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We investigated whether the depressed cardiac response to adrenergic stimulation is accompanied with impaired autonomic function in mildly symptomatic patients with idiopathic dilated cardiomyopathy (DCM). Twenty-seven patients with DCM (New York Heart Association class I or II) and 7 normal control subjects underwent exercise radionuclide ventriculography and 24-h ambulatory ECG. The following frequency components of heart rate variability were calculated: the areas under the low (low frequency component [LF], 0.04 to 0.15 Hz), high (high frequency component [HF], 0.15 to 0.40 Hz), and total frequency portions of the spectrum. HF and HF% (the ratio of HF to total power) were calculated as indexes of specific vagal influences, and LF% (the ratio of LF to total power) and the ratio of LF to HF were of sympathetic tone. The left ventricular ejection fraction (LVEF) increased by more than 5% in all normal control subjects during exercise, whereas 17 (63%) of patients failed to show more than a 5% increase in LVEF. The profile of the mean hourly HF% and LF/HF showed circadian variations in normal control subjects but not in patients. The HF and HF% during sleep were significantly lower and the LF/HF during sleep was higher in patients than in normal control subjects. In patients, the LVEF during exercise minus LVEF at rest was significantly correlated with HF, LF%, and LF/HF during sleep, and with the ratios of the mean values during early morning to the mean daytime values for those spectral indexes. Our results demonstrated that mildly symptomatic patients with DCM showed an attenuated cardiac response to exercise and altered autonomic function, and their close relationship, suggesting that autonomic nervous activity contributes to cardiac desensitization in DCM.

We compared the effects of semotiadil, a novel Ca2+ channel blocker, with those of diltiazem on survival and regression of right ventricular hypertrophy and media thickening of pulmonary arteries in a rat model of pulmonary hypertension. Pulmonary hypertension was induced by a single injection of monocrotaline (80 mg/kg). Four weeks later, after pulmonary hypertension was confirmed, oral administration of semotiadil (10, 30, or 100 mg/kg/day) or diltiazem (100 or 300 mg/kg/day) was initiated. The rats were observed for 3 weeks. Survival was significantly longer in the group that received semotiadil 100 mg/kg/day than in the groups treated with diltiazem 100 or 300 mg/kg/day. Media thickness and smooth muscle area in pulmonary arteries were significantly less in rats treated with semotiadil 100 mg/kg/day than in animals treated with diltiazem 100 mg/kg/day. The right ventricle to left ventricle mass ratio, right ventricular wall thickness, and right ventricular myocardial fiber diameter were equal in these two groups. Semotiadil 100 mg/kg/day improved the survival of rats, which responded with a significant regression of right ventricular hypertrophy and media thickening of pulmonary arteries in comparison with rats treated with diltiazem 100 or 300 mg/kg/day.

We examined the antimicrobial effects of human beta-defensin-2 (hBD-2) on 17 species of oral streptococci to investigate the involvement of antimicrobial peptide activity in oral microflora development and the clinical use of the antimicrobial peptide for oral microflora control. Oral streptococci exhibit diverse levels of susceptibility to human beta-defensin-2 (hBD-2). Two major cariogenic bacterial species, Streptococcus mutans ( S. mutans) and S. sobrinus, were found to be susceptible to the peptide, indicating that it is a potential therapeutic agent for preventing dental caries. S. mitis exhibited the lowest susceptibility to the peptide. S. mitis is a major indigenous bacterium in the oral microflora, and our results suggest that it might possess a certain resistance mechanism against hBD-2.

Many carbohydrates are involved in the biofilm formation and activities of glucosyltransferases (Gtfs) of Streptococcus mutans, and the effects of various disaccharides and polysaccharides were investigated in this study, including the hot water-extracted glucan fraction of the Lentinula edodes fruiting body (HWG). HWG was found to inhibit the initial adhesion of S. mutans to saliva-coated hydroxyapatite (sHA), and also laminarin to inhibit glucan synthesis by Gtfs. However, sucrose-dependent biofilm formation by S. mutans was not inhibited by these materials. Interestingly, dextran was found to have an inhibitory effect on the sucrose-dependent biofilm formation. The data suggest that the presence of such an edible glucan as dextran in daily foods would act to some degree on S. mutans for suppressing the cariogenic activity.

