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The purpose of Binding Things Together: Teaching as a Religious Activity, as Ronald Noone states in the introduction, is “to argue that religion and education remain indispensable vehicles for livi...

Some middle grades educators find ways to engage and inspire their students in an era of high-stakes testing and rigid accountability policies.I love my job, I love to teach and learn. ... I will never give up the good fight for the rights of my students to get the best from me as a teacher. ... I sadly and strongly feel our current direction with assessment is the wrong way and that there are other acceptable ways to move forward [that] don't take away quality teaching and learning. I love the kids, but the picture on a student's face today, knowing he was the only one not to finish the test, brought tears to my eyes. (MS-U.S. middle grades teacher, excerpt of an e-mail to his school's principal)After a decade of collaboration and research on middle grades education, the wisdom of dozens of teachers, administrators, and university faculty has led us to a compelling set of observations (e.g., Dalton, Samek, Olson, Greene, Caskey, & Musser, 2004; Greene, Caskey, Musser, Samek, Casbon, & Olson, 2008; Greene, Caskey, Musser, Samek, & Olson, 2005; Musser, 1998; Samek, Kim, Casbon, Caskey, Greene, & Musser, 2010; Samek, Musser, Caskey, Olson, & Greene, 2006). Teachers and principals know what is best for their students, value collaboration, and are passionate about teaching and learning. Yet, these educators also express deep concern stemming from the tension of trying to enact their heartfelt vision of teaching within a culture of standardization and accountability.The purpose of this article is to share wisdom collected from the field and offer a view of meaningful learning, explore the tensions that exist in educators' work, and invite conversation about the future of educational practice. The anecdotes and data come from a series of research studies conducted from 2001 to 2011 by a cadre of middle grades researchers- university faculty from public and private universities across Oregon. Over the past decade, we studied the perspectives of middle grades principals, middle grades teachers, university faculty, and district personnel directors representing distinct communities (urban, suburban, rural), disparate demographics (e.g., low SES to high SES), and varying school size (i.e., small to large middle schools). We guided each study with research questions such as: How are national policies affecting how teachers view the nature of their work? How does national policy affect the way middle school teachers balance the academic-cognitive needs of young adolescents with their social-emotional needs (Dalton et al., 2004)? How have high-stakes accountability measures based on yearly academic testing influenced teachers' curriculum, instruction, and assessment practices (Greene et al., 2008)? What are the perceptions of middle grades university faculty, classroom teachers, and principals regarding well-prepared middle grades teachers (Samek et al., 2010)? We used a variety of data collection methods including surveys, interviews, and focus groups to build an understanding of school and university perspectives.What we learned is that teachers often find themselves caught between the expectations of external influences and their responses to the deep needs and yearnings of their students. In the words of one veteran middle grades teacher, "I'm tired of my inability to do what's best for my kids." When teachers like this one act on their inclinations to do what is best for students, they may feel their behavior is subversive. Another middle grades teacher explained during a focus group interview,I feel like I do it a lot more, but I feel like I kind of have to hide it a little bit. If I'm going to be talking to some kids about something real, authentic, something emotional, I kind of have to go shut the door, you know what I mean? (Samek et al., 2006, p. 28)Although principals recognize the pressures placed on teachers, they are not positioned to question mandates because one of their roles is to enforce policy. …

There is general agreement that aortocoronary bypass surgery improves angina pectoris in a high percentage of patients (Council on Scientific Affairs 1979). There is also agreement that in certain subgroups of patients survival is improved through the revascularization procedure (Gunnar et al. 1980). There is less agreement as to whether the improved quality of life is reflected in a high return-to-work rate after bypass surgery (Wallwork et al. 1978; Lichtlen et al. 1978; Blumchen et al. 1979; Oberman and Kouchoukos 1979).

