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How to deal with the waste polystyrene and rubber has become a key research topic recently. This research attempted to process the waste rubber and waste polystyrene with chemical additives to produce the flexible coating material for concrete waterproofing. Based on the best guess on the configuration of the coating constituents by the grid-point method, the design experimental levels (3 levels) for different coating constituents could be decided by introducing the golden-section ratio. Then, the orthogonal experimental design method L27(313) was adopted by choosing surface-drying time, viscosity, water permeability, tensile strength, pull-elongation rate as orthogonal indicators. Through orthogonal experiment design method, the most influential coating constituents on different indicators were experimentally investigated. The results of the water permeability test showed that the water permeability of the coating was 0 mL and the water resistance was good. The analysis results of the orthogonal table showed that the material factors and levels affecting the tensile strength of the waste EPS flexible waterproof coating were: plasticizer (10.09%), polystyrene (17%), rubber powder (14%) and curing agent (5.1%), and the material factors and levels affecting the elongation of the waste EPS flexible waterproof coating are: plasticizer (2%), curing agent (5.1%), rubber powder (11.91%) and EPS (17%). This result can be used as a reference for adjusting the proportion of waste EPS flexible waterproof coating in the future.

This study was explored in series of the optical, thermal, and structure properties based on 60P2O5–10Al2O3–30ZnO (PAZ) glasses system that doped with varied rare-earth (RE) elements Yb2O3/Er2O3. The glass transition temperature, softening temperature and chemical durability were increased with RE-doping concentrations increasing, whereas thermal expansion coefficient was decreased. In the optical properties, the absorption and emission intensities also increase with RE-doping concentrations increasing, When Er2O3 and Yb2O3 concentrations are over than 3 mol% in the Er3+-doped PAZ system and Yb3+-doped concentration is over than 3 mol% for Er3+/Yb3+-codoped PAZ system, the emission intensity significantly decreases presumably due to concentration quenching, formation of the ions clustering, and OH− groups in the glasses network. It is suggested that the maximum emission cross-section (σe) is 7.64 × 10− 21 cm2 at 1535 nm is observed for 3 mol% Er3+-doped PAZ glasses. Moreover, the maximum σe × full-width-at-half-maximum is 327.8 for 5 mol% Er3+-doped PAZ glasses.

The cathode erosion rate, arc root velocity and output power of a well-type cathode (WTC), non-transferred plasma torch operating in air are studied experimentally in this paper. An external solenoid to generate a magnetically driven arc and a circular swirler to produce a vortex flow structure are equipped in the studied torch system, which is designed to reduce the erosion rate at the cathode. A least square technique is applied to correlate the system parameters, i.e. current, axial magnetic field and mass flow rate, with the cathode erosion rate, arc root velocity and system power output. In the studied WTC torch system, the cathode erosion has a major thermal erosion component and a minor component due to the ion-bombardment effect. The cathode erosion increases with the increase of current due to the enhancement in both Joule heating and ion bombardment. The axial magnetic field can significantly reduce the cathode erosion by reducing the thermal loading of cathode materials at the arc root and improving the heat transfer to gas near the cathode. But, the rise in the mass flow rate leads to the deterioration of erosion, since the ion-bombardment effect prevails over the convective cooling at the cathode. The most dominant system parameter to influence the arc root velocity is the axial magnetic field, which is mainly contributed to the magnetic force driving the arc. The growth in current has a negative impact on increasing the arc root velocity, because the friction force acting at the spot due to a severe molten condition becomes the dominant component counteracting the magnetic force. The mass flow rate also suppresses the arc root velocity, as a result of which the arc root moves in the direction against that of the swirled working gas. All system parameters such as current, magnetic field and gas flow rate increase with the increase in the torch output power. The experimental evidences suggest that the axial magnetic field is the most important parameter to operate the straight-polarity WTC plasma torch at high output power with a limited cathode erosion rate. This emphasizes the importance of an external magnetic field on a WTC torch system for reducing the erosion at the cathode.

Inhibition of diacylglycerol lipase (DGL)β prevents LPS-induced pro-inflammatory responses in mouse peritoneal macrophages. Thus, the present study tested whether DGLβ inhibition reverses allodynic responses of mice in the LPS model of inflammatory pain, as well as in neuropathic pain models.Initial experiments examined the cellular expression of DGLβ and inflammatory mediators within the LPS-injected paw pad. DAGL-β (-/-) mice or wild-type mice treated with the DGLβ inhibitor KT109 were assessed in the LPS model of inflammatory pain. Additional studies examined the locus of action for KT109-induced antinociception, its efficacy in chronic constrictive injury (CCI) of sciatic nerve and chemotherapy-induced neuropathic pain (CINP) models.Intraplantar LPS evoked mechanical allodynia that was associated with increased expression of DGLβ, which was co-localized with increased TNF-α and prostaglandins in paws. DAGL-β (-/-) mice or KT109-treated wild-type mice displayed reductions in LPS-induced allodynia. Repeated KT109 administration prevented the expression of LPS-induced allodynia, without evidence of tolerance. Intraplantar injection of KT109 into the LPS-treated paw, but not the contralateral paw, reversed the allodynic responses. However, i.c.v. or i.t. administration of KT109 did not alter LPS-induced allodynia. Finally, KT109 also reversed allodynia in the CCI and CINP models and lacked discernible side effects (e.g. gross motor deficits, anxiogenic behaviour or gastric ulcers).These findings suggest that local inhibition of DGLβ at the site of inflammation represents a novel avenue to treat pathological pain, with no apparent untoward side effects.

