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Hypertension is a disease state characterized by increased blood pressure (BP) associated with hemodynamic abnormalities, including elevated systemic vascular resistance index (SVRI); and altered cardiac index (CI). The objective of this study was to use noninvasive impedance cardiography (ICG) to evaluate hemodynamic characteristics of subjects with and without hypertension.A total of 19 healthy nonhypertensive and 136 hypertensive subjects were retrospectively evaluated. Hemodynamic parameters were measured with ICG and included CI, SVRI, total arterial compliance index (TACI), and thoracic fluid content (TFC); these were compared with subject type, blood pressure value, demographics, and medications.The BP levels of healthy and hypertensive subjects were 117/71 and 154/90 mm Hg, respectively (P.0001). Subjects with prehypertension had a lower TACI (0.97 v 1.21, P.05) compared with those with a normal BP, ie,120/80 mm Hg. Hypertensive subjects had significantly lower SI, CI, TACI, and TFC and significantly higher SVRI. Subjects with stage 2 hypertension had higher SVRI (4149 v 3418 dyne.sec(2).cm(-5).m(2), P.01) and lower TACI (0.61 v 0.53 mm Hg/mL/m(2), P.05) than those with stage 1 hypertension. Compared with subjects with controlled hypertension, normal subjects had significantly lower SVRI (1996 v 2746 dyne.sec(2).cm(-5).m(2), P.0001) and significantly higher CI (3.23 v 2.63 L/min/m(2), P.001), SI (48.2 v 37.4 mL/m(2), P.0001), TACI (1.08 v 0.85 mm Hg/mL/m(2), P.01), and TFC (29.1 v 24.1/kOhm, P.0001). The parameters of TACI, SVRI, and CI demonstrated modest correlation (-0.75, 0.62, and -0.30), respectively, with SBP. In the 54 subjects with BP140/90 mm Hg, SVRI values varied significantly, with 32 subjects (39.2%) with SVRI values in the high range (2483 dyne.sec(2).cm(-5).m(2)).Hemodynamic parameters from ICG displayed significantly different hemodynamic profiles between hypertensive and nonhypertensive subjects. However, significant individual variation of hemodynamic status exists. Hemodynamic measurements with ICG characterize hemodynamic status and may be helpful in diagnostic, prognostic, and therapeutic decision making in hypertensive subjects.

Pulmonary thromboendartectomy (PTE) for chronic thromboembolic pulmonary hypertension may be complicated by reperfusion lung injury. This has previously been demonstrated to be neutrophil-mediated. We postulated that blocking selectin-mediated adhesion of neutrophils to the endothelium with Cylexin (CY-1503) would prevent reperfusion lung injury in this patient population. In this double-blind, randomized, placebo-controlled, parallel study, 26 patients received Cylexin the day of surgery and 25 received placebo. Significantly fewer patients in the treated group (31%) compared with the placebo group (60%) developed lung injury (p = 0.036). However, the average number of days of mechanical ventilation, days in the intensive care unit (ICU) and hospital, as well as mortality were not significantly different between the treatment groups. Those with reperfusion lung injury had significantly elevated percent neutrophils, total protein, and soluble P-selectin in bronchoalveolar lavage fluid compared with those without lung injury. We conclude that reperfusion lung injury after PTE is a high-permeability lung injury and its incidence can be reduced by the administration of Cylexin on the day of surgery.

