Intracardiac ultrasound measurement of volumes and ejection fraction in normal, infarcted, and aneurysmal left ventricles using a 10-MHz ultrasound catheter

BACKGROUND

Our objective was to examine the accuracy of intracardiac ultrasound (ICUS) measurement of left ventricular (LV) volumes and ejection fraction (EF) using a 10-MHz ultrasound catheter. ICUS can image the LV in cross sections at all levels along the long axis with a transducer mounted on the tip of a catheter. Sequential serial LV cross-sectional images can be obtained during cardiac catheterization and used to calculate LV volumes by Simpson's rule. This technique may be an alternative to contrast LV angiography.

METHODS AND RESULTS

A beating-heart in vivo model was created to measure LV volume directly and continuously with an intracavity high-compliance latex balloon connected to a calibrated extracardiac reservoir in eight dogs in 35 experimental stages. A 10F ICUS catheter with a 10-MHz single-element transducer was introduced retrogradely via the aortic valve to the apex. Series of sequential LV cross-sectional images were recorded from the apex to the base during a calibrated pullback of the catheter. At each 5-mm interval, the LV cross section was traced at end diastole and end systole. LV volume was calculated by Simpson's rule by integrating all segmental areas multiplied by segmental height. The effect on accuracy of selecting 5-, 10-, or 15-mm heights or a single section at the midventricular level for measurement was assessed. The influence of distorted ventricular shape on the accuracy of ICUS measurements of LV volume was evaluated. This method was applied in 19 experimental stages in 10 intact dogs and pigs catheterized via the femoral artery. In the in vivo canine model, LV end-diastolic volume, end-systolic volume, and EF determined by ICUS using 5-, 10-, or 15-mm segments were not different from the actual measurements. But correlation and agreement between ICUS end-diastolic volume and direct measurements for 5- and 10-mm segments were significantly better than for 15-mm segments or a single section. Similar excellent correlations and agreement were observed for actual and ICUS-derived end-systolic volumes using 5-, 10-, or 15-mm segments. The ICUS-derived EF correlated very well with actual EF with a small measurement error of 3.91 +/- 2.59% for 5-mm or 4.13 +/- 2.79% for 10-mm segments but a significantly greater measurement error for 15-mm segments (5.35 +/- 3.76%) or single sections (14.8 +/- 12.2%). The presence of LV infarction or aneurysm did not significantly influence the accuracy of ICUS calculations for segmental heights < or = 10 mm. Application in intact animals demonstrated a good correlation between stroke volume measured by ICUS and by thermodilution or flowmeter. ICUS-derived LV volumes correlated well with biplane angiographic volumes, with a tendency toward underestimation. There was no significant difference between ICUS-determined LV EF and EF determined by angiography.

CONCLUSIONS

Intracardiac echocardiography accurately measures LV volumes and global systolic function in both regularly shaped and distorted left ventricles. This technique directly and continuously visualizes circumferential LV endocardium and wall thickness without contrast agents or geometric assumptions for calculation of LV volume. Thus, it should be particularly useful in patients at high risk for contrast-related complications or distorted LV shapes in which geometric assumptions may not be valid.

Kinetics of uptake, transport, and accumulation of liposome-associated fluorescent dolichol esters in human fibroblasts

The anthroyl and n-(7-nitrobenz-2-oxa-1,3-diazol-4-yl)amino (NBD) hexanoyl esters of dolichol were synthesized and incorporated into phospholipid liposomes. Fluorescence spectrometric methods were used to estimate the kinetics and dynamics of the incorporation and turnover of these esters in normal human fibroblasts. For anthroyl dolichol a saturable uptake of 2.5 x 10(3) pmol/10(6) fibroblasts was obtained. Half-maximum uptake was seen at a labeling concentration of 19 microM. The time required for half-maximum uptake of fluorescence (t1/2) was about 10 h. Over 50% of the anthroyl dolichol taken up remained in fibroblasts 24 h after the labeling medium was removed. Uptake was higher for esters of 9 isoprenes than for those with 16-21. Dolichol labeled with the NBD fluorophore appeared to enter fibroblasts in higher concentration than the same dolichol labeled with anthracene. Uptake was not influenced by the presence of agents that disrupt lysosome function (leupeptin and chloroquine) prior to or during fluorescence labeling. The amount of fluorescent dolichol in the (i) lysosomes and endosomes and (ii) nuclei of labeled fibroblasts was determined after Percoll density gradient centrifugation and cell lysis in culture, respectively. Most of the fluorescent dolichyl ester (and most of the free alcohol form) taken up by fibroblasts was recovered in lysosomes.

