Reversibility of cardiac dysfunction after valve replacement in elderly patients with severe aortic stenosis

BACKGROUND: The role of aortic valve replacement for aortic stenosis has not been fully defined in terms of the postoperative reversibility of cardiac dysfunction and pulmonary hypertension in elderly patients. METHODS: Cardiac function, assessed by radioisotope ventriculography and catheterization data, was evaluated before and after operation, and their results were compared between preoperative and postoperative data in each group of younger patients (<69 years, group I, n = 29) and elderly patients (> or =70 years, group II, n = 21). RESULTS: One month postoperatively the peak ejection rate determined by radioisotope ventriculography improved significantly in comparison with the preoperative value in elderly patients (preoperatively, 228 +/- 38 versus postoperatively, 319 +/- 116% end-diastolic volume per second, p < 0.05), although their preoperative peak ejection rate was severely depressed. The postoperative peak filling rate of the elderly group was not completely reversible to almost normal value, whereas that of the younger group was completely reversible. Early diastolic peak filling rate (one-third peak filling rate) was not reversible in both two groups. Pulmonary hypertension in the elderly patients was reversible to postoperative almost normal pulmonary artery pressure despite the severity of aortic stenosis (systolic pulmonary artery pressure preoperatively, 37 +/- 16 mm Hg versus postoperatively, 25 +/- 5 mm Hg, p < 0.02; diastolic pulmonary artery pressure preoperatively, 15 +/- 6 mm Hg versus postoperatively, 10 +/- 4 mm Hg, p < 0.05). CONCLUSIONS: Both cardiac dysfunction, reflected by reduction of peak ejection rate, and pulmonary hypertension in elderly patients with severe aortic stenosis were reversed, reaching almost normal values 1 month after operation.     

Successful management of primary left ventricular aneurysm (of the apex) in a child

A technique has been worked out for determining amino alkyl phosphonic acids in ruminal fluid by using methods of hydrolysis, partition of the phosphonic acid on a cation exchange column and ashing of the eluate. After evaporation to total dryness the phosphonic acids were determined as phosphates. The amounts of acid found in the ruminal fluid of goats varied between 0.4 and 1.1 muMol/ml. In view of the fact that these acids are microbial compounds it will appear that any change in the amount of compounds produced in the rumen would indicate changes in the concentration of the microbial mass in the rumen.     

Genetic liability, environment, and the development of fussiness in toddlers: The roles of maternal depression and parental responsiveness.

Using a longitudinal, prospective adoption design, the authors of this study examined the effects of the environment (adoptive parents' depressive symptoms and responsiveness) and genetic liability of maternal depression (inferred by birth mothers' major depressive disorder [MDD]) on the development of fussiness in adopted children between 9 and 18 months old. The sample included 281 families linked through adoption, with each family including 4 individuals (i.e., adopted child, birth mother, adoptive father and mother). Results showed that adoptive mothers' depressive symptoms when their child was 9 months old were positively associated with child fussiness at 18 months. A significant interaction between birth mothers' MDD and adoptive mothers' responsiveness indicated that children of birth mothers with MDD showed higher levels of fussiness at 18 months when adoptive mothers had been less responsive to the children at 9 months. However, in the context of high levels of adoptive mothers' responsiveness, children of birth mothers with MDD did not show elevated fussiness at 18 months. Findings are discussed in terms of gene–environment interactions in the intergenerational risk transmission of depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Aortic complications after aortic valve replacement in patients with dilated ascending aorta and aortic regurgitation

AIMS/BACKGROUND: Compared with nanosecond (ns) pulses of conventional Nd-YAG lasers, picosecond (ps) laser pulses allow intraocular surgery at considerably lower pulse energy. The authors report initial clinical experiences using a Nd:YLF ps laser for the treatment of various indications for photodisruption. METHODS: A Nd:YLF laser system (ISL 2001, wavelength 1053 nm) was used to apply pulse series of 100-400 microJ single pulse energy at a repetition rate of 0.12-1.0 kHz. Computer controlled patterns were used to perform iridectomies (n = 53), capsulotomies (n = 9), synechiolysis (n = 3), and pupilloplasties (n = 2). Other procedures were vitreoretinal strand incision (n = 2) and peripheral retinotomy (n = 1). For comparison, 10 capsulotomies and 20 iridotomies were performed with a Nd:YAG ns laser. The ps laser cut of an anterior capsule was assessed by scanning electron microscopy (SEM). RESULTS: Open, well defined iridectomies (mean total energy 4028 mJ, mean diameter 724 microns), were achieved at first attempt in 92% of the cases. In 64% an iris bleeding and in 21% an IOP increase of > 10 mm Hg occurred. All capsulotomies were performed successfully (mean energy 690 mJ/mm cutting length) but with a high incidence of intraocular lens damage. The attempted vitreoretinal applications remained unsuccessful as a result of optical aberrations of the eye and contact lens. Although ps laser capsulotomies and iridectomies required much higher total energy than ns procedures, the resulting tissue effects of the ps pulses were more clearly defined. SEM examination of a ps incision of the anterior lens capsule demonstrated, nevertheless, that the cut was more irregular than the edge of a continuous curvilinear capsulorhexis. CONCLUSION: Series of ps pulses applied in computer controlled patterns can be used effectively for laser surgery in the anterior segment and are considerably less disruptive than ns pulses. The ps laser is well suited for laser iridectomies while the ns laser is preferable for posterior capsulotomies. As vitreoretinal applications remained unsuccessful, the range of indications for intraocular photodisruption could not be extended by the ps laser.     