This study was designed to compare the effects of semotiadil, a novel calcium antagonist, with those of diltiazem on the development of right ventricular hypertrophy and medial thickening of pulmonary arteries in a rat model of pulmonary hypertension. Pulmonary hypertension was induced by a single injection of monocrotaline (80 mg/kg). Twenty-four hours later (day 1), oral administration of semotiadil (10, 30, or 100 mg/kg per day) or diltiazem (100 or 300 mg/kg per day) was initiated. The wall thickness of the right ventricle (RV), the RV myocardial fiber diameter, the percent medial pulmonary artery thickness, and the percent area of smooth muscle in pulmonary arteries were determined on day 28. The magnitude of all parameters was significantly less in the group of seven rats that received semotiadil at 100 mg/kg per day than in the group of seven rats treated with diltiazem at 300 mg/kg per day. Semotiadil at 100 mg/kg per day inhibits the development of RV hypertrophy and medial thickening of pulmonary arteries significantly more effectively than diltiazem at 300 mg/kg per day.

We investigated the effects of amiloride, a Na(+)-H+ exchange blocker, on ventricular remodeling in an infarcted rat model. In the amiloride group, the left descending coronary artery was ligated and rats were given amiloride (1 mg/kg/day, n = 11) in their drinking water for 4 weeks. In the control group, rats were given water for 4 weeks (n = 8) after myocardial infarction. The rats were killed on day 28. Both the ratio of heart weight to body weight and that of left ventricular weight to body weight were significantly less in the amiloride group (p0.05). The diameter of a myocardial fiber in the region adjacent to the operated area was significantly reduced in the amiloride group compared with the control group (p0.05). Left ventricular cavity dimension was significantly smaller in the amiloride group than that in control group (p0.05). Our findings suggest that amiloride prevents ventricular remodeling after myocardial infarction.

A monoclonal antibody specific to a cell wall antigen of Streptococcus rattus (S. rattus) was prepared after cell fusion of mouse myeloma cells to the spleen cells of mice immunized with whole cells of strain FA1. The monoclonal antibody reacted with a crude and purified polysaccharide antigen of S. rattus in precipitin reactions as well as in a solid phase enzyme assay (EIA). It also reacted in the EIA with whole cells of S. rattus strains, but did not react with any other species of the mutans group or of other oral and streptococcal species. Moreover, among many haptenic sugars and their derivatives tested, D-galactosamine and D-glucosamine strongly inhibited the reaction in a competitive enzyme immunoassay using the purified antigen and whole cells, indicating that the type-specific antigenic determinant of the organism has a structure similar to the amino group of the sugar molecules. Furthermore, immunoelectron microscopy revealed that the antigen epitopes formed an irregular fibrous structure over the entire surface of individual cells.

The purpose of this study was to assess the effect of adenosine-triphosphate (ATP) on hemodynamics and left ventricular (LV) function, and to examine the value of ATP radionuclide-ventriculography (RNVG) for detecting coronary artery disease (CAD) in comparison with standard exercise RNVG. Thirty-eight consecutive patients with suspected CAD underwent ATP (0.18 mg/Kg/min) RNVG and symptom-limited exercise RNVG. Coronary angiography revealed 27 patients with CAD (Group S) and 11 without CAD (Group N). In group S, exercise induced an increase in LV end-diastolic volume (LVEDV) and LV end-systolic volume (LVESV), and a decrease in LV ejection fraction (LVEF). In contrast, ATP infusion caused LVESV to decrease in both groups, improving LVEF. Only 14 of 39 segments whose wall motion was deteriorated by exercise showed worsening regional wall motion during ATP infusion. The sensitivity and specificity of ATP RNVG for detecting CAD were 22.2% and 100%, while those of exercise RNVG were 77.8% and 81.8%, respectively. Although ATP induced a depression of peak filling rate in group S as compared with group N, the deterioration of systolic function was not apparent with this method. ATP RNVG was not adequate for detecting CAD because of its lower sensitivity compared with exercise RNVG.