Quantification of pericardial effusions by three-dimensional echocardiography

OBJECTIVES

The purpose of this study was to examine the accuracy of three-dimensional echocardiography for the quantification of asymmetric pericardial effusion volume and to compare this new technique with two-dimensional echocardiography.

BACKGROUND

Quantification of pericardial effusion by two-dimensional echocardiography relies on a symmetric distribution of the fluid. Three-dimensional echocardiography can quantitate volume without these limitations, but its accuracy for pericardial effusion volume has not yet been assessed.

METHODS

In six open chest dogs, 41 different asymmetrically distributed pericardial effusions of known volume were created by serial infusions of fluid through a pericardial catheter. The hearts were imaged using an automated echocardiographic method that integrates three-dimensional spatial and imaging data. The surfaces of the pericardial sac and heart were then reconstructed, and the volumes of pericardial effusions were calculated. Two-dimensional echocardiography was performed simultaneously, and volumes were calculated using the prolate ellipsoid method. Asymmetric distribution of the fluid was obtained by applying localized hydrostatic pressure to the pericardium.

RESULTS

The volumes of pericardial effusion quantified using three-dimensional echocardiography correlated well with actual volumes (y = 1.0x - 1.4, SEE = 7.7 ml, r = 0.98). Two-dimensional echocardiography had an acceptable correlation (y = 1.0x + 2.3, SEE = 23 ml, r = 0.84), but a marked degree of variation from the true value was observed for any individual measurement.

CONCLUSIONS

Three-dimensional echocardiography accurately quantifies pericardial effusion volume in vivo, even when the fluid is distributed asymmetrically, whereas two-dimensional echocardiography is less reliable. This new technique may be of clinical value in quantitating pericardial effusion, especially in the serial evaluation of asymmetric or loculated effusions.

Three-dimensional echocardiography: in vivo validation for right ventricular free wall mass as an index of hypertrophy

OBJECTIVES

This study tested the ability of three-dimensional echocardiography to reconstruct the right ventricular free wall and determine its mass in vivo using a system that automatically combines two-dimensional images with their spatial locations.

BACKGROUND

Right ventricular free wall thickness is limited as an index of right ventricular hypertrophy because right ventricular mass may increase by dilation without increased thickness and because trabeculations and oblique views can exaggerate thickness in individual M-mode and two-dimensional scans. Three-dimensional echocardiography may have potential advantages because it can integrate the entire free wall mass, uninfluenced by oblique views or geometric assumptions.

METHODS

The three-dimensional system was applied to 12 beating canine hearts to reconstruct the right ventricular free wall in intersecting views. The corresponding mass was compared with actual weights of the excised right ventricular free wall (15.5 to 78 g). For comparison, right ventricular sinus and outflow tract thickness were also measured by two-dimensional echocardiography, and the ability to predict mass from these values was determined.

RESULTS

The three-dimensional algorithm successfully reproduced right ventricular free wall mass, which agreed well with actual values: y = 1.04x + 0.02, r = 0.985, SEE = 2.7 g (5.7% of the mean value). The two-dimensional predictions showed increased scatter: The variance of mass estimation, based on thickness, was 9.5 to 12.5 (average 11) times higher than the three-dimensional method (p < 0.02).

CONCLUSIONS

Despite the irregular crescentic shape of the right ventricle, its free wall mass can be accurately measured by three-dimensional echocardiography in vivo, providing closer agreement with actual mass than predictions based on wall thickness. This method, with the increased efficiency of the three-dimensional system, can potentially improve our ability to evaluate the presence and progression of right ventricular hypertrophy.

The binding site for ribosomal protein S8 in 16S rRNA and spc mRNA from Escherichia coli: minimum structural requirements and the effects of single bulged bases on S8-RNA interaction

Through specific interactions with rRNA and mRNA, ribosomal protein S8 of Escherichia coli plays a central role in both assembly of the 30S ribosomal subunit and translational regulation of spc operon expression. To better understand S8-RNA association, we have measured the affinity of S8 for a number of variants of its rRNA and mRNA binding sites prepared by in vitro transcription or chemical synthesis. With the aid of site-directed deletions, we demonstrate that an imperfect, 33-nucleotide helical stem encompassing nucleotides 588-603 and 635-651 possesses all of the structural information necessary for specific binding of S8 to the 16S rRNA. This segment consists of two short duplexes that enclose a conserved, asymmetric internal loop which contains features crucial for protein recognition. The S8 binding site in spc operon mRNA is very similar in both primary and secondary structure to that in 16S rRNA except for the presence of two single bulged bases in one of the duplex segments. In addition, the apparent association constant for the S8-mRNA interaction is approximately fivefold less than that for the S8-rRNA interaction. We show that the difference in affinity can be attributed to the effects of the bulged bases. Deletion of the bulged bases from the mRNA site increases its affinity for S8 to a level similar to that of the rRNA, whereas insertion of single-base bulges at equivalent positions within the rRNA site reduces its affinity for S8 to a value typical of the mRNA. Single-base bulges in the proximity of essential recognition features are therefore capable of modulating the strength of protein-RNA interactions.

