Improved exercise tolerance following enhanced external counterpulsation: cardiac or peripheral effect?

Tissue damage, inflammation and necrosis are hallmarks of myocardial infarction. In the present study significant elevations of serum alpha-1-antitrypsin were noted in coronary artery disease and angina cases. Interestingly chronic rheumatic heart disease which is also characterized by tissue injury. Inflammation revealed normal levels of serum alpha-1-antitrypsin. The level in chronic rheumatic heart disease was 3.37 +/- 0.57 mumol/mt/ml (control level was 3.37 +/- 0.54 mumol/mt/ml). The corollary of these observations is that in heart diseases acute phase response in terms of enhanced levels of alpha-1-antitrypsin differ depending on the causative factors. Except chronic rheumatic heart disease, in all other stressful states studied there is (to a certain degree) an altered systemic homeostasis and haemostasis. On the other hand chronic rheumatic heart disease encompass certain amount of acute phase status in terms of tissue damage and inflammation does exist unaccompanied by altered systemic homeostasis and haemostasis. However, bacteriological etiologies predominate the triggered immune responses. It is hypothesised that serum alpha-1-antitrypsin enhancement will not occur even though acute phase state exists if specific immune responses are also a part of the disease manifestation.     

Similarities in coronary flow between external counterpulsation and intra-aortic balloon pumping

The ability of external counterpulsation (Cardiassist) and intra-aortic balloon pumping (AVCO) to influence collateral coronary blood flow in ischemic myocardium was measured in anesthetized dogs. Cardiac output and heart rate (atrial pacing) were held constant on right-heart bypass. Both external counterpulsation and balloon pumping augmented peak diastolic pressure (30 mmHg and 38 mmHg, respectively), while mean aortic pressure, peak left-ventricular pressure, left-ventricular end-diastolic pressure, maximum left-ventricular dp/dt, hematocrit, and osmolality remained unchanged. Regional coronary blood flow was measured using 9-mum radioactive microspheres. External counterpulsation and balloon pumping begun immediately following ligation of the left-anterior descending coronary artery significantly increased collateral coronary blood flow 29 +/- 7.5% (SE, P is less than .01) and 20 +/- 8% (P is less than .05), respectively, to ischemic myocardium. This redistribution of collateral coronary blood flow produced by both methods of counterpulsation was primarily to the subepicardial region of the ischemic myocardium. The mechanism responsible for the measured increases in collateral coronary blood flow appears most likely to be an increased pressure gradient produced by diastolic augmentation.     

Are intra-aortic ballon pumping and external counterpulsation effective in the treatment of cardiogenic shock?

The epithelial cells of the midgut in 1-40 day old adult female houseflies were examined by electron microscopic X-ray microalnalytic and histochemical techniques in order to study the mode of genesis, chemical nature and age-associated distribution of dense bodies. Dense bodies contain high concentration of phosphorus sulphur, chlorine, calcium, iron and copper; they are therfore termed concretions. Concretionary material is initially deposited within Golgi vesicles, lamellar bodies and residual bodies. The average size of the concretion granules and the concentration of the sequestered material increases with age, while new concretions are continually formed throughout life. With advancing age, concretions accumulate in the epithelial cells and occupy a considerable proportion of the cytoplasm in old flies. It is postulated that the concretions sequester superfluous minerals and may play an important role in the excretory system of the adult housefly.     

Living situation of heart patients--long waiting list for revascularization increases uncertainty and fear]

In 80% of cases, antituberculosis antibodies from the sera of patients with tuberculosis were ascertained to react in enzyme immunoassay (EIA) with antigens (ultrasound disintegrants (USDs)) of reverse mycobacteria isolated (initially) from patients with sarcoidosis. The USDs of reverse mycobacteria isolated from patients with sarcoidosis reacted in EIA with monoclonal antibodies (MAb) against M. tuberculosis complex antigens (unique and crossover). Both common and distinctive (unique) antigenic determinants were detected via MAb against different mycobacterial types by immunoblotting in the antigenic complexes of M. tuberculosis H37Rv and reverse strains isolated from patients with sarcoidosis.     