Objective: Hypertension affects 73 million Americans and costs the US healthcare system over $73 billion annually. Despite increasing awareness of the consequences of uncontrolled hypertension, numerous antihypertensive pharmacologic clinical studies and consistent updates to hypertension guidelines, control rates are suboptimal and have not met national goals. Among treated hypertensives, only 45% of women and 51% of men have reached blood pressure (BP) levels below 140/90 mmHg. Individualization of antihypertensive regimens with hemodynamic information from impedance cardiography (ICG) has been advocated to further improve hypertension control rates. We therefore undertook a quantitative analysis of the trials evaluating the role of ICG as an adjunct to therapeutic decision-making in the treatment of hypertension and the attainment of BP control. Methods: Five studies comprising a total population of 759 patients met the inclusion criteria. Two randomized controlled trials (RCTs) involving a total of 268 patients and three single-arm prospective trials with 491 patients were evaluated using ICG data to guide therapeutic decision-making in the treatment of hypertensive patients. Results: Significant benefit was found in both RCTs for ICG-guided BP treatment. The combined odds ratio for the two trials was 2.41 (95% CI = 1.44-4.05, p = 0.0008), in favor of ICG treatment, meaning that it was more than twice as likely to achieve BP success when using ICG than if ICG was not used. Success attainment of goal BP of Conclusion: The results of this meta-analysis confirm the value of using ICG-derived hemodynamic data as an adjunct to therapeutic decision-making in the treatment of hypertension. The data reviewed here demonstrate that ICG-based approaches are in keeping with previously advocated strategies incorporating patient-individualized drug regimens, evidence-based medicine, and practical, easy to apply, cost-effective principles to further improve hypertension control rates.

Background Morbid obesity results in multiple comorbidities and an increased mortality rate. The National Institutes of Health has stated that surgery is the most effective long-term therapy; therefore, we evaluated a laparoscopically implantable adjustable gastric band. Methods We reviewed 2 multicenter prospective, open-label, single-arm surgical trials—trial A (3 years) and trial B (1 year)—with ongoing safety follow-up. These trials were conducted in United States community and university hospitals (trial A = 8 sites and trial B = 12 sites). Trial A comprised 292 subjects (mean ± SD preoperative weight: 133 kg ± 24.4), and trial B comprised 193 subjects (129 kg ± 20.8). Intervention included placement of a constrictive, adjustable band around the upper stomach to limit food intake and induce weight loss. Main outcome measures were the primary efficacy end point of weight loss. Secondary end-points were change in quality-of-life, safety parameters, and complications, including band slippage, reoperation, and device explantation. Results In the 2 trials, 485 devices were implanted (92% laparoscopically), and no deaths occurred. Of the patients in trial A, 206 (70.5%) completed the 3-year follow-up, and 142 (73.6%) of patients in trial B completed the 1-year follow-up. Weight-loss results, using the last value carried forward, for all 292 patients in trial A and all 193 patients in trial B demonstrated a change in mean body mass index (kg/m2) ± SD from 47.4 ± 7.0 to 39.0 ± 7.3 in trial A and from 46.7 ± 7.8 to 38.4 ± 7.6 in trial B subjects at 1 year (P < .001 for both trials A and B), with minimal further change at 3 years (39.0 ± 8.5) in trial A subjects. The percentage of initial body weight lost at 1 year was 17.7% ± 9.4% for trial A subjects and 18.2% ± 8.9% for trial B subjects, whereas the 3-year total for trial A subjects was 18.3% ± 13.1%. At 1 year, 76% of patients in trial A and 66% of patients in trial B had complications, mostly related to upper gastrointestinal symptoms. By 9 years after surgery, 33% (96 of 292) of trial A subjects had their devices explanted because of complications or inadequate weight loss. Conclusions These first-generation implantable adjustable gastric band results suggest that this is a viable bariatric surgery therapeutic option for the treatment of obesity.

36 male students, 29 undergraduate, and 7 graduate, were given a photograph of one of two women (one of whom was judged to be considerably more attractive than the other) and one of two “autobiographical” statements (one of which depicted a warm, friendly person and the other a cold, unfriendly person). Each subject examined the material from one of the four possible treatment levels and rated the woman for personality, social, and physical attractiveness. The subjects also rated themselves for physical attractiveness. Two 2 × 2 multivariate analyses of variance were performed to evaluate subjects' ratings of personality and social attractiveness and a 2 × 2 analysis of variance was used to evaluate ratings of physical attractiveness. Personality ratings were significantly increased by the friendliness and physical attractiveness of the stimulus while the social attractiveness of the woman was significantly increased only by her physical attractiveness. Ratings of physical attractiveness were significantly influenced only by the photographs. The subjects' self-ratings were uncorrelated with their ratings of the women's physical attractiveness.