This study investigates the removal of perchlorate in solution using single-walled carbon nanotubes (SWCNTs) as sorbents. The perchlorate adsorption capacity, kinetics, and thermodynamics of the SWCNTs were assessed. The influences of pH, solution ionic strength, time, and temperature on the adsorption were examined. Adsorption equilibrium was achieved in approximately 8 h. The adsorption data were fitted with three models: modified Freundlich, pseudo-first-order, and pseudo-second-order. The modified Freundlich model produced the best fit to describe the kinetic adsorption processes. The adsorption capacity increased as the concentration of perchlorate increased and as the ionic strength of the solution decreased. Maximum perchlorate adsorption capacities of 10.03–13.64 mg/g were attained within a temperature range of 5–45°C. The thermodynamic parameters were also calculated: equilibrium rate constant, standard free energy change, standard enthalpy change, and standard entropy change. In summary...

Noah (version 2.7.1), the community land-surface model (LSM) of NCEP-NCAR, which is widely used to describe the land-surface processes either in stand-alone or in coupled land–atmospheric model systems, is recognized because snow–water equivalent (SWE) can be underestimated. Noah's SWE bias can be attributed to its simple snow sub-model, which does not effectively describe the physical processes during snow accumulation and melt period. To improve SWE simulation in the Noah LSM, the Utah Energy Balance (UEB) snow model is implemented in Noah to test alternate snow-surface temperature and snow-melt outflow schemes. Snow surface temperature was estimated using force–restore method and snow melt event is regulated by accounting for the internal energy of the snowpack. The modified Noah SWE is compared with the SWE observed at California's NRCS SNOTEL stations for seven water years: 2002–2008, while the model snow-surface temperature is verified with observed surface-temperature data at an observation site in Utah. The experiments show that modification in Noah's snow process substantially reduced SWE estimation bias while keeping the simplicity of the Noah LSM. The results suggest that the model did not benefit from the alternate temperature representation but primary improvement can be attributed to the substituted snow melt process.

The implementation of Restriction of Hazardous Substances Directive (RoHS) in 2006 has led to a requirement that soldering materials used in the fabrication of printed circuit boards (PCBs) should be lead-free. This change has raised the peak reflow temperature by 30 C as compared with a tin-lead process. A protective surface finishing should be designed to maintain good solderability, by preventing the copper surface from being oxidized, both during storage after PCB fabrication and during exposures to soldering temperatures. Organic solderability preservative (OSP) is considered as a preferred low cost surface mount technology (SMT)-compatible non-metallic surface finishing method, due to the excellent surface co-planarity of the coated pads. However, the protectiveness of some commercial available OSPs is still poor and their solderability performances are always deteriorated after the multiple lead-free reflow cycles. This article presents experimental data to illustrate the newly developed OSP coating in terms of thermal resistance, copper diffusion suppression and solderability.

There are a number of final finishing technologies available in the market, each with different cost and performance attributes. The unique attributes of the Selective ENIG process have made it a popular choice for mobile device and high density interconnect (HDI) applications. This hybrid final finishing process combines the benefits of both ENIG and organic solderability preservative (OSP) processes. ENIG surfaces typically exhibit excellent planarity, electrical contact performance, solderability, wire bondability and wear/abrasion resistance, while OSP shows excellent solder joint reliability. However, the OSP process, applied after the ENIG step, induces a great stress on the corrosion resistance of the ENIG deposit. Attack of the aggressive process chemistries used in the OSP process on an ENIG deposit with insufficient corrosion resistance might cause nickel corrosion, gold peel-off or solder joint failure, which could affect the reliability of final product. Appropriate corrosion protection against multiple passes through an OSP process is therefore required. A new electroless nickel, which is compatible with a low gold immersion gold process, has been developed to protect ENIG deposits from corrosion after multiple OSP exposures, and to minimize the potential for galvanic corrosion during immersion gold plating. In this article, the characteristics of this newly developed electroless nickel process are described. Corrosion resistance capability to OSP is compared with currently available ENIG processes. The solder joint intermetallic compound structure and reliability performance are also discussed.