In the article the analysis of a monochromatic elastic surface wave in an unlimited plate of limited thickness whose opposite surfaces are planar and mutually parallel, made of an elastic isotropic material of a constant density is described. Equations are calculated for the wave number calculation — speed of surface wave propagation, and an equation for the calculation of the vector components deformation (component trajectory) of the elastic medium.

Chemical resistance of fluorozirconate glasses of the following compositions (mol%): 58 ZrF 4 , 36 BaF 2 , 6 LaF 3 , 10 AlF 3 and 58 ZrF 4 , 36 BaF 2 , 6 LaF 3 , 10 AlN, to water and humid air of 100% relative humidity were investigated. Hydrolytic susceptibility of the glasses was examined by chemical methods analysing the compositions of water solutions in contact with glass samples of standard dimensions. The normalized etching rates for the particular components diminish in the following order: F − , Zr 4+ , Ba 2+ , La 3+ , Al 3+ . Based on the transmittance curve of the examined glasses it has been found that on the surface of the glasses the following groups occur: OH − , H 2 O, Zr(OH) 4 . Changes on the surface of the glasses were observed in a scanning microscope. Layers of the hydrolysis products on the surface of a glass not subjected to nitrogen hardening are loose and porous, while on the surface of a glass containing nitrogen they are more dense and contain less water. The results of the chemical, optical and physical investigations of glasses exposed to water in the temperature range 20–80°C allow the conclusion that additions of nitrogen, even as small as some hundredths of 1 wt.%, can influence the increase of the glass resistance to water and to atmosphere of 100% relative humidity.

The linear and non-linear optical properties of fluorozirconate glasses with and without nitrogen, namely ZrF4BaF2LaF3AIF3 and ZrF4BaF2LaF3AIF3AIN, have been studied. The glass containing nitrogen exhibits a 5 nm shift of the transmittance edge in the UV region towards longer wavelength, whereas there is no change in the IR transmittance. Measurements show a small increase in the linear index of refraction in the visible region and a small decrease in the non-linear (intensity-dependent) refractive index coefficient n2. Longitudinal and transverse sound velocities estimated from Brillouin-scattering experiments for both glasses amount to 6311 and 4514 ms−1, respectively.

Solid particles emitted from diesel and petrol engines were studied using a scanning electron microscope fitted with an energy dispersive spectrometer. The soot emitted from different engines under different operating conditions differed in particle size, and the form and size of aggregates. Identification of the soot particles emitted from diesel or petrol engines in urban aerosol based on their size and morphology was found to be impossible.

Fluorozirconate glasses represent a new type of material for optoelectronics and electronics. Besides many advantageous qualities they also have several adverse features such as a greater tendency for crystallization, poor chemical resistance and low mechanical strength. In order to improve these qualities, the glasses have been modified with nitrogen, which was introduced into the glasses by means of AIN. The analysis for nitrogen content was performed by the Kjeldahl method. The effect of the method of the synthesis of the glasses, the melting atmosphere and addition of AIN on the properties and structure of fluorozirconate glasses has been described. Raman and Fourier transform infrared spectra of the examined glasses were obtained.

Fluorozirconate glasses modified with nitrogen were melted. For basic fluorozirconate glasses of the composition 58 ZrF 4 , 36 BaF 2 , 6 LaF 3 ,10 AlF 3 the aluminium fluoride was replaced by aluminium nitride. The Raman and FT-IR spectra were registered for the studied glasses. Addition of N atoms into the fluorozirconate glass network caused a shift of the bands attributed to vibrations of Zr — F bridging and Zr — F nonbridging groups towards a higher wavenumber. This procedure might cause introduction of the nitrogen atoms into the bridging and nonbridging positions of the fluorine atoms. The nitrogen ions are introduced into the fluorozirconate glasses to improve their mechanical and thermal properties as well as chemical resistance.