The clinical implications of single-photon emission computed tomography using both a beta-methyl-branched fatty acid analog, 123I-15-(p-iodophenyl)-3-methyl-pentadecanoic acid (BMIPP), and thallium-201 (201Tl) were assessed in 30 patients with myocardial infarction (MI), 8 diabetics, 4 patients with impaired glucose tolerance, and 18 nondiabetic patients. Discordant decreases in BMIPP uptake, as compared with 201Tl uptake, in diabetic patients were significantly (p0.01) more frequent than in nondiabetic patients. The left ventricular (LV) ejection fraction in diabetics was significantly (p0.05) reduced and the LV diastolic dimension was significantly increased (p0.01), as compared with those in nondiabetic subjects. Analysis of peripheral blood showed no significant differences among the three test groups in metabolic abnormality. A discordant decrease in BMIPP uptake, as compared with Tl uptake, in cardiac tomography may indicate a metabolic derangement of the myocardium in diabetic patients with MI.

This paper provides a step-by-step guide to estimating infinite horizon discrete choice dynamic programming (DDP) models using a new Bayesian estimation algorithm (Imai, Jain and Ching, Econometrica 77:1865-1899, 2009) (IJC). In the conventional nested fixed point algorithm, most of the information obtained in the past iterations remains unused in the current iteration. In contrast, the IJC algorithm extensively uses the computational results obtained from the past iterations to help solve the DDP model at the current iterated parameter values. Consequently, it has the potential to significantly alleviate the computational burden of estimating DDP models. To illustrate this new estimation method, we use a simple dynamic store choice model where stores offer "frequent-buyer" type reward programs. We show that the parameters of this model, including the discount factor, are well-identified. Our Monte Carlo results demonstrate that the IJC method is able to recover the true parameter values of this model quite precisely. We also show that the IJC method could reduce the estimation time significantly when estimating DDP models with unobserved heterogeneity, especially when the discount factor is close to 1.

To assess myocardial viability in the region of a persistent defect, reinjection thallium201-scintigraphy was performed in 80 patients with coronary artery disease. Reinjection 201Tl myocardial images were obtained by additional injection of 201Tl (37MBq) after making conventional 201Tl delayed images. The myocardial viability was evaluated by regional left ventricular wall motion. Of 75 segments with persistent defects on conventional 201Tl stress images, new fill-in, increased 201Tl uptake was observed in 33 segments on the reinjection images. The abnormal wall motion score evaluated by left ventriculography was significantly better in fill-in (+) regions (1.70±0.87) than in fill-in (-) regions (2.60±1.05, p

We examine the ability of male immigrants to transfer their occupational human capital using information from the O*NET and a unique dataset that includes both the last source country occupation and the first four years of occupations in Canada. We first augment a model of occupational choice and skill accumulation to derive predictions about the cross-border transferability of occupational human capital. We then test the empirical implications using the skill requirements of pre- and post-immigration occupations. We find that male immigrants to Canada were employed in source country occupations that required high levels of cognitive skills, but relied less intently on manual skills. Following immigration, they find initial employment in occupations that require the opposite. Regression analysis uncovers large returns to the quantitative skill requirements of Canadian occupations, but no returns to source country skill requirements. Finally, our empirical findings suggests that occupational skill gaps are detrimental to immigrants` earnings.

To clarify how angiotensin converting enzyme inhibition affects left ventricular function through ventricular unloading, ventricular wall stress, ventricular volumes, and other cardiac indices and exercise tolerance were evaluated in 17 patients with mild to moderate chronic congestive heart failure before and after 3 months of treatment with enalapril. Echocardiographic examination revealed that treatment with this angiotensin converting enzyme inhibitor resulted in significant reductions in end-systolic wall stress (117 +/- 25 to 89 +/- 28 g/cm2, p < 0.01) and left ventricular volume indices (end-diastolic: 163 +/- 56 to 143 +/- 60; end-systolic 99 +/- 51 to 77 +/- 57 ml/m2 p < 0.01). Ejection fraction (42 +/- 11 to 48 +/- 13%, p < 0.01) and systolic blood pressure/end-systolic volume (SBP/ESV; 1.06 +/- 0.30 to 1.33 +/- 0.48 mmHg/ml, p < 0.01) were both increased. By radionuclide ventriculography, ejection fraction and peak ejection rate (2.30 +/- 0.74 to 2.80 +/- 0.76 EDV/sec, p < 0.01) were increased, while time to peak ejection, time to peak filling, and peak filling rate were unchanged. Heart rate and double product at exercise were decreased and delta EF was significantly increased (-1.4 +/- 4.1 to 1.6 +/- 4.4%, p < 0.02). The decrease in end-systolic wall stress was consistently related to both the increase in ejection fraction and SBP/ESV, while the decrease in end-diastolic volume was related only to SBP/ESV and not to ejection fraction. Furthermore, there was a direct relationship between the decrease in systolic wall stress and the decrease in end-diastolic volume.(ABSTRACT TRUNCATED AT 250 WORDS)