Summary A new glyco-derivative compound (OCTAM) was developed and labelled with isotope to form 188Re-OCTAM as a candidate nuclear medicine imaging agent for testing the liver function. We evaluated the potential of isotope-labelled OCTAM for estimating the remnant liver function in vitro and in vivo schistosoma-infected mice. The affinity of OCTAM to liver asialoglycoprotein receptors (ASGPR) was assessed by competitive inhibition assay in vitro. In vivo assessments were performed to score the remnant liver function in mice at different schistosomal infection stages. OCTAM binds specifically to ASGPR and showed competitive inhibition of anti-ASGPR antibody binding to hepatocytes, and was higher than that of other galactosyl ligands. Micro-SPECT/CT images of uninfected mice revealed strong liver uptake. Quantified serial images of mice infected for 9, 12 and 18 weeks showed delayed liver uptake, and the retention of uptake was inversely correlated with stage and grade of schistosoma infection. Pathological and biochemical analysis demonstrated that gradually accumulating liver injury caused by infection significantly influenced uptake of 188Re-OCTAM. Hepatic ASGPR expression diminished only in the chronic infection stage. This study demonstrated that the isotope-labelled OCTAM could accumulate in the liver, might have potential as an imaging agent for in vivo hepatic function evaluation of schistosomiasis.

Diastolic heart failure (DHF) refers to an abnormality of diastolic distensibility, filling or relaxation of the left ventricle. The genetic study of DHF is scarce in the literature. The association of renin-angiotensin system (RAS) and DHF are well known. We hypothesized that RAS genes might be the susceptible genes for DHF and conducted a case-control study to prove the hypothesis.A total of 1452 consecutive patients were analysed and 148 patients with a diagnosis of DHF confirmed by echocardiography were recruited. We had two control populations. The first controls consisted of 286 normal subjects while the second were 148 matched controls selected on a 1-to-1 basis by age, sex, hypertension, diabetes and medication use. The angiotensin-converting enzyme (ACE) gene insertion/deletion polymorphism; multilocus polymorphisms of the angiotensinogen gene; and the A1166C polymorphisms of the angiotensin II type I receptor (AT(1)R) gene were genotyped.In a single-locus analysis, the odds ratios (ORs) for DHF were significant with the ACE DD genotype and the AT(1)R 1166 CC plus AC genotype. In addition, the concomitant presence of ACE DD and AT(1)R 1166 CC/AC genotypes synergistically increased the predisposition to DHF.Genetic variants in the RAS genes may determine an individual's risk to develop DHF. There is also a synergistic gene-gene interaction between the RAS genes in the development of DHF.

INTRODUCTION Precipitation is the key hydrologic variable linking the atmosphere with land-surface processes, and playing a dominant role in both weather and climate. The Global Water and Energy Cycle Experiment (GEWEX), recognizing the strategic role of precipitation data in improving climate research, strongly emphasized the need to achieve global measurement of precipitation with sufficient accuracy to enable the investigation of regional to global water and energy distribution. Additionally, many other international research programs have also placed high priority on the development of reliable global precipitation observation. During the past few decades, satellite-sensor technology has facilitated the development of innovative approaches to global precipitation observations. Clearly, satellite-based technologies have the potential to provide improved precipitation estimates for large portions of the world where gauge observations are limited. Recently many satellite-based precipitation algorithms have been developed (Ba and Gruber, 2001; Huffman et al ., 2002; Joyce et al ., 2004; Negri et al ., 2002; Sorooshian et al ., 2000; Tapiador 2002; Turk et al ., 2002; Vicente et al ., 1998; Weng et al ., 2003). These algorithms generate precipitation products consisting of higher spatial and temporal resolution with potential to be used in hydrologic research and water-resources applications. Evaluation of recently developed precipitation products over various regions is ongoing (Ebert, 2004; Kidd, 2004; Janowiak, 2004). In this chapter, we will introduce one near-global precipitation product generated from the PERSIANN (Precipitation Estimation from Remotely Sensed Information using Artificial Neural Networks) algorithm.

Amyotrophic lateral sclerosis (ALS) is a motor neuron disease involving both the upper and lower motor neurons in the brain stem and spinal cord. Although it is well known that various central nervous system disorders can produce a 'pseudo-infarction' pattern on the electrocardiogram, there have been no reports of this particular pattern in ALS patients. This report concerns an ALS patient who presented with an ECG pattern of S-T elevation followed by biphasic T and inverted T without any detectable myocardial abnormality. Data from the present case suggest that this pattern may be an inherent characteristic of ALS.

Genetic and environmental factors may contribute to the pathogenesis of essential hypertension. To facilitate genetic studies of hypertension and renal disorders, we sought to clone novel genes from a modified, equalized kidney (MEK) cDNA library of a spontaneously hypertensive rat (SHR).A kidney cDNA library of an SHR was synthesized using the modified equalization method. Inserts of 350 random clones were amplified by polymerase chain reaction (PCR) and sequenced, of which 246 were presumably unknown after being compared against a nonredundant database in the GenBank. The cDNA ends of clone 38S were obtained by rapid amplification of cDNA ends, sequenced, and then analyzed with Translate, Prosite, Profile, SignalP, and TMpred programs.The full-length cDNA was 938 bp, and translated into a 182-amino acid protein. The deduced protein had a metallophosphoesterase domain, a signal peptide at its amino end, a protein kinase C phosphorylation site, and a transmembrane domain. Northern blot analysis revealed that this gene was expressed in the heart, brain, spleen, lungs, liver, skeletal muscles, kidneys and testes of Sprague-Dawley rats. A putative protein of Arabidopsis thaliana shares 62% homology with protein 38S, but the two proteins differ in terms of function and structure.Our results support that protein 38S is a novel membrane metallophosphoesterase, although its function in the kidneys remains to be elucidated. This study also demonstrates the feasibility of using PCR to clone novel genes from our MEK cDNA library.