Chemical resistance of fluorozirconate glasses of the following compositions (mol%): 58 ZrF 4 , 36 BaF 2 , 6 LaF 3 , 10 AlF 3 and 58 ZrF 4 , 36 BaF 2 , 6 LaF 3 , 10 AlN, to water and humid air of 100% relative humidity were investigated. Hydrolytic susceptibility of the glasses was examined by chemical methods analysing the compositions of water solutions in contact with glass samples of standard dimensions. The normalized etching rates for the particular components diminish in the following order: F − , Zr 4+ , Ba 2+ , La 3+ , Al 3+ . Based on the transmittance curve of the examined glasses it has been found that on the surface of the glasses the following groups occur: OH − , H 2 O, Zr(OH) 4 . Changes on the surface of the glasses were observed in a scanning microscope. Layers of the hydrolysis products on the surface of a glass not subjected to nitrogen hardening are loose and porous, while on the surface of a glass containing nitrogen they are more dense and contain less water. The results of the chemical, optical and physical investigations of glasses exposed to water in the temperature range 20–80°C allow the conclusion that additions of nitrogen, even as small as some hundredths of 1 wt.%, can influence the increase of the glass resistance to water and to atmosphere of 100% relative humidity.

The paper presents the results of investigations of light absorption and emission by fluorozirconate glasses activated with the following rare earth elements: holmium, europium, dysprosium, neodymium, erbium and ytterbium. The absorption spectra were measured within the range 0.2–10 μm, while the luminescence induction spectra and luminescence spectra were measured within the range 0.2–0.8 μm. On the basis of the absorption and luminescence spectra the particular bands have been assigned to the rare earth elements.

The paper contains an RDF analysis of glasses in the ZrF4–BaF2 and ZrF4–BaF2–LaF3–AlF3 systems and Raman spectroscopic investigations of multicomponent fluorozirconate glasses. On the basis of these investigations, a theory is presented of the structure of fluorozirconate glasses. Some physical properties were measured for the multicomponent fluorozirconate glasses studied (refractive index, density, coefficient of linear thermal expansion, infrared light transmittance and thermal properties). The results obtained form a basis for developing the technology for the synthesis of these glasses.

Die Aufgaben der Bewegungstherapie und ihre Wirkung richten sich nach Stadium und Schweregrad der Erkrankung sowie der korperlichen Leistungsfahigkeit des Patienten. Ganz allgemein kann man folgende Zielrichtungen anfuhren: In der Akutphase der Erkrankung soll bei bettlagerigen Patienten die basale korperliche Leistungsfahigkeit erhalten und die Pravention von Zweiterkrankungen (z. B.Thromboembolien) bewirkt werden. Wahrend der Rekonvaleszenz soll die korperliche Leistungsfahigkeit gesteigert und wenn moglich wiederhergestellt werden. Im chronischen Stadium der Erkrankung wird im Sinne der lebenslangen Sekundarpravention die Erhaltung und ggf. die Steigerung der korperlichen Leistungsfahigkeit, die Verbesserung der metabolischen Fitness mit begleitender Senkung von pro-atherogenen und pro-inflammatorischen Risikofaktoren und schlieslich die Erhohung der motorischen Kompetenz und der Lebensqualitat im Alltag angestrebt.

The effect of nitrogen on the properties and structure of fluorozirconate glasses in the system ZrF4-BaF2-LaF3-AlF3 (ZBLA) was investigated. Nitrogen was introduced by means of aluminium nitride. The substitution of fluorine by nitrogen in ZBLA glasses resulted in a considerable increase of microhardness, reduction of the linear expansion coefficient, and a small increase in characteristic temperatures. Structural investigations comprised RDF and Fourier transform-infrared (FT-IR) examinations. From radial distribution function (RDF) it followed that the introduction of nitrogen caused an increase of the mean distances Zr-F(N), Ba-F(N), La-F(N). From FT-IR spectra, it followed that nitrogen became incorporated into the bridging fluorine atoms which was evinced by a shifting of bands deriving from the bending vibrations between the [ZrF6]2− octahedra towards higher wave numbers.