Many statistical tests assume homogeneity of variance, and may be affected by the violation of this assumption. This is particularly the case with analysis of variance for unequal cell size. For this reason, a powerful and robust test to detect heterogeneity of variance is de­ sirable. Unfortunately, most commonly used tests of homogeneity of variance are sensitive to departures from normality, especially with respect to departures from nonzero kurtosis (Box, 1953). A test that has been shown to be robust to violation of distribution assump­ tions is the Scheffe test, described by Winer (1971, pp.219·220). In the Scheffe test, each treatment group is randomly divided into a number of subsamples, and their variances are computed. The logarithms of the variances are taken, and an analysis of variance is performed. Two major drawbacks exist with the Scheffe pro­ cedure. First, because the grouping of subsamples is random, the test does not yield a unique solution. This has led some to reject it as unacceptable (Brown & Forsythe, 1974). Second, the test generally has poor power to detect existing heterogeneity of variance. Description. The present program uses a Monte Carlo sampling procedure to minimize the uniqueness problem and to provide information on the power to detect a specified degree of heterogeneity of variance. Essentially, the program computes the F statistic for a randomly generated group of subsamples and repeats this process a specified number of times, each time operating on a newly generated set of subsamples. The size of the loop is presently set at 100. In this manner, a mean F ratio, based on the series of replications, provides a stable estimate of the F ratio, with reduced influence from random subsample formation. To provide information on power to detect a given level of hetero­ geneity of variance, a series of runs can also be performed on a set of internally generated normal random deviates with a built-in degree of variance heterogeneity. In this way, a simulation, conforming to a researcher's design in terms of sample size and number of treatment groups, yields an empirical estimate of power to detect a degree of heterogeneity of variance. The number of replications performed to provide an estimate of power is currently set at 500.

Singer, Gollob, and Levine (1967) found that Ss who had viewed brutal Goya etchings rated aggressive cartoons as significantly less funny than Ss who had viewed neutral Goya etchings; this effect did not occur with the nonaggressive cartoons. Singer, et al. attributed the decreased humor ratings to the psychoanalytic concept of mobilized inhibitions against aggression. The present study attempted to mobilize these inhibitions by means of a written description of torture. ColIege students (15 male and 15 female) were randomly assigned to three treatment groups. One group read a vivid description of a brutal torture-murder which was introduced in such a way as to condemn the act fully while a second group read the identical description so introduced as to mitigate the enormity of the torture (expected to lessen the inhibition effect). A control group read a nonaggressive passage of equal length. Immediately after reading the passage. all Ss rated 16 cartoons for humor on a four-point scale ranging from not funny to very funny. Eight of the cartoons were nonaggressive and 8 aggressive; the aggressive cartoons depicted beatings, torture, and murder. The cartoons were arranged in random order. A two-way analysis of variance (sex and treatment as main effects) was performed on the difference berween Ss' aggressive cartoon score and neutral score to check for the predicted differential lowering of ratings in the aggressive cartoons. Another two-wag analysis of variance was performed on rhe total humor scores to check for a possible generalized inhibitory effect. Neither test yielded significant results (Ps < 1.00). Although all but two of the 20 Ss reported that the torture description was unpleasant to read, it is quite possible that the treatment did not have the desired potenq. Or, it may have been that inhibitions were mobilized but that a concomitant arousal of aggressive drive neutralized the effect. Dworkin and Efran (1967) demotutrated that aggressive arousal is capable of increasing humor ratings of aggressive humor. It remains for fume research to determine the validity of the psychoanalytic framework by manipulating the degree to which each variable operates.