During early ventricular depolarization, the normal body surface potential map (BSPM) has a maximal potential that is greater than the absolute value of the minimal potential; this reverses in late depolarization, so that the absolute value of the minimal potential is greater. Nevertheless, an abnormal "early reversal" BSPM pattern has been observed in some patients with cardiovascular disease. To investigate the implications of this abnormal pattern, BSPMs were studied in 100 patients with angiographically proven coronary artery disease (CAD). There were 57 patients (57%; group A) with an abnormal early reversal pattern and 43 (43%; group B) without this early reversal pattern. A significant (70% narrowing) CAD lesion was observed in a significantly higher proportion of group A (97%) than group B (77%) patients, although the number of involved coronary arteries was not significantly different between the two groups. The maximal extent of the abnormal negative potential was significantly greater in group A (21.2 +/- 9.6 cm2) than in group B (12.2 +/- 7.5 cm2). The abnormal negative potential lasted significantly longer in group A (22.1 +/- 12.1 msec) than in group B (14.4 +/- 9.2 msec). Similarly, the minimal potential lasted significantly longer in group A (20.1 +/- 11.3 msec) than in group B (11.8 +/- 7.1 msec). These findings suggest that the abnormal early reversal BSPM pattern is a valuable indicator of extensive myocardial lesions and the severity of CAD.

The central neural mechanisms of circadian rhythm are well known in animal models but less so in humans. In this study we looked for correlations between abnormalities of circadian rhythm and the sites of stroke, with the aim of identifying the location regulating the circadian rhythm in humans. We investigated the circadian profiles of arterial pressure in 100 stroke patients by ambulatory blood pressure monitoring within 2 days after their first stroke. Patients also underwent brain computed tomography and measurements of plasma norepinephrine and adrenal hormones. A total of 52 patients (group A) had abnormal patterns of circadian blood pressure rhythm while 48 patients had normal patterns (group N). The risk of an abnormal 24-hour blood pressure pattern was strongly inversely correlated with the distance between the lesion and the hypothalamus. There was also a close positive correlation between the distance from the lesion to the hypothalamus and the circadian indices of arterial blood pressure (systolic and diastolic pressure) in both groups. Abnormal circadian changes in adrenal hormones were found in 30 of 52 patients in group A, and in nine of 48 patients in group N. Apparently, the circadian rhythm of blood pressure is modulated mainly by direct neural effects and partly by the hormonal effects of the hypothalamus and its associated neural pathways. Individualized antihypertensive treatment and additional monitoring for possible cardiac events should be performed for those at a high risk of autonomic dysfunction.

A 37-year-old man with fever, jaundice, severe right upper quadrant abdominal pain and impending septic shock was pre-operatively diagnosed to have hypoplastic right lobe liver with retrohepatic gallbladder, left hepatolithiasis and liver abscess by computed tomography. An urgent operation with cholecystectomy, choledocholithotomy, operative choledochoscopy and T-tube drainage was performed. Postoperative cholangiograms depicted multiple residual stones behind the sharply angulated biliary strictures in the medial branches of the left intrahepatic duct, which could not be eradicated by biliary dilatation via the T-tube tract. The left hepatolithiasis might be coincidental, or secondary to the congenital anomaly of the liver, because of the distorted biliary architecture, and the hypoplastic right lobe liver was associated not only with the retrohepatic gallbladder, but also with the much more complicated left biliary strictures and the hepatolithiasis behind them.

Interatrial septal dissection and penetration into the aorta by a balloon catheter occurred in a 38-year-old man with mitral stenosis as a complication of percutaneous transluminal mitral commissurotomy during trans-septal puncture. It was speculated that the thickened septum was partially punctured into the potential space between the septa primum and secundum. Then, the balloon catheter went through the interatrial septum dissection into the aortic root. Emergency surgery was performed with the catheter left in situ. The surgical findings confirmed the speculated mechanism of this rare complication. In order to avoid this complication, the location of the tip of the Brockenbrough catheter after transeptal puncture must be confirmed. Checking the left atrial pressure tracing, arterial oxygenation and contrast injection are all important and indispensable procedures.

