bluuebunny/crossref_metadata_2025_split huggingface dataset:
Selective coronary angiography in tetralogy of Fallot
Authors: Sharma Satyavan , Sundaram Usha , Loya Yunus , Desai Dhruman 
Published: August 2008

SummarySelective coronary angiography was performed in 110 cases (aged 1–45 years) of tetralogy of Fallot. Anomalies of surgical importance were seen in 26 cases (23.6%). In 17 (15.4%) these anomalies existed alone, and in nine (8.2%) they coexisted with relatively minor anomalies. Isolated minor anomalies involving the terminal branches existed in 15 cases (13.6%). The coronary arterial anatomy was normal in the other 69 (62.7%) cases. Our study shows that coronary angiography can safely be performed in patients with tetralogy of Fallot, providing the surgeon with vital information for subsequent planning of the time and type of surgery required.
New imaging modalities in absent pulmonary valve syndrome
Authors: Fletcher Scott E. , Greene Craig A. , Wiles Henry B. 
Published: August 2008

AbstractTetralogy of Fallot with absence of the leaflets of the pulmonary valve is often complicated by marked respiratory involvement. Newer imaging modalities such as magnetic resonance imaging and color Doppler echocardiography underscore the inter-relationship of the cardiorespiratory systems in this disorder.
Divided left atrium with absence of the interatrial septum in monozygotic twins
Authors: Cochrane Andrew D. , Menahem Samuel , Mee Roger B.B. 
Published: August 2008

AbstractDivision of the left atrium is a rare congenital lesion, but one which is amenable to complete surgical correction. We describe twin brothers, demonstrated to be monozygotic, who presented in infancy with cardiac failure, pulmonary congestion and mild cyanosis. Both were found to have systemic and pulmonary venous return to a common atrial chamber, separated from the left atrial appendage and the vestibule supporting the mitral valve by a typical muscular diaphragm with a single small orifice. In one twin, there was also persistence of the left superior caval vein, while, in the other twin, a remnant of the primary atrial septum was present. Excision of the diaphragm and neoseptation of the atrial chambers was performed in both infants. At 10 years after surgery, there was normal growth and development in both twins, with no evidence of recurrent obstruction.
Vertebral arterial steal following surgical repair of neonatal coarctation
Authors: Sreeram Narayanswami , Brown Christopher , Walsh Kevin 
Published: August 2008

AbstractA five day old infant underwent repair of coarctation by resection and end-to-end anastomosis of the proximal and distal segments of the arch. Four weeks later, cross-sectional Doppler echocardiography showed a tight recoarctation proximal to the origin of the left subclavian artery. A dilated proximal left subclavian artery was demonstrated, with continuous flow from it into the descending aorta. These findings were confirmed at catheterization. This “vertebral arterial steal” disappeared following transcatheter balloon angioplasty.
Total correction of tetralogy of Fallot with pulmonary atresia associated with an unusual aortopulmonary collateral artery
Authors: Hashimoto Kazuhiro , Kurosawa Hiromi , Tatara Akira 
Published: August 2008

SummaryWe report a patient with tetralogy of Fallot and pulmonary atresia who displayed an atypical aortopulmonary collateral artery extending from the ascending aorta to the pulmonary trunk. The internal thoracic artery, instead of the right subclavian artery (which was aberrant), was used as the source ofblood during unifocalization of the right pulmonary arteries to avoid the potential formation of a vascular ring. Unifocalization in the left lung was carried out by enlargement with a patch of the previously stenotic Blalock-Taussig shunt. The palliation set the scene for final intracardiac repair achieved one month after unifocalization of the right sides. The postoperative course was good and uneventful.
The application of transthoracic dynamic three-dimensional echocardiography by computer-controlled parallel slicing in patients with fixed subaortic obstruction
Authors: Vogel Michael , Lösch Shideh , Bühlmeyer Konard 
Published: August 2008