The CIS was undertaken with the aim to evaluate the effects of lipid modifications on angiographic progression and regression of CAD in patients with CAD and hypercholesterolemia. The design included a multicenter randomized, double-blind, parallel, placebo-controlled comparison, with target and safety limits for adjusting the trial medication depending on the LDL cholesterol level (LDL-C) achieved, i.e., up to 40 mg of simvastatin (S) or placebo (P) daily, add-on medication (up to 3 x 4 g Colestyramin), and diet counselling. Male patients, average age 49 (or = 56) years, were included with angiographic CAD and a screening total cholesterol of 207-350 mg/dl, who were not due to undergo coronary bypass surgery or PTCA, who did not suffer from serious other disease (e.g., diabetes mellitus), and who had not undergone coronary bypass surgery previously.All baseline variables were comparable in the treatment groups, with 129 patients taking S and 125 taking P. Of these 254 patients 217 had their final study visit and 207 underwent a second angiography after an average treatment time of 2.3 years under an average daily dose of 37 mg S. 205 pairs of films were available for analysis. Vital information was obtained of all patients until closure of the data bank, half a year after the last study angiography. Five deaths occurred within the study period, 12 through March 15, 1995 (S: 1/6, P: 4/6). 37 patients (S: 18, P: 19) discontinued trial drug and protocol. Concomitant CAD medication was comparable in both groups, except lipid-lowering add-on medication which was significantly higher in the P group (38% versus 13%). Significant changes in lipid levels, on treatment, were observed in the S group amounting to a mean difference in LDL-C of -35%, in Apo-Protein B (ApoB) of -30%, in VLDL-C of -37%, and in triglycerides (TG) of -27%, and in HDL-C of +6%, in comparison to the control group; these differences were even greater in 137 fully compliant patients: -41, -36, -39, -31, and +7%, respectively. Progression in the S group was significantly less, as defined by the two primary target criteria: 1) the minimum obstruction diameter (MOD), determined by quantitative coronary angiography (QCA), decreased about five times less in comparison to the control group (S: by -0.017; P: -0.0954 mm), and 2) the standardized visual global change score (GCS) deteriorated almost three times less in the S group (by +0.20) than in the P group (+0.58). Of the secondary target criteria, the mean lumen diameter (QCA) also developed a significant difference (S: -0.20; P: +0.23 mm; p = 0.0006) with a trend toward regression in the S group. The QCA-%-stenosis deteriorated three- to four-times less in the S group as compared to the control group (S: by 0.69%; P: by 2.73%; p = 0.0022), and the number of patients with angiographic progression was nearly halved (S: 30%; P: 56%; p0.0000). These differences were determined by intention to treat analysis (ITT), and they were obtained in spite of lipid lowering add-on medication in 38% of the P patients; they turned out to be more pronounced in 137 fully compliant patients, in an analysis "as treated". The mean decrease in LDL-C serum level caused by S was significantly correlated to the decrease in progression, and multivariate regression analysis of both treatment groups identified LDL-C (or ApoB) and TG as independent predictors of progression. Progression appeared to be most pronounced in low and medium sized lesions, and the beneficial effect of lipid intervention dominated in lesions with 12-56% QCA stenosis severity. A small fraction of patients who suffered from exercise-induced angina, with ST-segment-depression at the beginning of the study, experienced a significant improvement under S as compared to P treatment. Although the study was not designed to show differences in clinical events, the combined number of all major cardiovascular events tended to be less frequent in the S than in the C gr