A case-control study was carried out on 272 Chinese subjects over 40 years of age, including 157 hypertensives and 115 normotensives, to examine the association between angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism and blood pressure (BP) status. The I/D polymorphism of the ACE gene was identified by polymerase chain reaction. As a whole group, the difference of allele frequencies between normotensives and hypertensives was statistically significant (chi 2 = 4.46, P = 0.03; D/I odds = 1.46), while there was no difference in the genotype distribution (chi 2 = 3.95, P = 0.13). In a subgroup with elderly hypertension (age65), the frequencies of D-allele and DD genotype significantly increased (chi 2 = 4.43, P = 0.03 and chi 2 = 4.03, P = 0.08, respectively; D/I odds = 2.28). The association and relative risk increased further in the male gender (chi 2 = 6.65, P = 0.01 and chi 2 = 7.51, P = 0.02 respectively; D/I odds = 4.57 and DD/II odds = 12.00 respectively). The D-allele increased with age in the hypertensives, while the I-allele increased with age in normotensives. Thus, we conclude that the deletion polymorphism of the ACE gene is significantly associated with male elderly hypertension, at least in this Chinese population. This observation, if proved in a larger population, may have some implications for the prevention and treatment strategy for elderly hypertension.

Conflicting viewpoints exist concerning the risk of cardiovascular morbidity for patients with white coat hypertension. The aim of this study was to compare cardiac end-organ change in white coat hypertension with persistent mildly hypertensive patients. Twenty-two white coat hypertensive patients and 15 persistently hypertensive patients were considered eligible for the study after 24 hour ambulatory blood pressure monitoring. Echocardiography was performed on all patients. The results demonstrated that both groups had similar clinical backgrounds except that white coat hypertensives were predominantly female and had less family history of hypertension. Persistent hypertensives had significantly higher average ambulatory blood pressures and pressure loads than white coat hypertensives but there was no difference in blood pressure variability. There were no differences in cardiac structural and functional changes between the two groups. As a result, we were unable to ascertain whether white coat hypertension is a benign condition. The prognostic significance of white coat hypertension requires long term follow-up and further investigation.

This study attempted to evaluate the efficacy of several "long-acting" antihypertensive agents. One-hundred consecutive hypertensive subjects with normal casual blood pressure after once-daily antihypertensive monotherapy treatment were studied. They were divided into three groups: group A, metoprolol (100 mg, daily); group B, atenolol (100 mg, daily); and group C, nadolol (80 mg, daily). Ambulatory blood pressure monitoring (ABPM) was used to evaluate the efficacy of the antihypertensive agents. The overall average ambulatory blood pressures were within the normal limits for all three groups. However, there were some abnormally high blood pressure (BP) readings shown on ABPM. Patients with an abnormally high systolic blood pressure (SBP) average140 mmHg accounted for 16.7% of group A, 19.4% of group B and 20% of group C. Those with an abnormally high diastolic blood pressure (DBP) average90 mmHg accounted for 16.7%, 19.4% and 10%, respectively, of the corresponding groups. There were no significant differences in the frequency of abnormally high SBP and DBP among the three groups. These "long-acting" antihypertensive drugs did not effectively control BP throughout the entire day. The duration of antihypertensive effect is not necessarily reflected by the blood half-life of the drug. ABPM is an effective way to ascertain the efficacy of "long-acting" hypertensive agents.

To find the best predictors of outcome for patients undergoing intra-aortic balloon counterpulsation (IABP) for cardiogenic shock, we prospectively studied 30 consecutive patients by examining hemodynamic parameters and cardiac lactic acid extraction ratios before the procedure. 1 hour after and then every 6 hours for 3 days. Complete hemodynamic data were obtained from the recordings of Swan-Ganz catheterization. Blood samples were drawn from the peripheral artery, central vein, pulmonary artery wedge position (PAW) and right atrium (RA) to quantify lactic acid levels. The simplified lactic acid extraction ratio was defined as the concentration of lactic acid in RA--the concentration of lactic acid in PAW/the concentration of lactic acid in PAW. The traditional systemic lactic acid production ratio was defined as the concentration of lactic acid in the central vein--the concentration of lactic acid in the peripheral artery/the concentration of lactic acid in the peripheral artery. Of the 30 patients studied, 19 died of cardiogenic shock, (group 1), while the surviving 11 patients formed group 2. The lactic acid extraction ratios at each of the time periods after the procedure were all significantly different, while the differences in the systemic lactic acid production ratio and hemodynamic parameters, including the systemic arterial pressure, cardiac output, cardiac index and PAW pressure, became significant at varying times after IABP. In group 2, the lactic acid extraction ratios 1 hour after IABP and later were all significantly higher than at baseline. This trend was not seen in group 1.(ABSTRACT TRUNCATED AT 250 WORDS)