Three-dimensional echocardiography. In vivo validation for right ventricular volume and function

BACKGROUND

Current two-dimensional echocardiographic measures of right ventricular volume are limited by the asymmetrical and crescentic shape of the ventricle and by difficulty in obtaining standardized views. Three-dimensional echocardiographic reconstruction, which does not require geometric assumptions or standardized views, may therefore have potential advantages for determining right ventricular volume. Three-dimensional techniques, however, have not been applied to the right ventricle in vivo, where cardiac motion and contraction could affect accuracy. The purpose of this study was to determine the feasibility and accuracy of three-dimensional echocardiographic reconstruction for quantifying right ventricular volume and function in vivo. In particular, it was designed to test the accuracy of a newly developed system that provides rapid, efficient, and automated three-dimensional data collection (minimizing motion effects) and takes advantage of the full three-dimensional data set to obtain volume.

METHODS AND RESULTS

The three-dimensional system was applied to reconstruct the right ventricle and measure its volume and function during 20 hemodynamic stages created in five dogs. Actual instantaneous volumes were measured continuously by an intracavitary balloon connected to an external column. Hemodynamics were varied by volume loading and induction of ischemia. Three-dimensional reconstruction successfully reproduced right ventricular volume compared with actual values at end diastole (y = 1.0 chi-3.4, r = .99, SEE = 1.8 mL) and end systole (y = 1.0 chi+ 2.0, 4 = .98, SEE = 2.5 mL). The mean difference between calculated and actual volumes throughout the cycle was 2.1 mL, or 4.9% of the mean. Ejection fraction also correlated well with actual values (y = 0.96 chi-0.3, r = .98, SEE = 3.3%).

CONCLUSIONS

Despite the irregular crescentic shape of the right ventricle, this newly developed three-dimensional system and surfacing algorithm can accurately reconstruct its shape and quantitate its volume and function in vivo without geometric assumptions. The increased efficiency of the system should increase applicability to issues of clinical and research interest.

Three-dimensional echocardiographic reconstruction of right ventricular volume: in vitro comparison with two-dimensional methods

Two-dimensional echocardiographic measures of right ventricular volume are limited by the asymmetric and crescentic shape of that ventricle and the difficulty in obtaining standardized views. We have developed a three-dimensional echocardiographic system that automatically integrates images and positional data and calculates right ventricular volume without the need for geometric assumptions or standardized views and a surfacing algorithm that takes advantage of the full three-dimensional data set. The accuracy of this system was studied and compared with two-dimensional methods in 12 gel-filled excised human right ventricles (18 to 74 ml). Volumes calculated by three-dimensional echocardiography correlated well with actual values (r = 0.99) and agreed more closely with them than did those obtained by two-dimensional methods (p < 0.02).

Skin elicitation threshold of ethylbutyl thiourea and mercaptobenzothiazole with relative leaching from sensitizing products

We studied 3 contact sensitizers present in rubber products, ethylbutyl thiourea (EBT), 2-mercaptobenzothiazole (MBT) and 2,2-dithio-bis-benzothiazole (MBTS), to relate the amount of sensitizer eliciting allergic contact dermatitis to the quantity leaching from a product into various biological fluids: normal saline, human plasma and 3 synthetic sweat solutions of pH 5.5 to 7.5. To determine the amount of sensitizer remaining after leaching, Soxhlet extraction with acetonitrile was subsequently performed. High-performance liquid chromatography was used for chemical analysis. 12 MBT-sensitive patients were patch tested with serial dilutions of MBT and MBTS in petrolatum. A Latin Square design was used in statistical analysis of variance of the patch test results. Large amounts of thioureas leached from 2 rubber articles eliciting thiourea dermatitis, the literature suggesting that these would have been well above the elicitation threshold. Leaching of MBTS was relatively greater than MBT into most media, whereas MBT was a more potent elicitor than MBTS at equivalent concentrations. The lowest eliciting concentration of MBT in 1 subject was 0.01%. Such information should prove helpful to manufacturers in designed products that do not release allergens sufficiently to cause reactions in consumers.