AbstractA 64-element phased-array echocardiographic transducer mounted on a sliding carriage was used transthoracically in 11 patients with subaortic obstruction caused by various different morphological substrates. The transducer is moved in a plane from the outflow tract to the apex of the heart in steps of 0.5 to 1.3 mm and records a tomographic slice of the heart at each step. Parallel images are recorded at a frame rate of 25–30 images per second and triggered to heart rate and respiration. A complete cardiac cycle is recorded at each level. The images are digitized and stored in the image-processing computer, which reconstructs the anatomic structures of the heart in a three-dimensional format by means of different gray-scales. Good quality echocardiographic pictures were obtained in 10 of the 11 patients and three-dimensional reconstructions were possible in those 10 patients. The technique is able to display the heart in real-time in any desired plane, and in up to five planes simultaneously, without the need to change the position of the transducer on the chest. Thus the best views with which to display the substrate of subaortic stenosis could be selected. The left ventricular outflow tract could also be displayed in a view similiar to the one obtained by the surgeon during operative procedures for resection of the subaortic stenosis through an incision in the aortic root. Image acquisition took three to five minutes, and three-dimensional reconstruction of various cardiac structures took 20–90 minutes. Display of the subaortic area in three-dimensional format may enhance our understanding of cardiac anatomy and identify the different morphological lesions in the left ventricular outflow tract which cause subaortic obstruction.
Sizes of the descending aorta and pulmonary arteries in infants with atrioventricular septal defects
Authors: Ahn Jae H. , Knott-Craig Christopher J. , Elkins Ronald C. , Lane Mary M. , Overholt Edward D. , Ward Kent E. , Razook Jerry D. 
Published: August 2008

AbstractThe descending aorta appears small relative to unusually large pulmonary arteries in infants with atrioventricular septal defects. To determine whether this discrepancy in great arterial size influences the outcome after repair of atrioventricular septal defects, we reviewed our experience with 34 infants younger than one-year-old undergoing primary repair. There were four early deaths (11.8%), one in 16 patients with normal chromosomes (6.3%), and three of 18 with Down's syndrome (16.7%). There was no difference between survivors and non-survivors in terms of either the size of the aorta at the level of the diaphragm (descending aortic index, 149±34 versus 139±46 mm2/m2), the pulmonary arterial index (675±170 versus 745±182 mm2/m2), or the ratio of the descending aorta to the pulmonary trunk arterial (4.85±1.6 versus 5.93±2.8). Compared with survivors, non-survivors had higher ratios of vascular resistance (0.48±0.42 versus 0.23±0.14, p<0.05), and tended to have larger preoperative cardiothoracic ratios (0.63±0.05 versus 0.55±0.08, p=0.12) Compared to patients with normal chromosomes, the patients with Down's syndrome tended to have smaller descending aortas (140±34 versus 159±34 mm2/m2, p=0.12), higher ratios of vascular resistance (0.32±0.2 versus 0.18±0.1, p=0.08), and higher mean pulmonary arterial pressures (47±11 versus 39±18 mm Hg, p=0.12), suggesting that pulmonary vascular obstructive disease may be more severe in patients with Down's syndrome. The size of the descending aorta and pulmonary arteries do not influence outcome after repair of atrioventricular septal defect in infants.
Divided left atrium (cor triatriatum sinistrum) presenting with syncope
Authors: Camerieri Angelo , Pongiglione Giacomo , Bertolini Alberto 
Published: August 2008

SummarySyncope has never been described as the presenting symptom of divided left atrium (cor triatriatum sinistrum). We have now encountered this mode of presentation in an otherwise asymptomatic patient. An upright tilt test elicited syncope prior to surgical correction, but failed to induce any symptom, even subsequent to infusion of isoproterenol, after surgery.
Tetralogy of Fallot with coarctation of the aorta
Authors: Yoshigi Masaaki , Momma Kazuo , Imai Yasuharu 
Published: August 2008

SummaryWe report a two-year-old boy with a rare combination of tetralogy of Fallot and aortic coarctation. The obstruction in this patient had an hourglass-like configuration, with a pressure difference of 15 mm Hg. There was a right aortic arch, bilateral brachiocephalic arteries, and persistent left superior caval vein. Percutaneous transluminal balloon angioplasty was performed to lower the resistance to the left ventricular ejection, considered a risk factor for subsequent corrective surgery of tetralogy. Six months later, he underwent combined repair of tetralogy of Fallot and coarctectomy with end-to-end anastomosis, thus avoiding the future potential for restenosis. During surgery, a ligament was found extending from the right subclavian artery to the distal side of the coarctation. The perioperative course was uneventful, indicating the success of the preoperative balloon angioplasty. We speculate that the embryogenesis of the coarctation could be related to an abnormal involution of the aortic arches.
Endocarditis in the young
Authors: Al Jubair Khalid , Al Fagih Mohamed R. , Al Yousef Saad , Ali Khan Mohamed A. , Sawyer William 
Published: August 2008