The objectives of this study were to examine the serial vectorcardiographic changes following acute myocardial infarct and to assess the relationship between QRS loop changes and infarct size. Fifty adult male Long-Evans rats of 250-350 gm body weight were used to study experimental acute myocardial infarction induced by coronary artery ligation. Vectorcardiograms (VCG) of the Frank lead system were recorded before, and 1 day and 7 days after operation. Animals were sacrificed on the 7th day for histological quantitation of infarct area ratios. We found that (1) before operation, rats have ST elevation, probably due to early repolarization. (2) After coronary artery ligation, ECG showed characteristic dome-shaped ST elevation at 1 hr after ligation which returned to normal during the first day. Abnormal Q waves appeared thereafter. (3) After ligation, maximum QRS vector, ST vector and maximum T vector were reduced in magnitude the first day and recovered by the 7th day. The vectors tended to shift their direction to the right and to the posterior. QRS-T angle, however, widened as time went on. About half of the rats revealed changes in the inscription direction of the QRS loop and abnormal QRS morphology also appeared in about half of the ligated rats. (4) Those in whom abnormal QRS loop morphology and/or biting appeared had significantly larger infarct area ratios (p0.01). (5) Change in QRS loop inscription direction seemed not to be related to the infarct size. (6) In the LS plane, the difference in max QRS vector magnitude between the 1st and 7th days significantly correlated with the infarct area ratio (r = 0.533, p0.05). In the H plane, the change in the max QRS vector magnitude at the 7th day correlated with the infarct area ratio (r = -0.531, p0.05). In the F plane, changes in the direction of the max QRS vector were significantly correlated to the infarct area ratio both on the first (r = 0.431, p0.05) and 7th days (r = 0.531, p0.05). It is concluded that the VCG, like the ECG, had evolutional changes in AMI and that the QRS loop seen on vectorcardiography has only a slight correlation with the histological myocardial infarct size.

EGb 761 is a preparation of Ginkgo biloba extract, which has complex biologic actions including free radical scavenging activity. To examine the anti-arrhythmic effect of EGb 761, a canine preparation of coronary artery occlusion-reperfusion was tested. Under intravenous anesthesia and open chest conditions, 32 dogs were subjected to 30 min of coronary occlusion, followed by reperfusion. Twelve received EGb 761 by intravenous injection, 1 mg/kg five minutes before coronary occlusion, followed by a continuous infusion of 0.1 mg/kg/min until five minutes after reperfusion. Immediately prior to reperfusion, an additional bolus dose of EGb 761 (1 mg/kg) was again injected (group A). The remaining 20 dogs received saline injection, and served as the control (group B). The electrocardiographic changes were recorded during the whole experimental course. The results showed that, during coronary occlusion, group A dogs had a lower count of ventricular premature beats than group B dogs. However, there was no difference in the incidence of ventricular tachycardia (VT) between the two groups. The duration of VT of the treated dogs was similar to that of the control dogs. The incidence of ventricular fibrillation (VF) was also similar. Upon reperfusion, the treated dogs were shown to be protected from VF. The duration of VT was also shorter in the treated group, although the incidence of VT was not different between the two groups. EGb 761 is effective in preventing early VF induced by coronary reperfusion while ineffective in protecting the ischemic VT and VF.

An unusual case of suprahepatic gallbladder with agenesis of the right lobe of the liver is reported. The anomalous position of the gallbladder was detected by ultrasonography. It was shown to be distended and to contain sludge. The suprahepatic location with agenesis of the right lobe of the liver was preoperatively confirmed by computed tomography. The patient underwent cholecystostomy with drainage and had an uneventful recovery. The postoperative follow-up examinations, including endoscopic retrograde cholangiopancreatography, ultrasonography, arteriography and portography, all added information rarely reported in the literature and helped in the understanding of this uncommon case. Laparoscopic cholecystectomies are widely used but such a procedure was contraindicated in this case because of the ectopic position and inaccessibility of the gallbladder.

To investigate the influence of age on ambulatory blood pressure monitoring (ABPM) in hypertensive patients whose controlled casual blood pressure was normal, we studied the ABPM in 225 patients, including 122 men and 103 women, aged from 45-74 years. They were classified into three groups: Group A included 93 patients aged 45 to 54 years; Group B included 99 patients, aged 55-64 years; and Group C included 33 patients, aged 65 years and over. The various ABPM data were analyzed and compared among the three groups. The following results were found. The blood pressure (BP) averages for the whole day were normal in all three groups. There was no difference in the systolic BP average among the three groups, but the diastolic BP average declined as age increased. The variability in the systolic BP measurements increased with age. The variability in diastolic BP did not seem to change as conspicuously with age, except for the group C patients who showed a larger variability at nighttime than the other two groups. There were 123 patients (54.7%) with evidence of diurnal change in BP, and the incidence of diurnal change in BP decreased with age. The frequency of abnormally high systolic BP was similar among the three groups, but the frequency of an abnormally high diastolic BP decreased significantly with age. As for the maximal BP levels recorded in the ABPM, group C patients had a higher maximal systolic BP than the other two groups. Therefore, age has a great influence on ABPM in controlled hypertensive patients with normal casual BP.