In healthy normal individuals (n = 69), coronary patients with myocardial ischaemia (n = 27) and patients with chronic heart failure (CHF, n = 33), four widely applied methods to determine ventilatory threshold (VT) were analysed: V-slope, ventilatory equivalent for O2 (EqO2), gas exchange ratio (R) and end-tidal partial pressure of oxygen. Lactate threshold [LAT, log lactate vs log oxygen uptake ( $$\dot V{\text{O}}_2 $$ )] was also determined. Analysis focused on rate of success of threshold determination, comparability of threshold methods, reproducibility and interobserver variability. Cycle ergometry protocols with ramp-like mode and graded steady-state mode used in exercise testing were considered separately. In healthy normal individuals and coronary patients with myocardial ischaemia, at least three VT could be determined during ramp-like mode and two VT during graded steady-state mode, 82% of the time. For CHF patients, the rate of successful determination of VT was lower. Compared to LAT, $$\dot V{\text{O}}_2 $$ at VT was significantly higher using R and EqO2 methods of VT determination in healthy normal subjects (P < 0.01), and significantly higher when using all four methods in coronary patients (P < 0.01 or P < 0.05, respectively). No difference was observed between $$\dot V{\text{O}}_2 $$ at VT and LAT in CHF patients. In healthy normal individuals, day-to-day reproducibility of VT and LAT was high (error of a single determination from duplicate determinations was between 3.9% and 6.2% corresponding to a $$\dot V{\text{O}}_2 $$ of 52.2 and 89.2 ml·min −1). Interobserver variability was low (error between 0.3% and 5% corresponding to a $$\dot V{\text{O}}_2 $$ of 9.8 and 68 ml·min−). In CHF patients, interobserver variability was moderately greater (error between 4.6% and 8.2%, corresponding to a $$\dot V{\text{O}}_2 $$ of 35.1 and 62.4 ml·min−1). To optimize threshold determination, standardized procedures are suggested.

Das Kapitel „Akuter Herzinfarkt“ ist als klinischer Beitrag konzipiert. Bewust wird auf eine ausfuhrliche Darstellung der pathologisch-anatomischen Veranderungen im Rahmen der koronaren Herzerkrankung oder auch auf die akute Pathophysiologie bei der Infarktentstehung verzichtet. Das Kapitel gliedert sich im wesentlichen in 3 Teile: Die Diagnostik (30.1 bis 30.2), die Beschreibung des klinischen Verlaufs vor Krankenhausaufnahme und wahrend der Zeit auf der Uberwachungsstation — hier wird auch die Therapie, die sich an den Komplikationen orientiert, besprochen — und schlieslich die Darstellung der „Standard-Therapie“ des akuten Myokardinfarkts (30.4). Hier haben sich seit Erscheinen der letzten Auflage (1989) die grosten Veranderungen ergeben: Therapieformen, die Mitte der 80er Jahre erstmals erprobt wurden, sind heute durch die Uberprufung an Tausenden von Infarktpatienten in sog.

Die Ergometrie in der Rehabilitation hat unterschiedliche Aufgaben, die uber den rein qualitativ diagnostischen Aspekt hinausgehen. Durch die Ergometrie soll auch eine optimale Kreislaufokonomie unter medikamentoser Therapie erreicht werden.

Waste management in the dental office is not a limited issue involving only dentists from the Region of Hamilton-Wentworth. While the ODA has had the opportunity to work with the Hamilton Academy of Dentistry and has the support of this society for a two-phased project, the Metro Toronto component societies will be joining the existing MOEE/Hamilton study. The MOEE in Halton-Peel has informed us that they will be conducting a similar survey and study. The committee would like to thank the Executive of the Hamilton Academy of Dentistry who have provided needed follow-up on this project. We look forward to the cooperation of individual dentists in all communities involved in this environmental study. Dentists are encouraged to complete the survey and to consider volunteering to take part in the in-office sample study. If you have any questions, we invite you to contact members of the Health Care Committee or the staff in the Department of Professional Affairs.