AbstractBetween February 1980 and February 1992, 28 children (17 males and 11 females) were treated for endocarditis on congenital cardiac lesions, most commonly the mitral valve (32%). Their ages ranged between four months and 14 years (mean 8.2 years). The most common infecting organism (in 25% of patients) was Staphylococcus aureus. Patients were divided into two groups. In the first, made up of eight patients, cardiac surgery was undertaken within one week of the start of antibiotic therapy. The second group of 20 patients was further divided into a group of seven patients who underwent surgery during the initial, active stage of endocarditis because of failure of medical management and a group of 13 patients who initially received antibiotic therapy alone. In this last group, three infections with the same organism recurred within two months and surgical intervention was necessary in the active phase of the recurrence. Subsequently, surgery for “healed” endocarditis was undertaken in three more patients. Mortality in the 21 patients undergoing surgery was 19%—one of eight (12.5%) in those undergoing surgery within one week of starting treatment and two of 10 in the remaining patients. Overall, three patients (15%) died from those in whom surgery was not undertaken within one week of the start of treatment. There were also fewer pre- and postoperative complications as well as a lower mortality rate in those undergoing early surgery. We conclude that early surgical intervention, in our hands, is the most appropriate management for endocarditis in congenital cardiac lesions.
Echocardiographic assessment of left ventricular function at rest and during exercise in postoperative patients with tetralogy of Fallot
Authors: Norgård Gunnar , Andersen Kai , Vik-Mo Harald 
Published: August 2008

AbstractDigitized M-mode echocardiograms of left ventricular function were obtained in 34 patients subsequent to surgical repair of tetralogy of Fallot and in 34 healthy subjects at rest. In 16 patients and 16 controls, studies were also made during submaximal semisupine bicycle exercise. At rest, the peak ejection rate and fractional shortening were slightly reduced in the patients, whereas peak filling rate was comparable in patients and controls. Pulmonary regurgitation did not seem to influence left ventricular function. During exercise, however, peak filling rate was reduced in the patients compared to the healthy subjects. At peak exercise, the peak filling rates were 27.8±6.3 cm•s−1 and 34.1±3.4 cm•s−1 in patients and controls, respectively (p<0.01). No differences were found in heart rate, fractional shortening, peak ejection rate or blood pressures between patients and controls throughout the exercise test. When the subjects were subdivided by median age, the oldest patients had reduced normalized peak filling rates throughout the exercise test, whereas no differences were found between younger and older healthy subjects. Thus, it is suggested that the reduced left ventricular peak filling rate found during exercise is caused by subclinical myocardial dysfunction which seems to be related to myocardial protection at surgery and the period of follow-up.
Reconstruction of the mitral valve in children— long-term follow-up in 63 cases
Authors: Attie Fause , Zabal Carlos , Juárez Alejandro , Buendía-Hernández Alfonso , Barragán Rodolfo , Calderón Juan , Mini-Miranda Miguel 
Published: August 2008

