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Selected AbstractsUsefulness of Live/Real Time Three-Dimensional Transthoracic Echocardiography in Evaluation of Prosthetic Valve FunctionECHOCARDIOGRAPHY, Issue 10 2009Preeti Singh M.D. We studied 31 patients with prosthetic valves (PVs) using two-dimensional and three-dimensional transthorathic echocardiography (2DTTE and 3DTTE, respectively) in order to determine whether 3DTTE provides an incremental value on top of 2DTTE in the evaluation of these patients. With 3DTTE both leaflets of the St. Jude mechanical PV can be visualized simultaneously, thereby increasing the diagnostic confidence in excluding valvular abnormalities and overcoming the well-known limitations of 2DTTE in the examination of PVs, which heavily relies on Doppler. Three-dimensional transthorathic echocardiography provides a more comprehensive evaluation of PV regurgitation than 2DTTE with its ability to more precisely quantify PV regurgitation, in determining the mechanism causing regurgitation, and in localizing the regurgitant defect. Furthermore, 3DTTE is superior in identifying, quantifying, and localizing PV thrombi and vegetations, in addition to the unique feature of providing a look inside mass lesions by serial sectioning. These preliminary results suggest the superiority of 3DTTE over 2DTTE in the evaluation of PVs and that it provides incremental knowledge to the echocardiographer. [source] Transthoracic Doppler Echocardiographic Coronary Flow Imaging in Identification of Left Anterior Descending Coronary Artery Stenosis in Patients with Left Bundle Branch BlockECHOCARDIOGRAPHY, Issue 10 2008Ozer Soylu M.D. Background: Conventional noninvasive methods have well-known limitations for the detection of coronary artery disease (CAD) in patients with left bundle branch block (LBBB). However, advancements in Doppler echocardiography permit transthoracic imaging of coronary flow velocities (CFV) and measurement of coronary flow reserve (CFR). Our aim was to evaluate the diagnostic value of transthoracic CFR measurements for detection of significant left anterior descending (LAD) stenosis in patients with LBBB and compare it to that of myocardial perfusion scintigraphy (MPS). Methods: Simultaneous transthoracic CFR measurements and MPS were analyzed in 44 consecutive patients with suspected CAD and permanent LBBB. Typical diastolic predominant phasic CFV Doppler spectra of distal LAD were obtained at rest and during a two-step (0.56,0.84 mg/kg) dipyridamole infusion protocol. CFR was defined as the ratio of peak hyperemic velocities to the baseline values. A reversible perfusion defect at LAD territory was accepted as a positive scintigraphy finding for significant LAD stenosis. A coronary angiography was performed within 5 days of the CFR studies. Results: The hyperemic diastolic peak velocity (44 ± 9 cm/sec vs 62 ± 2 cm/sec; P=0.01) and diastolic CFR (1.38 ± 0.17 vs 1.93 ± 0.3; P=0.001) were significantly lower in patients with LAD stenosis compared to those without LAD stenosis. The diastolic CFR values of <1.6 yielded a sensitivity of 100% and a specificity of 94% in the identification of significant LAD stenosis. In comparison, MPS detected LAD stenosis with a sensitivity of 100% and a specificity of 29%. Conclusions: CFR measurement by transthoracic Doppler echocardiography is an accurate method that may improve noninvasive identification of LAD stenosis in patients with LBBB. [source] Semiclassical path integral theory of a double-well potential in an electric fieldINTERNATIONAL JOURNAL OF QUANTUM CHEMISTRY, Issue 5 2006Theodosios G. Douvropoulos Abstract A recently published methodology based on semiclassical path integral (SCPI) theory was implemented in the case of a model of a double-well potential perturbed by a static electric field, with application to the inversion frequency of NH3. This model was chosen as an idealized case for testing of the present approach, as well as for quantum mechanical models that might be applied in the future. The calculations were concerned with the variation of the frequency of inversion as a function of field strength, F, and of distance, xf (from the symmetric point xo = 0), where the field is "felt." It is found that this variation occurs sharply in very small regions of values of these parameters, and the system switches from internal oscillation to diffusion to the continuum. The fact that the theory is in analytic form allows the extraction of results and conclusions not only at the full SCPI level, but also at the Jeffreys,Wentzel,Kramers,Brillouin (JWKB) level. Comparison shows that the discrepancy sets in as the field strength increases, in accordance with the well-known limitations of the JWKB method regarding its dependence on the degree of variation of the potential as a function of position. © 2005 Wiley Periodicals, Inc. Int J Quantum Chem, 2006 [source] Subgroup Analyses in Randomized Controlled Trials: The Need for Risk Stratification in Kidney TransplantationAMERICAN JOURNAL OF TRANSPLANTATION, Issue 10 2009M. Wagner Although randomized controlled trials (RCT) are the gold standard for establishing causation in clinical research, their aggregated results can be misleading when applied to individual patients. A treatment may be beneficial in some patients, but its harms may outweigh benefits in others. While conventional one-variable-at-a-time subgroup analyses have well-known limitations, multivariable risk-based analyses can help uncover clinically significant heterogeneity in treatment effects that may be otherwise obscured. Trials in kidney transplantation have yielded the finding that a reduction in acute rejection does not translate into a similar benefit in prolonging graft survival and improving graft function. This paradox might be explained by the variation in risk for acute rejection among included kidney transplant recipients varying the likelihood of benefit or harm from intense immunosuppressive regimens. Analyses that stratify patients by their immunological risk may resolve these otherwise puzzling results. Reliable risk models should be developed to investigate benefits and harms in rationally designed risk-based subgroups of patients in existing RCT data sets. These risk strata would need to be validated in future prospective clinical trials examining long-term effects on patient and graft survival. This approach may allow better individualized treatment choices for kidney transplant recipients. [source] The putative-farnesoic acid O -methyl transferase (FAMeT) gene of Ceratitis capitata: characterization and pre-imaginal life expressionARCHIVES OF INSECT BIOCHEMISTRY AND PHYSIOLOGY (ELECTRONIC), Issue 2 2010Laura Vannini Abstract Farnesoic acid O -methyl transferase (FAMeT) is the enzyme involved in the penultimate step of insect juvenile hormone (JH) biosynthesis and is thus a key regulator in insect development and reproduction. We report the characterization of the putative- FAMeT in the medfly or Mediterranean fruit fly, Ceratitis capitata. This gene was identified by suppressive subtractive hybridization and completely sequenced by the screening of a medfly cDNA library. The obtained sequence was analyzed for conserved protein domain identification and its expression profile was evaluated by quantitative Real-Time PCR in medfly pre-imaginal life. The tissue expression of the isolated gene was verified by in situ hybridization on third instar larvae sections. The characterization of the isolated gene pointed out several typical features of methyl transferase genes. The pre-imaginal putative- FAMeT expression levels were consistent with JH titer change in Diptera. As recognized in some crustaceans, this gene seems to be widely expressed in the medfly as well. Ceratitis capitata is one of the most relevant agricultural pests against which insecticides and the sterile insect technique (SIT) are extensively used in spite of the well-known limitations of these approaches. Although results are not conclusive for the physiological role of the isolated gene, they suggest the characterization of a new gene in the Mediterranean fruit fly potentially involved in JH biosynthesis and may, therefore, have implications for pest control. © 2010 Wiley Periodicals, Inc. [source] | |||||||||||||