Olsen et al, reported that changes simulating hypertrophic cardiomyopathy were produced in newborn rats when triiodothyroacetic acid (triac, an analogue of thyroxine) was given during the fetal period. However, triac is barely transported across the rat placenta, while thyrotropin releasing hormone (TRH) is readily transported across the rat placenta and acts directly on the fetus. In this study, TRH was administered to pregnant female rats and its effects on the hearts of their offspring were studied using morphologic and immunohistochemical techniques with Bromodeoxyuridine (BrdU). The hearts of the TRH-treated newborn rats showed disproportionate septal hypertrophy and frequent septal myocardial fiber disarray. The labeling index of BrdU in the septum was significantly higher in the TRH-treated newborn rats than in controls. In the TRH-treated newborn rats, the labeling index of BrdU was significantly higher in the septum than in the free wall. These results indicate that TRH administration during the fetal period causes an increase in myocardial cellular proliferation, especially in the septum, resulting in disproportionate septal hypertrophy in the newborn rats.

A 60 year-old man with Wolff-Parkinson-White (WPW) syndrome was admitted to our hospital because of atrial fibrillation and heart failure. He had a history of paroxysmal atrial fibrillation which had increased in frequency as mitral stenosis progressed over a period of 10 years. Since heart rate-dependent torsades de pointes appeared after DC defibrillation due to class IA antiarrhythmic agents, the drug was withdrawn and an intravenous infusion of isoproterenol was started. Sinus rhythm was restored and maintained by restarting the administration of the class I A antiarrhythmic agent. Electrophysiological examination revealed a single accessory conduction pathway and no retrograde conduction, the effective refractory period was prolonged to 330 msec. After the heart failure had improved, mitral valve replacement and transection of the bundle of Kent were performed. Because of the possibility of grave hemodynamic derangement induced by marked tachycardia, surgical treatment should be seriously considered in patients with mitral stenosis when associated with WPW syndrome and atrial fibrillation, even in those not classified as high risk patients.

In this paper, we focus on a novel and potentially important aspect of the workfare policy in the Danish labor market, namely its effect on crime. We do this by exploiting two policy changes. First, we examine the effect of a series of national welfare reforms introduced during the 1990s. Those reforms strengthened the work requirement for the young welfare recipients and were introduced gradually, starting with younger welfare participants first. We exploit the differential introduction of workfare reform across different age groups as the exogenous variation. Second, we use a unique policy experiment that began in 1987 by an innovative mayor of the Danish city of Farum, where he imposed a 100 % work or training requirement for all welfare recipients immediately from the date of enrollment. By comparing the changes in crime rates among the welfare recipients in Farum before and after 1987 with that of the rest of Denmark, we identify the effect of workfare on the crime rate. Our results show a dramatic decline in the arrest rate among welfare recipients after the introduction of the stronger workfare requirements, both at the national level and in Farum. Those results imply a strong and significant crime reducing effect of the workfare policy.

1. Japanese third molars were divided into sample groups based on the donor's year of birth, and 90Sr level in each sample group of 10 teeth was determined to compare it with the previously reported data obtained from sample groups of 28 teeth.2. Trace and detection-limit amounts of 90Sr were detected in the teeth from donors born in 1929-1931. The 90Sr level increased in the teeth from donors born in 1935, and reached a peak value of 66.9-72.8mBq/g Ca in the teeth from donors born in 1953. It decreased afer 1954 and reached 25.5mBq/g Ca in the teeth from donors born in 1970.3. Compared with previous data using 28 teeth as a sample group, good accordance was observed in period showing detection-limit level of 90Sr, tendency of increase thereafter, peak period, radioactivity at peak period, tendency of decrease after 1953 and radioactivity after peak period.4. These results clearly indicate that a small sample, that is, 10 teeth, is sufficient for the examination of annual change in the 90Sr level.