[Studies on the chemical constituents of Epimedium acuminatum Franch]

Five flavonoids were isolated from the aerial parts of Epimedium acuminatum. Their structures were determined chemically and spectroscopically to be baohuoside VI, tricin, icaritin, icariside I and baohuoside I.

The crystal structure and conformational analysis of substituted 2,7-dioxabicyclo[4,1,0]heptanes: 1,2-anhydro-3,4,6-tri-O-benzyl-beta-D-talopyranose

The title compound, C28H27O5, is triclinic, space group P1 with unit cell dimensions a = 12.763(2), b = 11.130(2), c = 4.764(3) A, alpha = 73.78(3), beta = 82.89(3), gamma = 62.16(1) degrees, V = 574.8(4) A3, and Z = 1. The pyranose ring has an 4H5 conformation with some flattening at C-4. Molecular mechanisms calculations indicate that the 4H5 conformation of the pyranose ring in the title compound is the most stable conformation.

Isolation of new nonsense and frameshift mutants in the immunoglobulin mu heavy-chain gene of hybridoma cells

In order to expand the experimental material available for genetic and biochemical analyses of the natural immunoglobulin genes, we have isolated a variety of mutant mouse hybridoma cell lines. Some of these mutants have partial or complete deletions of the mu gene. Other mutants have nonsense or frameshift mutations in the exons encoding the variable and the second and third constant region domains of the mu heavy chain. When combined with earlier mutant data, this collection of genotypically and phenotypically tight mutants of known sequence spans most of the 10 kb of the mu gene, providing material for a variety of studies of genetic recombination and mRNA metabolism.

[Hepatic schistosomiasis. X-ray computed tomographic aspects. Apropos of 97 cases]

Ninety seven patients with liver cirrhosis of schistosomiasis were collected. Its CT findings and features were analysed on the clinicopathological basis including (1) the high percentage of the hepatomegaly and of the enlargement of the left lobe; (2) occurrence of deposition and calcification of eggs in large bowel wall (5/5), the portal vein system (22/97), the root of the mesentery (9/97) and the liver (93/97); (3) the variety and characteristics of the appearances of the intrahepatic calcification; (4) widened and fibrotic changes in the portal canal region. It was also noted that high percentage of hepatocellular carcinoma associated with this disease in the present series (25/97).

Mutation of the gene for the human lysosomal serine protease cathepsin G is not the cause of aberrant APP processing in familial Alzheimer disease

Recent genetic linkage studies have implicated a gene on chromosome 14 in the pathogenesis of FAD. The identity of this gene remains unknown but it has been speculated that it may be involved in the cellular processing of the amyloid precursor protein (APP). We have analyzed the nucleotide sequence of the entire open reading frame of the cathepsin G gene located on chromosome 14q. No mutations were observed, suggesting that defects in this lysosomal protease are not responsible for aberrant accumulation of proteolytic products of APP in FAD brain tissue.

Land reforms in China

Describes the recent economic and land reforms in China, and the consequent changes in the emerging Chinese property market. Analyses the need for property management valuation skills in China in the light of problems of country size, regional differences, the scale of economic reforms and the speed with which they are being implemented, administration and the difficulty of educating a large number of property professionals.

Ultramark 1621 as a reference compound for positive and negative ion fast-atom bombardment high-resolution mass spectrometry

Ultramark 1621, a commercially available mixture of fluorinated phosphazines, was found to be a useful calibration compound for negative and positive ion fast-atom bombardment (FAB) high-resolution mass spectrometry. Ultramark 1621 worked very well with the most widely used matrices such as glycerol, nitrobenzyl alcohol, and triethanolamine. The negative and positive ion FAB mass spectra of Ultramark include a series of intense peaks extending from 700 to 1900 u.

Identification of calcitonin gene related peptide in ovine hypothalamic extract

Calcitonin gene-related polypeptide (CGRP) was purified from ovine hypothalamic extracts. Its amino acid sequence was determined as: Ser-(Cys)-Asn-Thr-Ala-Thr-(Cys)-Val-Thr-His-Arg-Leu-Ala-Gly-Leu-Leu-Ser- Arg-Ser - Gly-Gly-Val-Val-Lys-Ser-Asn-Phe-Val-Pro-Thr-Asn-Val-Gly-Ser-Gln-Ala-Phe- NH2. This sequence differs from rat CGRP by two amino acid substitutions (Ser for Asp25 and Gln for Glu35). Adenylate cyclase stimulating activity in rat pituitary cell cultures was monitored during the isolation. CGRP had adenylate cyclase stimulating activity comparable to corticotropin-releasing hormone, suggesting a hypophysiotropic role for CGRP. This is the first chemical characterization of CGRP in the brain (hypothalamus).