SummaryBetween June 1985 and June 1991, 63 children underwent surgical reconstruction of the mitral valve for rheumatic (46 cases), congenital (12 cases) and myxoid (five cases) disease. The ages ranged from two to 18 years (mean 14.1±3.7 years). Valvar dysfunction was classified according to its pathophysiological abnormalities. A group of four cases presented with regurgitation secondary to lesions located in the valvar structures but with normal motion of the leaflets. In a second group of 14 cases, mitral regurgitation was due to prolapsed leaflets because of lesions located mainly in the subvalvar structures. A third group was formed by 35 patients with mitral regurgitation with restricted motion of the leaflets due to lesions in the valvar and subvalvar structures. The final group, of 10 cases, presented with mitral stenosis. The overall surgical mortality rate was 4.7% (3/63), and follow-up data were available in all survivors from one to 96 months (mean 33.4±25.4). Four cases underwent reoperation due to residual incompetence, one case due to bacterial endocarditis, and two more are scheduled for replacement of the valve due to unfavorable evolution, giving an overall rate of reoperation of 4.3% per patient/year. One patient died in the period following valvar replacement (late mortality rate of 0.6% per patient/year). Thromboembolism occurred in four cases in the absence of anticoagulation; three of them were in atrial fibrillation (late thromboembolic rate 2.4% per patient/year). Prior to surgery, 28 cases were in functional class II of the New York Heart Association, 34 patients were in class III and one patient in class IV. At the end of the follow-up period, 49 patients were in class I, seven in class II and four in functional class III (p<0.0001). The cardiothoracic ratio before surgery ranged from 0.40 to 0.81 (mean 0.60±0.07) and, after surgery, the values ranged from 0.40 to 0.79 (mean 0.55±0.07) (p<0.0001). Randomized late echocardiographic evaluation in 24 cases revealed residual mild mitral regurgitation in 20 cases, moderate in two and severe in two. The latter are scheduled for valvar replacement. There were no significant differences in the surgical results among the four groups. Reconstruction of the mitral valve, therefore, provides stable functional results with low surgical and late mortality, as well as an acceptable rate of reoperation irrespective of the lesions of the valvar apparatus.
Transcatheter closure of the patent arterial duct as a day-case procedure
Authors: Galal Omar , Abbag Fuad , Fadley Fadel , Redington Andrew , Szurman Peter , Oufi Saud 
Published: August 2008

AbstractWe have now achieved transcatheter occlusion of the patent arterial duct as a day-case procedure in 26 patients. In all but two, who were judged not to be appropriate for the device, implantation was successful. Most of the patients arrived in the hospital at 8:00 a.m. and had to wait for a mean time of 154 minutes until they were taken for cardiac catheterization. The procedure, performed under sedation in 25 patients and under general anesthesia in two, took a mean of 91 minutes. The children were then monitored for two hours in the recovery room. The interval From the time of arrival in the Unit until waking was a mean of 196 minutes. Then, from the time of waking, a mean of 123 minutes elapsed prior to discharge. Admission of the patient was necessary in three instances (11.1%). Two patients vomited and remained too drowsy for safe discharge. A third patient had either occlusion or thrombosis of the femoral artery and received an infusion of heparin which necessitated admission overnight. All three patients were discharged the following morning. Patients from outside Riyadh stayed overnight in Riyadh before they went home. One patient complained of non-cardiac chest pains a few hours after discharge and was subsequently sent home. Total occlusion, as judged by mean follow-up of 13 months (5–26 months) using color flow Doppler was achieved in 19 of the 24 patients (79!) in whom devices were inserted. All patients are well and there are no complaints concerning the procedure done on a day-case basis. We conclude that the day-case protocol for transcatheter occlusion of the patent arterial duct is a safe and cost-effective option for selected patients.
Nitric oxide given via a head-box for persistent neonatal pulmonary hypertension
Authors: Martin Paul H. , Sreeram Narayanswami , Petros Andy J. 
Published: August 2008

AbstractA neonate presenting with persistent pulmonary hypertension and severe hypoxemia was treated with nitric oxide administered into a head-box. Improvement of clinical, biochemical and echocardiographic parameters were observed during therapy, suggesting an acute decrease of pulmonary arterial pressure. It is feasible to administer nitric oxide to non-ventilated neonates provided all recommended safety precautions are observed
The trilogy of double-chambered right ventricle, perimembranous ventricular septal defect and subaortic narrowing—a more common association than previously recognized
Authors: Ward Cameron J. B. , Culham J. A. Gordon , Patterson Michael W. H. , Sandor George G. S. 
Published: August 2008