1) Strontium-90 level was determined in May 1989 in 40 sample groups of Japanese teeth, for a total of 1022 third molars, obtained from donors born in 1900-1970.2) The teeth from donors born in 1925-1931, and which were extracted in the donors' twenties did not contain detectable strontium-90.3) Strontium-90 level of the teeth from donors born in and after 1942 suddenly increased, and reached peak value of 62.8 to 72.8mBq/g Ca in 1953. It abruptly decreased after 1954 and reached approximately 20mBq/g Ca by 1970.4) In the teeth obtained from donors born in 1900-1924, and which were extracted at the age of 30 to 69, a small amount of strontium-90 was detected.

Five patients with hepatic failure (4 with acute hepatic failure and 1 with chronic hepatic failure) were treated by plasma exchange.Improvement of coma grade was observed in 2 patients. but 3 patients died without recovery from coma.The death in 1 of the 3 fatal cases was due to chronic hepatic failure.PT in the 2 patients whose lives were saved showed recovery progressively at each plasma exchange, but PT in the 3 fatal cases remained below 50% of normal.It was concluded that measurement of PT is useful for the early diagnosis of acute hepatic failure and that it is essential to perform plasma exchange as quickly as possible once diagnosis is established.

This paper proposes a new test of the Protection for Sale (PFS) model by Grossman and Helpman (1994). Unlike existing methods in the literature, our approach does not require any data on political organizations. We formally show that the PFS model provides the following prediction: In the quantile regression of the protection measure on the inverse import penetration ratio divided by the import demand elasticity, its coefficient should be positive at the quantile close to one. We examine this prediction using the data from Gawande and Bandyopadhyay (2000). The results do not provide any evidence favoring the PFS model.

The oral cavity in healthy subjects has a well-balanced microbiota that consists of more than 700 species. However, a disturbance of this balance, with an increase of harmful microbes and a decrease of beneficial microbes, causes oral disorders such as periodontal disease or dental caries. Nowadays, probiotics are expected to confer oral health benefits by modulating the oral microbiota. This study screened new probiotic candidates with potential oral health benefits and no harmful effects on the oral cavity. We screened 14 lactobacillus strains and 36 streptococcus strains out of 896 oral isolates derived from healthy subjects. These bacteria did not produce volatile sulfur compounds or water-insoluble glucan, had higher antibacterial activity against periodontal bacteria, and had higher adherence activity to oral epithelial cells or salivary-coated hydroxyapatite in vitro. We then evaluated the risk of primary cariogenicity and infective endocarditis of the selected oral isolates. As a result, Lactobacillus crispatus YIT 12319, Lactobacillus fermentum YIT 12320, Lactobacillus gasseri YIT 12321, and Streptococcus mitis YIT 12322 were selected because they showed no cariogenic potential in an artificial mouth system and a lower risk of experimental infective endocarditis in a rat model. These candidates are expected as new probiotics with potential oral health benefits and no adverse effects on general health.

Using National Youth Survey (NYS) data, we examine the relationship of current criminal activity and past arrests using an ordered probit model with unobserved heterogeneity. Past arrests raise current criminal activity only for the non-criminal type, while past criminal experience raises current criminal activity for both types. Also, the age crime profile peaks at age 18 for non-criminal type individuals, but for criminal type individuals, it continues to rise with age. Past research indicates that age arrest profiles rise till age 18 and then fall for both types, suggesting lower apprehension rates for criminal type individuals.

This paper asks whether the results obtained from using the standard approach to testing the influential Grossman and Helpman "protection for sale" model of political economy might arise from a simpler setting. A model of imports and quotas with protection occurring in response to import surges, but only for organized industries, is simulated and shown to provide parameter estimates consistent with the protection for sale framework. This suggests that the standard approach may be less of a test than previously thought. © 2008 Elsevier B.V. All rights reserved.

This paper asks whether the results obtained from using the standard approach to testing the influential Grossman and Helpman protection for sale (PFS) model of political economy might arise from a simpler setting. A model of imports and quotas with protection occurring in response to import surges, but only for organized industries, is simulated and shown to provide parameter estimates consistent with the protection for sale framework. This suggests that the standard approach may be less of a test than previously thought.