Dissection of the aorta complicating intra-aortic balloon counterpulsation

A 61-year-old man with recent myocardial infarction complicated by a ventricular aneurysm and recurrent ventricular tachycardia underwent intra-aortic balloon counterpulsation prior to angiography and left ventricular aneurysmectomy. A dissecting aneurysm of the descending aorta adjacent to the position of the balloon catheter was found at autopsy. No intimal tear or cystic medial degeneration of the aorta was present to account for the dissection. The authors suggest that lateral and shearing forces generated by inflation of the balloon could result in dissection of the aorta.     

Priming in implicit memory tasks: Prior study causes enhanced dicriminality, not only bias.

R. Ratcliff and G. McKoon (1995, 1996, 1997; R. Ratcliff, D. Allbritton, & G. McKoon, 1997) have argued that repetition priming effects are solely due to bias. They showed that prior study of the target resulted in a benefit in a later implicit memory task. However, prior study of a stimulus similar to the target resulted in a cost. The present study, using a 2-alternative forced-choice procedure, investigated the effect of prior study in an unbiased condition: Both alternatives were studied prior to their presentation in an implicit memory task. Contrary to a pure bias interpretation of priming, consistent evidence was obtained in 3 implicit memory tasks (word fragment completion, auditory word identification, and picture identification) that performance was better when both alternatives were studied than when neither alternative was studied. These results show that prior study results in enhanced discriminability, not only bias. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Optimal modulation of a Brownian ratchet and enhanced sensitivity to a weak external force

We studied the dynamics of a Brownian particle moving in a spatially anisotropic potential acted on by multiplicative temporal modulations so that V(x,t) = g(t)U(x). Using the concept of the "thermodynamic action," we show that the class of modulation that maximizes the flow is a square-wave in time. We also show that adding a weak, homogenous force F in synergy with the square-wave modulation can cause particles of slightly different size to move in opposite directions. The synergetic change in velocity caused by F can be much greater than the drift velocity that would be caused by F alone.     

Improved hemodynamics shown by continuous monitoring of electrical impedance during external counterpulsation with the end-diastolic pneumatic boot and improved ambulatory EKG monitoring after 3 weeks of therapy

Some investigators have reported previously that phorbol esters inhibit in vitro erythropoietin production stimulated by hypoxia; whereas others have reported that phorbol esters enhanced Epo production during exposure to hypoxia. We have demonstrated in the present experiments that hypoxia significantly increased diacylglycerol levels in cultured human hepatocellular carcinoma (Hep3B) cells. 1-oleoyl-2-acetyl-ras-glycerol (OAG) and N-(6-phenylhexyl)-5-chloro-1-naphthalenesulfonamide (SC-9), two well-known protein kinase C activators, significantly increased medium levels of erythropoietin as well as erythropoietin messenger RNA levels in normoxic Hep3B cells. A potent protein kinase C inhibitor, chelerythrine chloride, significantly decreased hypoxia-induced increases in medium levels of erythropoietin as well as erythropoietin messenger RNA levels in Hep3B cells. A cis-unsaturated free fatty acid, oleic acid, significantly enhanced OAG-induced medium levels of erythropoietin in normoxic Hep3B cells, whereas a phospholipase A2 inhibitor, mepacrine, significantly decreased hypoxia-induced erythropoietin production in Hep3B cells. These results provide strong support for a positive role for protein kinase C in the hypoxic regulation of erythropoietin production.     

Transurethral balloon dilation of the external urinary sphincter: effectiveness in spinal cord-injured men with detrusor-external urethral sphincter dyssynergia

The authors investigated balloon dilation as a minimally invasive alternative to transurethral external sphincterotomy for the treatment of detrusor-external urethral sphincter dyssynergia (DESD). Seventeen spinal cord-injured men with voiding pressures greater than 60 cm H2O underwent balloon dilation of the external sphincter to 90 F at 4 atm of pressure for 10 minutes. The mean voiding pressures before and 12 months after dilation were 83 cm H2O +/- 35 and 37 cm H2O +/- 15, respectively (P = .008). There was a significant decrease in residual urine volume, from 163 mL +/- 162 to 68 mL +/- 59 (P = .05), whereas bladder capacity remained relatively unchanged at 253 mL +/- 181 and 230 mL +/- 97 (P = .30). Complications included one case of postoperative bleeding necessitating transfusion, two treatment failures, and one bulbous urethral stricture. Fourteen of the 17 patients (82%) now void without the aid of an indwelling catheter or alternative therapy. Balloon dilation has no detrimental effect on erectile function and may improve fertility.     