AbstractThe records of nine patients with double-chambered right ventricle, ventricular septal defect and subaortic narrowing were reviewed to clarify the natural history of the components of this pathological combination. All nine patients presented with heart failure related to a perimembranous ventricular septal defect, which underwent spontaneous reduction in eight and closed in one. Echocardiographic diagnoses of double-chambered right ventricle and subaortic narrowing were delayed in eight of the nine cases. The ratio of the distances from the pulmonary valve to moderator band/tricuspid valve annulus (the displacement index) was less than one in all patients. Subaortic narrowing was always discrete and was present at the diagnosis of double-chambered right ventricle. The subaortic narrowing was always recognized echocardiographically, and was seen in eight of nine patients at angiography. The subaortic gradient was 0–20 mm Hg and the subpulmonary gradient 0–110 mm Hg at catheterization. Five patients demonstrated aortic regurgitation. Subaortic narrowing should be diligently sought among patients with double-chambered right ventricle, and vice versa, even in the absence of a ventricular septal defect which may have closed. Both the subaortic narrowing and subpulmonary obstruction may progress, but probably at different rates. Patients with a perimembranous ventricular septal defect, particularly with a displacement index of less than one, should be monitored carefully for evolving subpulmonary obstruction, subaortic narrowing and aortic regurgitation. The subpulmonary obstruction should be resected at the time of any other surgical intervention. The indications for resection of the subaortic narrowing remain ill-defined.
The crystal structure of rabbit IgG-Fc
Authors: Girardi Enrico , Holdom Mary D. , Davies Anna M. , Sutton Brian J. , Beavil Andrew J. 
Published: September 2008

We report the structure of the Fc fragment of rabbit IgG at 1.95 Å (1 Å=0.1 nm) resolution. Rabbit IgG was the molecule for which Porter established the four-chain, Υ-shaped structure of the antibody molecule, and crystals of the Fc (‘Fragment crystallisable’) were first reported almost 50 years ago in this journal [Porter, R. R. (1959) Biochem. J. 73, 119–126]. This high-resolution analysis, apparently of the same crystal form, reveals several features of IgG-Fc structure that have not previously been described. More of the lower hinge region is visible in this structure than in others, demonstrating not only the acute bend in the IgG molecule that this region can mediate, as seen in receptor complexes, but also that this region has a tendency to adopt a bent structure even in the absence of receptor. As observed in other IgG-Fc structures, the Cγ2 domains display greater mobility/disorder within the crystals than the Cγ3 domains; unexpectedly the structure reveals partial cleavage of both Cγ2 intra-domain disulphide bonds, whereas an alternative conformation for one of the cysteine residues in the intact bridge within the more ordered Cγ3 domains is observed. The N-linked oligosaccharide chains at Asn297 are well-defined and reveal two alternative conformations for the galactose units on each of the α(1–6)-linked branches. The presence of this galactose unit is important for stabilizing the structure of the entire branched carbohydrate chain, and its absence correlates with the severity of autoimmune conditions such as rheumatoid arthritis in both human clinical studies and in a rabbit model of the disease. Rabbit IgG, through this high-resolution structure of its Fc region, thus continues to offer new insights into antibody structure.
Peer review and its contribution to manuscript quality: an Australian perspective
Authors: LU Yanping 
Published: September 2008

ABSTRACTJournal reviewers' understanding and expectations of peer review, their incentives to take on the task, and the reasons why they sometimes declined were explored through a questionnaire survey, with particular attention to potential differences between education, physics, and chemistry. Eighty‐four senior researchers from 27 Australian universities, who had served as reviewers in education, physics, and chemistry, returned a completed questionnaire. There were significant variations in reviewers' expectations and understanding of reviewing, mostly related to seniority rather than discipline. They valued peer review as a way of maintaining the quality of science publications, and were generally satisfied with the current system; their impression of peer review's effectiveness was significantly correlated with their own experience. They saw reviewing as a professional obligation and part of their personal professional development. The most frequently mentioned reasons for declining to review were lack of expertise and lack of time.
Pricing and other means of charging for scholarly journals: a literature review and commentary
Authors: KING Donald W. , ALVARADO‐ALBERTORIO Frances M. 
Published: September 2008

ABSTRACTThere has been a clear upward trend over the past 50 years in traditional listed print subscription prices. The more recent trend towards electronic publishing has made possible new ways of charging for journals, such as differential pricing structures and bundling of journals which are purchased through license fees/charges (both of which enable libraries to buy significantly more journals, but at the same time make it more difficult to analyze prices). We are now also seeing a new emphasis on the ‘author‐side payment’ model. This article analyzes pricing and charging policies and trends, illustrating how these are affected by the complexities of the evolving journal system.