The cDNA of a mouse Fab fragment was cloned from a hybridoma cell line that produces a mouse monoclonal antibody, KH5, that reacts with the peptide fragment of the surface protein antigen of Streptococcus mutans serotype c (PAc). After transfection with cDNA, recombinant Fab fragments were produced by Escherichia coli (T15 Fab) and cultured tobacco cells (X253 and X262 Fabs). The antipeptide activities of T15 and X253 were similar to that of KH5. X253 was secreted into the culture media, which had a specific affinity for the PAc peptide.

For humoral immunization, it may be possible to make effective and safe peptide vaccines for various diseases by selection of proper B-cell epitopes. However, a lack of T-cell epitopes on short peptides, such as those associated with major histocompatibility complex (MHC)-restriction, is a major problem for peptide vaccine development. We propose a solution for the design of peptide vaccines that involves induction of broadly reactive T-cell epitopes via agretopes. The strategy involves positioning multi-agretope type peptides on the N-terminal side of a di-lysine linker and B-cell epitopes on the C-terminal side. The addition of the arginine-glysine-aspartate (RGD)-motif to the N terminus of the peptide enhances its immunogenicity, and enables nasal immunization without adjuvants.

Objectives: Dental caries prevention programs using chlorhexidine (CHX) have been proposed, but CHX's effect in reducing levels of mutans streptococci (S. mutans and S. sobrinus) appears to last for only a few months. The aim of this study was to attempt to eradicate mutans streptococci from the oral cavity using intensive professional mechanical tooth cleaning (PMTC) and topical application of CHX in custom-made trays. Methods: Seven adult dentate subjects participated in this study (mean age 53.7 +/- 5.6, age range 46 to 62, mean DMFT, 9.1 +/- 4.2). For each subject, PMTC was carried out eight times within ten days. After each PMTC, 1% CHX was applied twice to the tooth surface using custom-made trays. In addition, as home treatment, subjects were required to carry out tooth brushing three times a day, and apply 0.2% CHX in custom trays after brushing in the morning and evening. In addition, subjects rinsed with 0.2% CHX solution after lunch. Salivary levels of mutans streptococci were evaluated using Dentocult- SM at baseline and on days 9, 20, 70, 120. Results: Mutans streptococci were eradicated by day 120 from 4 of the 7 seven subjects participating in this study. Those 3 subjects still harboring mutans streptococci exhibited deep periodontal pocketing. Conclusions: Eradication of mutans streptococci from the oral cavity is feasible using a combination of CHX application in custom-made trays and intensive PMTC. (J. Oral Sci. 46, 179-183, 2004)

This paper presents analysis of Magnetic Amplifying Magneto-Optical System (MAMMOS) with a combination of a 413 nm wavelength blue laser and an NA equals 0.9 objective lens. To study thermal properties, domain copying phenomena have been investigated. In addition, this paper describes the analysis of the expansive and shrinking force per domain wall area of the MAMMOS readout based on Huth's treatment of stable domain radii.© (2002) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.

Using monthly panel data we solve and estimate, using maximum likelihood techniques, an explicitly dynamic model of criminal behavior where current criminal activity adversely affects future employment outcomes. This acts as 'dynamic deterrence' to crime: the threat of future adverse effects on employment payoffs when caught committing crimes reduces the incentive to commit them. We show that this dynamic deterrence effect is strong in the data. Hence, policies which weaken dynamic deterrence will be less effective in fighting crime. This suggests that prevention is more powerful than redemption since the latter weakens dynamic deterrence as anticipated future redemption allows criminals to look forward to negating the consequences of their crimes. Static models of criminal behavior neglect this and hence sole reliance on them can result in misleading policy analysis.

Na+-H+ exchange inhibitors may reduce myocardial damage after reperfusion. However, their effects on microvascular deterioration are not known. We examined the potency of a novel Na+-H+ exchange inhibitor, SM-20550 [ N-(Aminoiminomethyl)-1,4-dimethyl-1H-indole-2-carboxamide methanesulfonate], and its effects on microvascular damage after reperfusion. In an in vitro study, the Na+-H+ exchange inhibiting activity of SM-20550 was about 10 times greater than that of ethylisopropyl amiloride. In in vivo experiments, we occluded the left circumflex coronary artery in 29 dogs for 2 h and then reperfused for 5 h. SM-20550 was administered either before ischemia (n = 11) or before reperfusion (n = 7). Another 11 dogs served as controls. We found that SM-20550 not only improved coronary vasodilator responses to acetylcholine and adenosine after reperfusion, but also reduced infarct size (P0.01). Intramyocardial bleeding, which should reflect microvascular damage, was not found in dogs with SM-20550 treatment. Infarct size was correlated inversely with collateral blood flow in control (both, P0.01) but not in SM-20550-treated animals. Furthermore, SM-20550 significantly suppressed ventricular fibrillation during both ischemia and reperfusion. These results suggest that protective effects of Na+-H+ exchange inhibitors on reperfused myocardium are due at least in part to microvascular protection.