Effects of mutation position on frequency of marker rescue by homologous recombination

Homologous recombination between transferred and chromosomal DNA can be used for mapping mutations by marker rescue, i.e., by identifying which segment of wild-type DNA can recombine with the mutant chromosomal gene and restore normal function. In order to define how much the fragments should overlap each other for reliable mapping, we have measured how the frequency of marker rescue is affected by the position of the chromosomal mutation relative to the ends of the transferred DNA fragments. For this purpose, we used several DNA fragments to effect marker rescue in two mutant hybridomas which bear mutations 673 bp apart in the exons encoding the second and third constant region domains of the immunoglobulin mu heavy chain. The frequency of marker rescue decreased greatly when the mutation was located near one of the ends of the fragments, the results indicating that fragments should be designed to overlap by at least several hundred base pairs. Possible explanations for this "end effect" are considered.

Chemical characterization of vasoactive intestinal polypeptide-like immunoreactivity in ovine hypothalamus and intestine

Two forms of pituitary adenylate cyclase activating polypeptides with 38 (PACAP38) and 27 residues (PACAP27) respectively were recently isolated from ovine hypothalamic tissues. The N-terminal 28 amino acids sequence of PACAP was found to have 68% homology with porcine vasoactive intestinal peptide (VIP). In order to determine whether the primary structure of VIP of ovine hypothalamus is identical with porcine VIP or similar to PACAP, VIP immunoreactivity as determined by radioimmunoassay for porcine VIP was isolated in a pure form from ovine hypothalamic extracts. VIP was also isolated from ovine intestine. Amino acid analysis as well as amino acid sequence analysis showed that ovine hypothalamic and intestinal VIP were identical to porcine VIP, but different from PACAP.

Tumors of the heart. An analysis of 79 cases

There were 79 cases of cardiac tumors seen from 1957 to July 1988. 49 (62.0%) of them were benign and 30 (38.0%) malignant. All the 49 benign tumors except 2 were surgically excised and found to be myxoma. Of them, 18 patients were male and 31 female. 85.7% of the tumors were located in the left atrium, 12.2% in the right atrium and 2.0% in the left ventricle. Palpitation, dyspnea, chest oppression, fever, episodes of syncope and hemiplegia, cough, diastolic and systolic murmurs at the apical or tricuspid area were the common symptoms and signs. Atrial fibrillation was found only in 2 cases. Echocardiographic findings were diagnostic while ECG and X-ray findings were nonspecific. Four patients died after operation. Of the 30 cases of malignant tumors, 15 were secondary tumors metastasized mainly from the lung or mediastinal malignancies. Of 11 primary tumor cases (7 males and 4 females), 3 were malignant lymphoma, 2 mesothelioma of pericardium, 2 malignant myxoma, 1 angiosarcoma, 1 leiomyosarcoma, 1 fibrosarcoma and 1 rhabdomyosarcoma. Another 4 cases were not studied histopathologically. The clinical manifestations, ECG and X-ray findings of the 11 primary tumors were nonspecific but echocardiography was helpful to the diagnosis. Six patients were operated on and 1 died during hospitalization.

[The value of using transesophageal echocardiographic Doppler color flow imaging in patients undergoing cardiac valvular surgery]

To assess the value of intraoperative transesophageal echocardiographical Doppler color flow imaging (TEE-DCFI) during cardiac valvular surgery, 85 consecutive patients with 102 diseased valves for surgery were studied with pre-and post-operative TEE-DCFI. There were 34 women and 51 men with an age range of 15 to 55 years (mean age, 34.91 +/- 9.33 years). The etiology of valve lesion was rheumatic in 57 (AV 10, MV 47), prolapse in 9 (AV 2, MV 7), endocarditis in 21 (AV 12, MV 3, PV 2, prosthetic infection 4), prosthetic dysfunction in 14 (AV 5, MV 9), congenital in 1 (TV). Preoperative TEE-DCFI findings were helpful either in completing with some new information or changing the operation plan in 29 valves (28.43%) including abscess at aortic root in 1, perforation of aortic valve in 2, perforation of mitral valve leaflets in 5 patients with aortic valvular endocarditis, regurgitation or perivalvular leak of prosthetic valve in 4 MVs and 4AVs, left atrial thrombus detected in 8 and excluded in 3 patients with MV disease, small calcified vegetation on PV with normal valve function in 2 patients with congenital heart disease. Postoperative TEE-DCFI evaluation was performed in 53 patients with 70 diseased valves. There was only one mild regurgitation of mitral bioprosthesis and one mild perivalvular leak of aortic prosthesis detected among 40 replaced prosthetic valves. Of 30 valves repaired 23 (77%) valves had trivial or mild residual regurgitation (Group A) and 7 (23%) had moderate residual regurgitation (Group B). Postoperative congestive heart failure was seen in 6 (26.09%) of Group A and 5 (71.43%) of Group B (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Isolation of a neuropeptide corresponding to the N-terminal 27 residues of the pituitary adenylate cyclase activating polypeptide with 38 residues (PACAP38)

