magnets was investigated. It was found that uniform cellular and lamellar structures are formed upon isothermal aging the as-spun ribbons at 850 °C for 3 h, without subsequent slow cooling. No microstructural changes and no obvious difference in the Cu content in the 2:17 matrix phase were observed after slow cooling but the coercivity was significantly enhanced from 0.32 to 3 T. A large gradient of the Cu content in the cell boundary phase was detected in the highly coercive melt-spun Sm(Co,Fe,Cu,Zr)z ribbons with slow cooling by nanoprobe chemical analysis, in contrast to a homogeneous Cu distribution in the cell boundary phase of the ribbons without slow cooling. Further investigation revealed that a spinodal structure is developed in the Cu-rich Sm(Co,Cu)5 cell boundary phase of 2:17 SmCo magnets during slow cooling and the high coercivity of the 2:17 type magnets could result from the large gradient of domain wall energy within the cell boundary phase.
Magnetic properties of (Nd,Pr,Dy)2Fe14B/α-Fe nanocomposite magnets crystallized in a magnetic field
Authors: Cui B. Z. , Huang M. Q. , Yu R. H. , Kramp A. , Dent J. , Miles D. D. , Liu S.
Published: May 2003

The effect of applying a magnetic field during the crystallization process of a melt-spun Nd2.4Pr5.6Dy1Fe85B6 alloy on the nanostructure, crystallographic texture, exchange coupling, and magnetic properties has been studied. Compared with samples annealed without magnetic field, there was a noticeable improvement in the intrinsic coercivity Hci, the remanence Br, and the maximum magnetic energy product (BH)max for Nd2.4Pr5.6Dy1Fe85B6 alloys annealed in a 12 kOe field. The magnetic performance improved with an increase in the magnetic fields applied up to 9 kOe. Crystallographic alignment and magnetically anisotropic behavior were found in the samples crystallized in the magnetic field. The improvement in magnetic properties after magnetic crystallization is considered to be the result of both magnetic-field-induced crystallite alignment and enhanced exchange coupling due to a reduction of grain size.
Spin-torque transfer in batch-fabricated spin-valve magnetic nanojunctions (invited)
Authors: Sun J. Z. , Monsma D. J. , Kuan T. S. , Rooks M. J. , Abraham D. W. , Oezyilmaz B. , Kent A. D. , Koch R. H.
Published: May 2003

A two terminal spin-injection device is fabricated using a nanostencil process with a Co–Cu–Co stack. The stack can be deposited both by sputtering and by electron-beam evaporation. A better edge definition is observed in evaporation-deposited films under cross section transmission electron microscopy. Both methods succeeded in producing junctions with sub-100 nm lateral dimensions and show spin-injection-induced magnetic switching.
Magnetic monitoring of the hydrogenation-decomposition-desorption-recombination process in SmFe-based alloys
Authors: McGuiness P. J. , Žužek K. , Podmiljšak B. , Kobe S.
Published: May 2003

A clear understanding of the reactions and phase changes that occur during the processing of a material is vital if we want to be able to achieve the best properties. In this series of experiments we have used a vibrating-sample magnetometer (VSM) to monitor the magnetic state of compacted powder samples of Sm13.7Fe86.3 and Sm13.8Fe82.2Ta4.0 during a standard hydrogenation-disproportionation-desorption-recombination (HDDR) cycle. The samples were mounted in the VSM and heated at 4 °C/min in 1 bar of flowing hydrogen to 750 °C, they were then held for 60 min under hydrogen and approximately 120 min under a vacuum before being cooled to room temperature under a vacuum at 4 °C/min. The results show that the initial absorption of hydrogen by the Sm2Fe17-type phase results in an increase in magnetization as well as TC. At higher temperatures, the disproportionation reactions of the Sm13.7Fe86.3 and Sm13.8Fe82.2Ta4.0 materials were observed to proceed at a faster rate for the second and third cycles of the HDDR procedure than for the first. The results are in agreement with our previous transmission electron microscopy studies, which showed that much of the Ta that was initially dissolved in the Sm2Fe17-type phase of the cast Sm13.8Fe82.2Ta4.0 material was reformed as Ta-based precipitates after a single HDDR cycle leaving the Sm2Fe17-type phase with much less dissolved Ta.
Phase transition, thermodynamic properties, and microstructure of Fe–Pt based alloys
Authors: Thang P. D. , Brück E. , Buschow K. H. J. , de Boer F. R.
Published: May 2003

The kinetics of the face-centered-cubic to face-centered-tetragonal phase transition in Fe59.7Pt39.8Nb0.5 and Fe59.85Pt39.9Al0.25 alloys was studied using data of differential-scanning calorimetry in conjunction with the Johnson–Mehl–Avrami model. The results show that in the Nb-containing alloy, the transition includes both nucleation and growth processes. In the Al-containing alloy, the growth process is dominant during the transition. These differences can be related to the microstructure of the studied alloys.
Exchange coupling in epitaxial Sm–Co(11̄00)/Nd–Co exchange-spring bilayers
Authors: Guo Z. J. , Jiang J. S. , You C. Y. , Vlasko-Vlasov V. K. , Welp U. , Liu J. P. , Bader S. D.
Published: May 2003

We have studied the exchange coupling behavior of the epitaxial Nd–Co(11̄00)/Sm–Co exchange-spring bilayers. A shifted and asymmetric magnetic hysteresis loop of Nd–Co was recorded at room temperature with the exchange field Hex=−625 Oe. The magnitude of Hex increases with increasing temperature from 300 to 350 K, which is due to the temperature-dependent magnetic anisotropy of the Nd–Co layer, and decreases with decreasing temperature because of the spin reorientation of the Nd–Co layer around 250 K. The coercive field of the pinned Nd–Co(1000 Å) layer was not varied systematically by exchange coupling, compared with that of the free single layer. The temperature dependence of Hex above 300 K has been simulated using a one-dimensional model. The result suggests that one can enhance Hex, hence, the maximum size of the soft phase for the effective exchange-spring coupling, by tailoring the magnetic anisotropy of the soft phase.
Modeling the magnetic properties of DyFe2/YFe2 superlattices
Authors: Bowden G. J. , Beaujour J.-M. L. , Zhukov A. A. , Rainford B. D. , de Groot P. A. J. , Ward R. C. C. , Wells M. R.
Published: May 2003

The Stoner–Wohlfarth model has proved reasonably successful in describing the coercivities of antiferromagnetically coupled DyFe2/YFe2 hard/soft superlattices in the absence of magnetic exchange springs. In particular, the coercivity rises sharply as the net magnetic moment of the superlattice approaches zero. However the situation becomes more complicated as the thickness of the YFe2 layers is increased. Two distinct “instability fields” can be identified: the bending field BB, signifying the onset of a magnetic exchange spring, and the irreversible switching field BIS associated with magnetic reversal. We have developed a computational model to address this problem. In particular, it is shown that the two instability fields in question are characterized by vanishing eigenvalues in the matrix formed by the double energy derivatives ∂2E/∂θi∂θj, where E is the total energy and θi the angle of each individual monolayer. It is shown that the model provides a very good description of the M–Bapp loops of DyFe2/YFe2 multilayer films. In particular, the coercivity of a nearly magnetically compensated multilayer (75 ÅDyFe2/150 ÅYFe2) is much reduced below the prediction of the Stoner–Wolhfarth model, in accord with experiment.