Surgical treatment for acute aortic arch dissection

The authors describe 2 patients with Takayasu's arteritis in whom lupus anticoagulant was positive and the titer of anticardiolipin antibody was elevated. One patient developed diffusely stenotic and occlusive changes in the multiple larger arteries. Histology of the small-sized arteries in another patient showed occlusive vasculitis without thrombosis, in addition to the findings in large-sized arteries compatible with Takayasu's disease. These findings are uncommon in Takayasu's arteritis. These findings suggest that antiphospholipid antibodies may have contributed to the pathogenesis of the extensive vasculopathy and may have triggered vasculitis in these patients.     

Bridging the divide: Openness in adoption and postadoption psychosocial adjustment among birth and adoptive parents.

Using 323 matched parties of birth mothers and adoptive parents, this study examined the association between the degree of adoption openness (e.g., contact and knowledge between parties) and birth and adoptive parents' postadoption adjustment shortly after the adoption placement (6 to 9 months). Data from birth fathers (N = 112), an understudied sample, were also explored. Openness was assessed by multiple informants. Results indicated that openness was significantly related to satisfaction with adoption process among adoptive parents and birth mothers. Increased openness was positively associated with birth mothers' postplacement adjustment, as indexed by birth mothers' self-reports and the interviewers' impression of birth mothers' adjustment. Birth fathers' report of openness was associated with their greater satisfaction with the adoption process and better postadoption adjustment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pubertal maturation and early substance use risks among African American children.

Using 2 waves of longitudinal data collected from approximately 870 African American adolescents, this study examined (a) changes in early risk factors for substance use during transition to early adolescence, including perceived prototypes of substance-using peers, willingness and intention to use substances, number of substance-using peers, and youths' own actual substance use; (b) the relationship between pubertal timing and these substance use risks; and (c) the interaction between pubertal timing and peer substance use in predicting the risks. Results showed that, first, risks for substance use increased, particularly among girls, during the transition to early adolescence. Children's prototypic images of substance users became increasingly favorable during this transitional period; a greater number of them were willing and intended to use substances during the transition to early adolescence; and an increased number of early adolescents and their friends began to use substances. Second, these changes were significantly more likely to occur among early maturing girls. Third, early physical maturation interacted with peer substance use to affect these changes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Spatial dose uniformity monitor for electrically scanned ion beam

A technique is described for direct and precise monitoring of the spatial dose uniformity of an electrically scanned ion beam. The method employs a two-dimensional 10x10 array of Faraday cups, individually connected to a current integrator, to measure local dose distribution. It also employs a microprocessor for rapid data processing and topographic data display. The technique is applicable to high quality ion implantation processes as a uniformity monitor with an accuracy of 1%. In addition, a new concept for uniform ion beam scanning is proposed.     

Complete nucleotide sequence of the genome organization of RNA2 of patchouli mild mosaic virus, a new favavirus

The complete nucleotide sequence and the genome organization of the RNA 2 of a patchouli mild mosaic virus (PaMMV) was determined. The sequence consists of 3591 nucleotides and contains a single long open reading frame sufficient to code for 118 K protein. Three proteins of 52 K, 44 K and 22 K could be encoded by the PaMMV RNA 2 genome. Our analysis of the N-terminal sequences of two species of coat protein (CP) allowed precise location of the CP cistrons within the polyprotein. 44 K and 22 K proteins are the coat proteins. The positions of the cleavage sites are Gln/Ala between 44 K and 22 K coat proteins and Gln/Gly between 52 K and 44 K proteins. Comparison of PaMMV RNA 2 with comoviral and nepoviral RNA 2 showed no sequence similarity. These results as well as previous serological studies strongly suggest that PaMMV is a member in the genus Fabavirus.     

Aggressive behavior between siblings and the development of externalizing problems: Evidence from a genetically sensitive study.

This study investigated the prospective links between sibling aggression and the development of externalizing problems using a multilevel modeling approach with a genetically sensitive design. The sample consisted of 780 adolescents (390 sibling pairs) who participated in 2 waves of the Nonshared Environment in Adolescent Development project. Sibling pairs with varying degree of genetic relatedness, including monozygotic twins, dizygotic twins, full siblings, half siblings, and genetically unrelated siblings, were included. The results showed that sibling aggression at Time 1 was significantly associated with the focal child’s externalizing problems at Time 2 after accounting for the intraclass correlations between siblings. Sibling aggression remained significant in predicting subsequent externalizing problems even after controlling for the levels of preexisting externalizing problems and mothers’ punitive parenting. This pattern of results was fairly robust across models with different informants. The findings provide converging evidence for the unique contribution of sibling aggression in understanding changes in externalizing problems during adolescence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)