A novel neuropeptide with 38 residues (PACAP38) was isolated from ovine hypothalamic tissues using the pituitary adenylate cyclase activation in rat pituitary cell cultures as a parameter of the biological activity (Miyata et al, Biochem. Biophys. Res. Commun. 164, 567-574, 1989). From the side fractions obtained during the purification of PACAP38, a shorter form peptide with 27 residues corresponding to the N-terminal 27 amino acids of PACAP38 and amidated C-terminus was isolated and named as PACAP27. Synthetic PACAP27 showed a biological activity of adenylate cyclase stimulation comparable to PACAP38. Moreover PACAP27 which shows a considerable homology with vasoactive intestinal polypeptide (VIP) demonstrated a similar vasodepressor activity as VIP, but the adenylate cyclase stimulating activity was about 1000 times greater than VIP.

[Influence of processing on trace elements in traditional Chinese drugs]

By comparing the contents of nine trace elements in fourteen Chinese drugs (including thirty-six samples) before and after processing, this experiment was carried out primarily in search of the ways in which bears on trace element contents, so as to help improve the quality of processed drugs.

A novel peptide which stimulates adenylate cyclase: molecular cloning and characterization of the ovine and human cDNAs

A novel neuropeptide which remarkably stimulates adenylate cyclase in rat anterior pituitary cell cultures has been recently isolated from ovine hypothalami by A. Arimura and his collaborators (Biochem.Biophys.Res.Commun.164, 567-574(1989)). This peptide was designated as PACAP38(Pituitary Adenylate Cyclase Activating Polypeptide with 38 residues). In an attempt to investigate physiological implications of PACAP38, we have succeeded in cloning the cDNAs encoding the precursor of PACAP38 from ovine hypothalamus and human testis. An ovine cDNA encodes a protein of 176 amino acids in which PACAP38 is proceeded by a putative signal peptide and a "pro"-region (107 amino acids), and followed by a Gly-Arg-Arg sequence for proteolytic processing and amidation. Deduced amino-acid sequence of human PACAP38 was completely identical to that of the ovine isolated peptide. Cloning of PACAP38 cDNAs confirms the expression of the corresponding mRNAs and the presence of this neuropeptide in ovine hypothalamus and also in human testis.

[A quantitative study of pulmonary artery systolic pressure in patients with tricuspid regurgitation using continuous wave Doppler]

Pulmonary artery systolic pressure (PASP) was assessed with simultaneous continuous wave Doppler echocardiography (CW) and cardiac catheterization (CATH) in 33 cases. There was a close correlation between CW-estimated peak pressure gradient of tricuspid regurgitation (TRPGp) and CATH-measured PASP (r = 0.96, P less than 0.0001). Excellent correlation (r = 0.96, P less than 0.0001) between CW-estimated PASP and CATH-measured PASP was also obtained. The derived regression equation was PASP = TRPGp + 1.33 kPa. When the patients had relative or pathologic pulmonic stenosis, the regression equation was corrected by pulmonary artery pressure gradient (PAPG). The regression equation became PASP = TRPGp + 1.33-PAPG.

Isolation of a novel 38 residue-hypothalamic polypeptide which stimulates adenylate cyclase in pituitary cells

A novel neuropeptide which stimulates adenylate cyclase in rat anterior pituitary cell cultures was isolated from ovine hypothalamic tissues. Its amino acid sequence was revealed as: His-Ser-Asp-Gly-Ile-Phe-Thr-Asp-Ser-Tyr-Ser-Arg-Tyr-Arg-Lys-Gln- Met-Ala- Val-Lys-Lys-Tyr-Leu-Ala-Ala-Val-Leu-Gly-Lys-Arg-Tyr-Lys-Gln-Arg-Val-Lys-Asn-Lys - NH2. The N-terminal sequence shows 68% homology with vasoactive intestinal polypeptide (VIP) but its adenylate cyclase stimulating activity was at least 1000 times greater than that of VIP. It increased release of growth hormone (GH), prolactin (PRL), corticotropin (ACTH) and luteinizing hormone (LH) from superfused rat pituitary cells at as small a dose as 10(-10)M (GH, PRL, ACTH) or 10(-9)M (LH). Whether these hypophysiotropic effects are the primary actions of the peptide or what physiological action in the pituitary is linked with the stimulation of adenylate cyclase by this peptide remains to be determined.