Two patients with diabetes mellitus sustained spontaneous calcaneus fracture after deep heel burns. Both cases had avulsion type fracture of the os calcis. The authors discuss the incidence and possible etiology with literature review.

A simple dynamic model of criminal behavior is estimated. The object is to see if the dynamics involved help differentiate between alternative structural hypotheses involving empirical regularities such as the age crime profile. This refers to the observation that criminal behavior seems to peak around age seventeen.

We describe an unusual case of acute myocardial infarction due to vasospasm in a 13-year-old boy. He was admitted to our hospital with severe congestive heart failure and shock. He had experienced a feeling of chest oppression with dyspnea while running, which grew worse. He then lost consciousness and was brought by ambulance to our intensive care unit. He had had similar but milder episodes of chest oppression months earlier. The family history revealed that his father had died suddenly from hypertrophic cardiomyopathy and that his grandmother also had hypertrophic cardiomyopathy. On admission, the patient was bathed in a cold sweat, his pulse was weak, and his blood pressure was too low to measure. Coarse crackling and wheezing were audible in both lung fields. Administration of catecholamine and intra-aortic balloon pumping failed to stabilize the hemodynamic variables, but percutaneous cardiopulmonary support proved to be lifesaving. Coronary arteriography performed during his convalescence showed on evidence of atherosclerosis. The acetylcholine provocation test ultimately revealed a diagnosis of acute myocardial infarction due to vasospasm.

The diagnostic values of adenosine, dobutamine, and exercise radionuclide ventriculography (RNVG) in the detection of coronary artery disease (CAD), and the characteristics of those patients who showed myocardial ischemia during the infusion of adenosine or dobutamine were assessed in 41 patients with suspected CAD. Sensitivity, specificity, and accuracy, respectively, for detecting patients with CAD were 35 (p < 0.01 vs. exercise RNVG), 100 and 46% (p < 0.01 vs. exercise RNVG) with adenosine RNVG, 74, 100 and 78% with dobutamine RNVG and 88, 71 and 85% with exercise RNVG. There was a significant difference in physiologic parameters during the provocation of ischemia by adenosine versus exercise RNVG, although these parameters were similar by dobutamine and exercise RNVG. Stepwise discriminant analysis revealed that the number of stenotic vessels was an important and independent predictor for the myocardial ischemia induced by each stress; the peak filling rate was the only predictor for adenosine-induced ischemia. Dobutamine induced myocardial ischemia in a way similar to that of exercise, and was more useful than adenosine for pharmacologic stress RNVG. The mechanism of the adenosine-induced ischemia seemed to differ from that of the ischemia induced by dobutamine or exercise, and to be closely associated with left ventricular diastolic function.

Monoclonal antibodies specific to chondroitin sulphate (CS-56) and keratan sulphate (AH12) were used to localize proteoglycans in the proximal tibial articular cartilage and growth plate of broiler chickens. There was no CS-56 labelling in the proliferative zone of the growth plate. In contrast, intense labelling with this antibody was observed in the transitional and hypertrophic zones of the growth plate and the articular cartilage. This was confirmed by extracting chondroitin sulphate fractions from different zones of the growth plate and articular cartilage, and examining their antigenicities to CS-56 by ELISA inhibition assay. It was suggested that the maturation of chondrocytes in the growth plate is related to the production of chondroitin sulphate with CS-56 epitope, which may be a prerequisite for normal endochondral bone formation in the chicken tibia. The role of chondroitin sulphate recognized by CS-56 in the articular cartilage is unknown.