Cardiac amyloidosis, an uncommon disease, has been reported to manifest as congestive heart failure (CHF) and/or various arrhythmias. Herein, we report a case of CHF and sick sinus syndrome. The patient, a 66-year-old man, was admitted to the National Taiwan University Hospital because of dizzy spells and recurrent syncope. Electrocardiogram showed a sinoatrial block, first degree atrioventricular block, right bundle branch block and low-voltage Q wave, R wave and S wave (QRS) complex. Prolonged corrected sinus node recovery time was documented by an atrial pacing study. A permanent pacemaker was implanted for the patient's bradyarrhythmia, but he developed progressive heart failure. Echocardiography revealed a normal-sized ventricular chamber, concentric left ventricular hypertrophy with a "granular sparkling" appearance of the myocardium, and impaired diastolic and systolic function of the left ventricle. Despite aggressive treatment, the patient expired due to intractable heart failure. Postmortem needle aspiration revealed amyloidosis involving the heart, lung and skin. We conclude that cardiac amyloidosis should be considered in elderly patients with conduction disturbance and unexplained congestive heart failure.

The pathogenic role of enterovirus in patients with idiopathic dilated cardiomyopathy has been determined through a molecular biologic approach. Sensitivity in the detection of viral genomes in tissues varied between conventional nucleic acid hybridization and polymerase chain gene amplification. To improve diagnosis, we developed a strategy for reverse transcription polymerase chain reaction (RT-PCR) to detect viral RNA. We synthesized two sequence-specific oligonucleotides, primer 1 (5'dACCGACGAATACCACTGTTA3') and primer 2 (5'dCCTCCGGCCCCTGAATGCGGCTAAT3'), complementary to the 5' conserved viral genomic fragments. Viral RNA was amplified by double PCR with these two primers and hybridized with a 32-P labeled inter-primer probe (5'dATGAAACCCACAGGCACAAAG3'). Using this strategy, we detected as little as 10(-8) micrograms of coxsackievirus B3 RNA after amplification with RT-PCR, but detected none in the plasma of eight healthy adults. Among 15 patients with idiopathic dilated cardiomyopathy, viral RNA could be detected in one out of 12 plasmas (8%) and three out of four explanted heart tissues (75%). In contrast, no viral RNA could be detected in six samples of myocardial tissue from patients with other heart diseases. The only patient who had viral RNA in his plasma also had viral RNA in his myocardium. Thus, the high incidence of viral RNA in these patients suggests a possible etiologic link between them. Correct selection of specific PCR primers and the application of double PCR can improve chances of diagnosing enteroviral infection.

To study the relationship between the plasma concentration of the atrial natriuretic peptide (ANP) and heart function and to discern the secretion pathway of ANP, we determined the peripheral plasma concentration of ANP in 18 heart patients and the intracardiac concentration of ANP in six heart patients during cardiac catheterization. All plasma was extracted through a Sep-Pak C18 cartridge by acid alcohol. The concentration of ANP was determined by a sensitive and specific radioimmunoassay method. We found that the plasma ANP concentration (pg/mL) in heart patients (ranging from 12 to 139, mean = 36.1 +/- 28.9) was statistically higher than that in normal adults (ranging from 8 to 20, mean = 12.4 +/- 3.3, n = 16; p less than 0.05). The ANP level in heart patients was inversely correlated with the left ventricular ejection fraction (r = -0.53, p less than 0.05) evaluated by radionuclide angiocardiography. The intracardiac level of ANP was 88 +/- 58 at the superior vena cava, 77 +/- 55 at the inferior vena cava, 124 +/- 68 at the right atrium, 98 +/- 64 at the right ventricle, 107 +/- 58 at the pulmonary artery, 98 +/- 52 at the left ventricle, 109 +/- 73 at the aorta and greater than 351 at the coronary sinus. In conclusion, ANP is mainly secreted via the coronary sinus into the atrial cavity. The peripheral plasma ANP concentration is higher in heart patients. It increases as the left ventricular ejection fraction decreases. Therefore, plasma ANP concentration may be a useful indicator for the assessment of cardiac function.

Atrial natriuretic peptide (ANP) is a cardiac hormone with an important role in fluid, electrolyte and hemodynamic homeostasis. Rat ANP cDNA was cloned from the cDNA library constructed using 1 microgram of atrial mRNA from the heart of Wistar rats. Eight positive clones were isolated with an ANP oligonucleotide probe. One of them with about a 0.8 kb insert was selected for further subcloning and sequencing analysis. The rat ANP cDNA had 813 base pairs with a concensus sequence for transcription initiation, termination and poly A tailing. The deduced amino acid sequence contains a potential glycosylation site and two putative protease cleavage sites. Northern blot analysis showed that the ANP gene was specifically transcribed in the rat atria rather than the ventricles. The results suggest that ANP gene expression is differentially and developmentally controlled.