Use of the thoracic aorta for renal revascularization

OBJECTIVE: The primary role of the anterior cruciate ligament is to resist anterior subluxation of the tibia. When the ligament is torn, the tibia is free to sublux anteriorly when the leg is pulled forward. In addition to visualizing the anterior cruciate ligament directly, MR imaging can show joint alignment. The purpose of this study was to test the efficacy of MR images of anterior subluxation of the tibia for diagnosing complete tears of the anterior cruciate ligament. MATERIALS AND METHODS: We evaluated the records of 120 consecutive patients who underwent MR imaging of the knee and subsequently had arthroscopy. Arthroscopy showed a complete tear of the anterior cruciate ligament in 21 patients, a partial tear in eight patients, and an intact anterior cruciate ligament in 91 patients. Two radiologists together reviewed the MR images, and interpretation of anterior cruciate ligament integrity was reached by consensus. The anterior cruciate ligament was categorized as intact, completely torn, or partially torn on the basis of conventional MR imaging criteria. The degree of anterior subluxation of the tibia was measured on a separate occasion in random order by a radiologist who used a sagittal section through the middle of the lateral femoral condyle. On the selected image, two vertical lines parallel to the left and right margins of the image frame were drawn tangent to the posterior cortical margins of the lateral femoral and tibial condyles. Anterior subluxation of the tibia was determined by the distance in millimeters between these two lines and measured with calipers by using the 5-cm scale on the images. Measurements were considered reliable only to one half of the smallest increment of this scale (i.e., 5 mm). Accordingly, tibial subluxation (x) was measured in 5-mm increments, with x < or = 0 mm designated grade 0, 0 mm < x < or = 5 mm designated grade 1, 5 mm < x < or = 10 mm designated grade 2, and so forth. RESULTS: Conventional MR imaging criteria had 90% sensitivity and 94% specificity for diagnosing complete tears of the anterior cruciate ligament. According to the receiver-operating-characteristic (ROC) curve, anterior subluxation of the tibia greater than 5 mm (grade 2 or greater) was considered to be the optimal threshold (sensitivity, 86%; specificity, 99%) for diagnosing complete tears of the anterior cruciate ligament. Notably, none of the six false-positive diagnoses of complete tears by conventional criteria (three partial tears and three intact ligaments at arthroscopy) were misdiagnosed when tibial subluxation was used as the diagnostic criterion. Subluxation greater than 5 mm can be falsely negative with chronic tears of the anterior cruciate ligament (n = 2) or when a displaced bucket-handle tear of the lateral meniscus blocks anterior subluxation of the tibia (n = 1). CONCLUSION: An anterior tibial subluxation greater than 5 mm (grade 2 or greater) is a simple objective measurement that serves as a helpful adjunctive sign in the diagnosis of complete tears of the anterior cruciate ligament. This sign also offers improved discrimination of complete from partial tears of the anterior cruciate ligament.     

Prevention of balloon damage during initiation of intra-aortic balloon counterpulsation

Damage to an intra-aortic balloon occurred on two occasions in 93 insertion procedures. The complication was recognized before gas embolization occurred, and neither patient suffered ill effects. On both occasions the balloon was holed when pinched by artery forceps applied to the 'dacron' graft.     

Prior knowledge and the desire for information.