Abstract Inflammatory cytokines play a key role in the myocardial injury produced by viral myocarditis. Although interleukin-6 (IL-6) reportedly possesses antiviral properties, its effect in viral myocarditis is unclear. To investigate the role of IL-6 in viral myocarditis induced by encephalomyocarditis virus (EMCV) in mice, we evaluated (1) the survival rate following IL-6 administration, (2) the viral titer in the heart, (3) viral replication in the heart by in situ hybridization, (4) histopathological changes using immunohistochemical staining, (5) neutralizing antibody against EMCV, (6) circulating interferon and tumor necrosis factor-α (TNF-α), (7) viral suppression in vitro by IL-6, and (8) natural killer (NK)–cell activity. Eight-week-old C3H/HeJ mice were injected intraperitoneally with EMCV (day 0) and were also injected subcutaneously twice daily for 4 consecutive days with 10 μg/0.1 mL of human IL-6 on day −4 (group A), day 0 (group B), or day +4 (group D) for 4 days. As a control, 0.1 mL PBS instead of IL-6 was injected on day 0 for 4 days (group C). Certain mice were killed on day 4. The myocardial virus titers, viral replication in situ, and NK-cell activity in the spleen were determined. Decreased viral titer and viral replication in the heart reduced the titer of circulating TNF-α, and lower NK-cell activity was observed in group B versus group C (control group). The titer of neutralizing antibodies against EMCV was significantly ( P

Losartan, a recently developed nonpeptide angiotensin II (AII) receptor antagonist, was orally administered for 14 days to mice with viral myocarditis, beginning 7 days after encephalomyocarditis virus inoculation. The angiotensin-converting enzyme inhibitors (ACEI) captopril and enalapril were also administered in the same manner to compare the therapeutic effects of these three drugs on the degree of myocarditis, acute heart failure, and left ventricular (LV) hypertrophy. Heart weight and the heart weight/body weight ratio were reduced by losartan (60 mg/kg/day) and captopril (7.5 mg/kg/day), but not by enalapril (1 mg/kg/day). LV wall thickness and cavity dimension were decreased in the losartan and captopril groups. Captopril reduced both myocardial necrosis and inflammation, whereas enalapril reduced myocardial necrosis but not inflammation. However, none of the studied losartan doses (1.2, 12, 60 mg/kg/day) influenced myocardial necrosis and inflammation resulting from viral infection. Thus, specific blockade of AII is beneficial in congestive heart failure (CHF) and LV hypertrophy but is not effective in viral-evoked inflammation and injury.

We investigated the effects of subcutaneous administration of 50 and 100 micrograms/kg/day of sandostatin on monocrotaline-induced medial proliferation of pulmonary arteries and right ventricular overload in rats. In a dosage of 100 micrograms/kg/day, sandostatin significantly reduced right ventricular systolic pressure, the mass ratio of the right ventricular free wall to the left ventricle, the right ventricular wall thickness, the right ventricular myofiber diameter, the percent medial pulmonary artery thickness, the percent area of smooth muscle cell, and proliferating cell nuclear antigen activity. Our results suggest that sandostatin inhibits development of medial proliferation of pulmonary arteries and right ventricular overload in a dosage of 100 micrograms/kg/day.

We conclude that IL-6 should be considered a marker of myxoma. The frequent immunologic abnormalities in patients with cardiac myxoma may be related to the IL-6 secreted from the myxoma itself.

We investigated the usefulness of 24-h Holter monitoring for identification of myocardial involvement in 38 patients with sarcoidosis, including 12 patients with cardiac sarcoidosis, and 58 healthy controls. Ventricular ectopic beats (VEB)or = 100 beats per day were detected in 8 (67 percent) of 12 patients with cardiac sarcoidosis, in 2 (8 percent) of 26 patients without cardiac sarcoidosis, and in 3 (5 percent) of 58 healthy controls. Holter monitoring was associated with a sensitivity of 67 percent and a specificity of 62 percent for cardiac sarcoidosis in the overall study population. In patients with sarcoidosis, specificity was 80 percent. Lown's grade 4 A and 4 B VEBs were detected in 8 (67 percent) of 12 patients with cardiac sarcoidosis, in 2 (8 percent) of 26 patients with sarcoidosis without cardiac involvement, and in 2 (3 percent) of 58 controls. Holter monitoring was associated with a sensitivity of 67 percent and a specificity of 80 percent for identification of cardiac involvement in patients with systemic sarcoidosis. Our findings suggest that 24-h Holter monitoring provides a convenient and inexpensive means of noninvasive screening for cardiac involvement in generalized sarcoidosis, even in patients and outpatients who are without symptoms.