Between 1978 and 1987, 1270 patients who survived single aortic or mitral valve replacement at the Rehabilitation Center in Bad Krozingen, Germany, underwent a comprehensive rehabilitation program. The preoperative diagnosis was isolated aortic stenosis in 425, isolated aortic regurgitation in 159, mixed aortic lesion in 211, isolated mitral stenosis in 208, isolated mitral insufficiency in 137 and mixed mitral lesion in 130 cases. Follow up examinations were carried out one and six months after surgery, and at yearly intervals thereafter. Exercise testing was performed with an electrically braked bicycle ergometer in the supine position, and the load was increased by 25 or 50 watts every two minutes until fatigue, severe angina, more than 0.3 mV ST-segment depression, or 80% of the age predicted maximum heart rate was achieved. Patients after aortic valve replacement had a better exercise performance one month after operation than did those after mitral valve replacement. Those with mitral stenosis showed more severe impairment of exercise tolerance than did the mitral insufficiency group. There was a steady increase in exercise tolerance between one and six months postoperatively, both in patients with aortic and those with mitral valve replacement, but the difference in performance between the two groups was still present (72% versus 57% of normal). The results of univariate and multivariate analyses showed that the preoperative employment status was the most important factor for postoperative return to work, followed by gender (malefemale), exercise tolerance and valualar lesion (aorticmitral).(ABSTRACT TRUNCATED AT 250 WORDS)

In the rehabilitation of coronary patients there is an increased interest in using complementary resistance exercise training. Therefore, we studied nine patients (males; age: 51 +/- 7 years) with chronic stable coronary heart disease during extensive resistance exercise (ex RE) (legpress, abduction, adduction) (60-s work: 60-s rest; contraction intensity: 65% of 1 RM) and during intensive resistance exercise (int. RE) (legpress) (30-s work: 45-s rest) with 85% of 1 RM. Non-invasive continuously measured blood pressure, heart rate, norepinephrine, epinephrine, lactic acid, and glucose were compared with values from maximal bicycle ergometry (3-min steps, each 25 w; max. performance: mean 156 w; range 125-200 w).1) Comparing ex RE and int RE with bicycle ergometry there were no differences in blood pressure (systolic: 206 and 204 vs. 210 mm Hg; ns; diastolic: 98 and 104 vs. 92 mm Hg; ns). Heart rates (104 and 103 vs. 125/min; p.01), norepinephrine (3.8 and 3.3 vs. 8.8 nmol/l; p.01) and epinephrine (0.7 and 0.6 vs. 1.4 nmol/l; p.01) were considerably lower. 2) The most significant increase and decrease of blood pressure and heart rate occurred within 15-30 s after the beginning and end, respectively, of isometric exercise.1) ex RE is suitable for patients with stable CHD and cardiac exercise tolerances of 1.5-2 W/kg = 125-150 watts. 2) Blood pressure monitoring by the cuff method (RR) immediately after RE did not reflect blood pressure during RE. 3) Controlling RE by the training heart rate prescribed for endurance exercise is not possible.

Understanding what transcription costs and controlling the costs are two interrelated subjects, yet two very different subjects. Understanding what it costs is critical for your budgeting activity. Controlling the cost is essential for your management effectiveness.

Parameter of catecholamine metabolism were examined in patients (Groups II to V) in chronic, stable stages of coronary heart disease (n = 45), dilated cardiomyopathy (n = 17) and healthy control subjects (Group I). Plasma and urinary catecholamine patterns, catecholamine plasma half-life and catecholamine metabolism following administration of levodopa were determined. In cases of slight (Group II, ejection fraction (EF) 54 +/- 7%) to marked left-heart damage (Group III, EF 44 +/- 5%), the findings indicate elevated catecholamine excretion and a beginning reduction of plasma clearance as the cause of excessive, circulating and renally excreted catecholamines (applies to noradrenaline, less to adrenaline). The renal 24-h dopamine elimination is already slightly reduced in these patients. In cases of severe left-heart damage, the findings are not uniform. In some cases, noradrenaline at rest and at comparable exercise levels are elevated (Group IV, EF 20 +/- 11%), in some cases they are normal (Group V, EF 16 +/- 4%). The 24-h dopamine elimination is reduced in both groups to 34-41% of normal. Noradrenaline and adrenaline elimination is normal, or reduced (Group V, adrenaline). The exercise-induced, maximum plasma noradrenaline concentrations in Group IV and V are much lower (33-40% of normal) than in the healthy control individuals and patients in Groups II and III. Oral administration of 2-4 g levodopa per day result in a 20- to 40-fold dopamine increase in patients with heart failure (Group IV) and healthy control persons (Group I) (free and conjugated plasma dopamine, as well as free urinary dopamine).(ABSTRACT TRUNCATED AT 250 WORDS)