[Analysis and comparison of free amino acids in Rehmannia glutinosa Libosch, and its processed products]

15 kinds of free amino acids were detected in Rehmannia glutinosa and its processed products, it was found that their contents were reduced in processed products.

[Quantitative assessment of pulmonary arterial diastolic and mean pressure using continuous wave Doppler]

Continuous wave Doppler echocardiographic study was performed almost simultaneously with right heart catheterization in 24 patients with a variety of cardiovascular disorders and evidence of pulmonary regurgitation detected by pulsed wave Doppler. Their pulmonary arterial diastolic and mean pressure (PADP and PAMP) measured during catheterization were ranging from 5 to 70.6 (mean 30.26 +/- 18) mmHg and from 6.7 to 91.14 (mean 42.41 +/- 23.23) mmHg, respectively. The right ventricular end-diastolic pressure was within normal limit in all but one. The peak, mean and end-diastolic pressure gradients of pulmonary regurgitation (PPRPG, MPRPG and PRPGed) were calculated using simplified Bernoulli Equation and their correlations with PADP and PAMP were analysed using linear regression method. There were close correlations between all PRPGs and PADP or PAMP (r = 0.85 - 0.94, P less than 0.0001). The best equation for assessing PADP was MPRPG + 6 mmHg (r = 0.94, P less than 0.0001), for PAMP was PPRPG + 8 mmHg (r = 0.92, P less than 0.0001). It is evident that those constants in the equations should be adjusted in individual patient who has coexisting right heart failure.

Allergic contact dermatitis to nickel: bioavailability from consumer products and provocation threshold

Twelve subjects sensitive to nickel underwent patch testing with serial dilutions of nickel sulfate in petrolatum and in water. The provocation threshold (the lowest amount of nickel producing a reaction) varied from 5.2 mg (2.5%) to 0.47 microgram (0.01%) when tested in petrolatum. The provocation threshold was higher with aqueous solutions. The lowest provocation threshold in a statistically significant number of individuals was 1.5 micrograms. Nickel bioavailability from dermatitis-inducing earrings and a necklace was determined by immersing them in plasma, normal saline solution, and synthetic sweat at different pH values over 7 days. Nickel leaching under these conditions exceeded the provocation threshold 1.4- to 93-fold, depending on object and solution. The time course varied with solution. After leaching, surface nickel was measured by the action of dilute nitric acid and total nickel was determined by complete dissolution in aqua regia. Nickel was more bioavailable from earrings than from the necklace, presumably reflecting different metallurgy. Plasma was the most effective solution for removing available nickel from earrings, a possible explanation for the frequent induction of sensitization by ear piercing. Comparison of provocation threshold and leaching results may help determine risks from consumer products.

A model for the release of adsorbed molecules from the surfaces of airborne particulate matter based on liquid-phase desorption from amorphous carbon blacks

The release of molecules adsorbed on the surfaces of amorphous carbon blacks has been studied using liquid-solid chromatography. Adsorbate molecules, adsorbents, and mobile phases were selected on the basis of their relevance as models for the release of toxic agents adsorbed on inhalable environmental particulate matter that originates from the incomplete combustion of organic materials. The presence of surface active groups on the carbon blacks has been shown to adsorb and retain adsorbate molecules selectively, and this selectivity can be reduced by competition for these active groups by the displacing solvent. Release is also governed by the surface coverage of the particles and increases as coverage approaches the monolayer.

An integrated mechanism for systolic anterior motion of the mitral valve in hypertrophic cardiomyopathy based on echocardiographic observations