Conducted 2 experiments to test D. Berlyne's theory that the desire for knowledge increases with the degree of conceptual conflict, and that new information serves to reduce the conflict. In Exp. I, 38 6th graders rated the extent to which they wished to explore 155 items of information. They also indicated their knowledge of these items. It was found that Ss wished mostly to experience those things about which they had a moderate amount of prior knowledge. In Exp. II, 43 11th graders indicated the extent of agreement with 24 controversial issues, and were then offered further information on each of the items. When Ss had no set attitude towards statements, they were less likely to reject additional information and more likely to accept the opportunity to receive general rather than biased information. Both studies support the authors' hypothesis that new information is sought when there is some prior knowledge and when conceptual conflict exists. (French summary) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Late revascularization for partial amputation of the thumb]

The authors report a case of partial amputation of the thumb, still attached to the medial branch of its nerve, and which was successfully revascularized after 18 hours of ischemia with the thumb still warm. They discuss the operative technique employed, and other similar cases from the literature.     

A review of the literature: transmyocardial laser revascularization

Cavernous hemangiomas are vascular malformations of the central nervous system that may rarely affect the epidural space of the spine. We report a case of an epidural cavernous hemangioma which was originating from the left C8 nerve root and extending anteriorly to the apex of the left lung.     

Simplified revascularization of the celiac and superior mesenteric arteries

A fifty-six year old female is presented with significant stenosis of both the celiac and superior mesenteric arteries at their origin. A simplified method of revascularizing both vessels utilizing a single length of saphenous vein with two anastomoses is described. Also, the rationale for revascularizing all significantly involved vessels is discussed.     

Assisted circulation to the right ventricle through pulmonary counterpulsation using a biological method

The association between asthma exacerbations and use of antiasthmatics has been studied with a drug dispensing database. Exacerbations were identified through use of oral corticosteroids and the risk was determined for each medication. use of fenoterol and oral xanthines increases the frequency of exacerbations, but a channelling phenomenon is not excluded. This method could be used in the study of treatment combinations or new treatments, facilitating the monitoring of asthmatic populations. A second study collects ambulatory drug use data (POM and OTC drugs) of elderly patients. These data are analysed for the distribution of several variables, such as concomitant use of several medications of the same therapeutic class. As an example, about 15 per cent of NSAIDs users also use aspirin, exposing themselves to increased risk for gastrointestinal effects. These studies illustrate the use of drug dispensing databases in monitoring populations at risk and assessing treatment quality.     

Prior experience and expectation in the context of crowding.

Experience and expectations have been found to influence judgments of settings and stimuli. M. Manis and J. Paskewitz's (see record 1985-12026-001) social judgment model predicts separate paths of influence for comparison standards and expectations based on experience. This research was extended by manipulating both expectancy and prior experience in the context of crowding. Groups of male Ss worked together in a high- or low-density environment. Half of the groups expected that their next work setting would be high density and half low density. The next setting was high density for half the groups and low density for the remaining groups. The Manis–Paskewitz model did not predict the results. A model was proposed involving the affective quality of the prior experience and the affective reaction that follows a confirmed or disconfirmed expectation. Social judgments made in contexts of personal relevance and affective consequences are discussed with respect to this model. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The efficacy of the high volume counterpulsation technique at very low levels of aortic pressure

Nitric oxide synthase activity was measured in Langerhans islets isolated from control and streptozotocin diabetic rats. The activity of the enzyme was linear up to 150 micrograms of protein from control rats and was optimal at 0.1 microM calcium, when it was measured after 45 min of incubation at 37 degrees C in the presence of 200 microM arginine. Specific activity of the enzyme was 25 x 10(-4) nmol [3H]citrulline 45 min-1 mg protein-1. Streptozotocin diabetic rats exhibited less enzyme activity both in total pancreas homogenate and in isolated Langerhans islets when compared to control animals. Nitric oxide synthase activity measured in control and diabetic rats 15 days after the last streptozotocin injection in the second group of animals corresponded only to a constitutive enzyme since it was not inhibited by aminoguanidine in any of the mentioned groups. Hyperglycemia in diabetic rats may be the consequence of impaired insulin release caused at least in part by reduced positive modulation mediated by constitutive nitric oxide synthase activity, which was dramatically reduced in islets severely damaged after streptozotocin treatment.