Vectorcardiographic (VCG) studies were conducted in 71 patients with pure mitral stenosis (MS) documented by clinical findings, echocardiograms and cardiac catheterization. Among them, 31 were males and 40 females, with ages ranging from 20 to 58 (mean age 36.3) years. The Frank lead system was adopted for the VCG study. By VCG, 67 patients (94.4%) showed right ventricular hypertrophy (RVH), among whom 15 (21.2%) were type A, 30 (42.3%) type B and 22 (31.0%) type C. Forty-five patients (63.4%) were in sinus rhythm (NSR), while the remaining 26 (36.6%) were in atrial fibrillation (AF). Patients with type A RVH had a significantly higher pulmonary wedge (PAW) and main pulmonary arterial (MPA) pressures than those with type B or C. Patients with type C had a higher mean MPA pressure (39.0 +/- 11.3 mmHg) than those with type B (32.3 +/- 10.1 mmHg) (p less than 0.05). Among the 3 types of RVH, the mean right atrial (RA) pressures were similar (p greater than 0.05). Patients with AF had a lower mean MPA pressure, but a higher RA pressure than those with NSR (p less than 0.05). The maximal anterior force and maximal rightward force at the horizontal plane were significantly correlated with the mean MPA pressure (r = 0.54 and 0.49, respectively, both p less than 0.01), but they did not correlated well with the PAW and RA pressures (p greater than 0.05). We conclude that in patients with MS, as pulmonary hypertension progresses, VCG seems to begin with type B RVH, then emerges into type C and finally becomes type A.(ABSTRACT TRUNCATED AT 250 WORDS)

Body surface potential maps (BSPMs) and the pathology of 32 dogs with coronary artery ligations were analyzed to research the application of BSPMs to acute myocardial infarction (AMI). The group consisted of 18 dogs with left anterior descending coronary artery (LAD) ligations, 8 with right coronary artery (RCA) ligations and 6 with left circumflex coronary artery (LCX) ligations. The abnormal distribution of negative potential and minimal potential were observed in all of the dogs. In dogs with RCA ligations, the abnormal negative potential displayed on the right-superior, right-inferior or right portion of the anterior thorax. In those with LAD ligations, the abnormal potential appeared on the left-superior, left-inferior, middle-superior or middle portion of the anterior thorax. In those with LCX ligations, the abnormal potential showed on the left-superior or left-middle portion of the thorax. A good correlation was observed between the area of myocardial lesion and the extent of abnormal negative potential distribution (r = 0.82, p less than 0.001). A close correlation was also found between the area of myocardial lesion and the duration of abnormal negative potential (r = 0.61, p less than 0.05). This study suggests that BSPMs are useful in the assessment of AMI in terms of diagnosis, location and extent of myocardial infarct.

The friction and wear characteristics of types 304, 316 and Nitronic 60 stainless steel sliding against 440C have been compared. The studies involved a wide range of experimental techniques to characterize the wear specimens and the debris particles including optical metallography, microhardness tests, X-ray diffraction, scanning electron microscopy, microprobe analysis and transmission electron diffraction. These complementary techniques reveal that strain-induced ϵ and α' martensite phases are formed during sliding. The friction, wear and galling characteristics of these alloys depend on the stability of the austenite phase, the hardness of the α' phase and the hardness gradient.

Measurements of thermal conductivity of heat-treated and γ-irradiated polytetrafluoroethylene (PTFE) are reported for the 10–180°C. temperature range. Conductivity of PTFE is observed to be largely temperature-independent with a value of about 6.5 × 10−4 cal./cm.-sec.-°C. for the as-received material. Slight anomalous changes in conductivity data occur in the 20 and 125°C. temperature regions. The former is assumed to be associated with the first-order crystalline transitions which occur near 19 and 30°C., while the latter may be associated with a relaxation process near 400°K. The anomaly in the conductivity which occurs near 20°C. is affected by annealing or radiation treatments, and is correlated with crystallinity and specific volume changes previously reported. The overall conductivity level is observed to decrease for annealed, quenched, or irradiated samples. From estimates of crystallinity, it is noted that the thermal conductivity is not a simple function of per cent crystallinity in these cases.

The aim of this study was to investigate the efficacy of the influenza vaccine among cancer patients in Taiwan. We determined the effect of immunization on the following outcomes of disease: hospitalizations, emergency department visits, hospital out-patient visits, physician office visits, and deaths. Cost-effectiveness was analysed from the perspectives of the healthcare system and society. A decision tree was used, with estimates of disease burden and costs based on data from published and unpublished sources. The model followed 34 112 cancer patients aged 20–64 years who were registered by the Taiwan National Cancer Registry in 2002. An influenza immunization programme for the cancer population would prevent 2555 cases of all types of influenza infection, 660 of which would be serious cases involving hospitalization, emergency department visits and death. From the perspective of the healthcare system, the programme would cost US$7.7 million, providing net savings of US$5.4 million. From a societal perspective, the programme would cost US$28.6 million, providing net savings of US$22.3 million. This corresponds to savings of US$2107 and US$6338 per case averted, from healthcare and societal perspectives, respectively, as well as 110 lives saved. Lesser disease burden, greater vaccine efficacy and lower cost of hospitalizations increased cost-effectiveness. Influenza immunization for cancer patients is cost-saving and cost-effective from a healthcare and societal perspective in Taiwan. We highly recommend annual influenza vaccinations for this patient group.