Although many mechanisms have been proposed to explain systolic anterior motion (SAM) of the mitral valve in hypertrophic cardiomyopathy, the precise mechanism of its onset and cessation remain undefined. The Venturi theory, based on increased flow velocity in a narrowed outflow tract, is widely accepted but fails to explain several important characteristics of SAM. It also neglects the potential role of drag forces generated by interposition of the leaflets into the path of ejection and of factors that would decrease the effectiveness of papillary muscle restraint. In order to obtain further insight into the mechanism of SAM, a detailed geometric study of the left ventricle and mitral apparatus was performed with cross-sectional echocardiography in three equal-sized groups of patients with hypertrophic cardiomyopathy and SAM, patients with hypertrophy and no anterior motion, and normal control subjects. A salient finding was that SAM began prior to ejection in patients with hypertrophic cardiomyopathy, which cannot be explained by the Venturi theory. Further, SAM began and was most prominent in the central portion of the leaflet as opposed to its lateral edges; this finding is not predicted by the Venturi mechanism. In addition to outflow tract narrowing, other structural changes unique to patients with SAM included anterior and inward displacement of the papillary muscles, anterior displacement of the mitral leaflets, and elongation of the mitral leaflets, which were, on the average, 1.5 to 1.7 cm longer than in the other subjects (p less than 0.0001). On the basis of these observations, an integrated mechanism for the initiation and resolution of SAM is proposed that would explain observed features such as onset before ejection and central prominence. This mechanism combines the effects of outflow tract narrowing with those of papillary muscle displacement. In particular, anterior and inward displacement of the papillary muscles can be predicted to alter the effectiveness of chordal support so that the central leaflet portions become relatively slack and are more readily displaced anteriorly. The altered distribution of chordal tension can also be predicted to orient the distal leaflets upward into the outflow tract at the onset of systole, prior to aortic valve opening, so that ventricular ejection will actually drag the interposed leaflets anteriorly. The resolution of SAM can be understood in terms of a reverse Venturi effect created by mitral regurgitation, as well as continued traction of the centrally displaced papillary muscles on the lateral leaflet margins.(ABSTRACT TRUNCATED AT 400 WORDS)

Variable effects of changes in flow rate through the aortic, pulmonary and mitral valves on valve area and flow velocity: impact on quantitative Doppler flow calculations

Doppler echocardiographic methods for measuring volumetric flow through the aortic, pulmonary and mitral valves provide the cardiologist with several potentially interchangeable noninvasive methods for determining cardiac output. In addition, comparison of flow differences through individual valves offers the potential to quantitate shunt flow and regurgitant volumes. To date, however, no study has compared the relative accuracies of each of these flow measurements in a controlled experimental setting. Therefore, in this study, Doppler echocardiography was used to measure aortic, pulmonary and mitral valve flows in seven open chest dogs on right atrial bypass where forward cardiac output was precisely controlled with a roller pump. Correlations with roller pump output were better for Doppler measurements of aortic (r = 0.98, SD = 0.3) and mitral (r = 0.97, SD = 0.3) than for pulmonary (r = 0.93, SD = 0.5) valve flow. Interobserver reproducibility was also better for aortic (r = 0.94) and mitral (r = 0.97) than for pulmonary (r = 0.88) valve flow measurements. All valves showed flow-related increases in cross-sectional area, but the slope of this response was variable: 0.05, 0.16 and 0.21 for the aortic, the pulmonary and the mitral valve, respectively. Increased forward flow through the aortic valve, therefore, was manifested primarily by an increase in velocity, whereas increasing flow through the pulmonary and mitral valves produced more significant area changes with correspondingly smaller increases in the velocity component. Recalculation of Doppler-determined outputs, assuming a fixed valve area for the entire range of flows, resulted in a decreased correlation with roller pump output. Both velocity and valve area should be measured at each flow rate for greatest accuracy in volumetric flow calculations.

A Doppler-two-dimensional echocardiographic method for quantitation of mitral regurgitation

A noninvasive method to accurately quantitate the severity of mitral insufficiency would be of major clinical value. In theory, in the absence of confounding variables, regurgitant mitral flow should represent the difference between forward mitral blood flow and aortic blood flow. Since Doppler-two-dimensional echocardiographic (D2DE) methods for measuring transvalvular mitral and aortic flow have been validated, it should be possible to use mitral and aortic flows derived by this method to calculate regurgitant mitral flow. To assess the validity and accuracy of this combined approach for quantitation of regurgitant flow, we developed an open-chest canine preparation in which we could simulate, vary, and accurately measure degrees of mitral regurgitation. Seven animals were anesthetized and prepared to allow controlled right heart output. Mitral regurgitation was than simulated by placing a flexible conduit incorporating a one-way valve and electromagnetic flowmeter between the left ventricular apex and left atrium. Flow through the tube (effective mitral regurgitation) was varied between 0.2 and 1.8 liters/min and forward cardiac output ranged between 0.5 and 4 liters/min. Transmitral and transaortic flows were calculated by previously reported Doppler methods. Doppler-derived estimates of forward flow through the aortic valve correlated well with the flow measured by flowmeter (r = .92), and regurgitant flow and regurgitant fraction calculated by the D2DE approach also compared well with those measured by flowmeter (r = .84 and .83, respectively). This study demonstrates that mitral regurgitant flow and regurgitant fraction calculated by the D2DE method provide an acceptable measure of both absolute regurgitant flow and the regurgitant fraction in the experimental setting.