The Coronary Intervention Study, CIS, is a multicentre, randomized, doubleblind. placebo-controlled study to investigate the effects of lipid-modifying therapy on progression in 254 men with documented coronary artery disease (CAD) and hypercholesterolemia. Entry criteria were the presence of at least 3 coronary stenoses of ≥25% and a mean serum total cholesterol (C) of : ≥207 mg/dl after diet. Treatment with up to 40 mg simvastatin (S) or placebo (P) o.d. included diet and — as a reserve medication: — colestyramine, and was pursued for 2.3 years (S/P: 865/835 days). The two treatment groups (see below) were comparable with respect to baseline variables, e.g. average age (49.9/49.1 y), height(175.4/175.2 cm), weight(80.1/80 kg), blood pressure (123,5/79.8 vs. 123.1/78.6 mmHg), diastolic hypertension ≥90 mmHg (9.6/9.1%), fasting serum glucose ≥120 mg/dl (2.9/5.1%), family history (47.1/48.0%), smoking (83.6/85.9), ventricular score (1.0/0.9), coronary score (2.12/1.93 — vessel-disease), and lipid values, with a baseline LDL-C of 163.8/166.7 mg/dl. Treatment resulted in significant changes of serum lipids with a decrease of LDL-C by 33% and -1.5% in the Sand P group, respectively. 204 (81; 104/100) patients had a second angiography. Two primary end points were chosen: — the within-patient change in minimum diameter avenged over all assessable coronary segments (“ΔminD”, determined by quantitative analysis using the CAAS system), and—the visual Global Change Score (“GCS”, Blankenhorn), and calculated according to Bonferroni-Holme on a multiple significance level of 5%. The detailed results will be presented. Supported by MSD Sharp and Dohme, Munich, Germany.

The nonlinear oscillations of a spherical gas bubble in a compressible viscous liquid subject to the action of a sound field are investigated by means of the multiscale perturbation method. Approximate analytical solutions for the transient and steady-state oscillations in the region of the main resonance are presented to second order in expansion. The time dependence is shown of the pressure in the liquid near the surface of the oscillating spherical bubble either in a compressible or an incompressible liquid.

The study was designed to assess the antiarrhythmic and antianginal properties of pindolol as well as the tolerance to the drug by patients who had experienced a myocardial infarction 5 to 6 months previously. Exercise tests were performed in 521 postinfarct patients before and after a single oral 5 mg dose of pindolol. Depending on the physical condition of the patient, the initial work load was 25 or 50 watts, which was increased by 25 watts every 5 minutes. In patients with an initial heart rate (HR) of more than 68 bpm on the average, HR at rest was reduced with pindolol. This reduction was more pronounced the higher the initial HR. If the initial HR was below 68 bpm, HR increased slightly with pindolol, reflecting the drug's intrinsic activity. The frequency-regulating effect of pindolol depended on the level of exercise that produed the tachycardia: tachycardia at rest responded more markedly to pindolol than exercise-induced tachycardia; tachycardia due to low-level exercise responded better than that due to higher level exercise. Of the 88 patients who developed typical effort angina and/or ischemic ST-segment depression, 62 became symptom free during exercise when taking pindolol. The patient sample included 66 patients with effort-related premature ventricular contractions (PVCs), 44 of whom responded well to pindolol. Of the 453 patients with a stable HR, 15 exhibited PVCs during exercise for the first time while receiving pindolol. Overall, pindolol exerted a statistically highly significant antiarrhythmic effect. Tolerance to pindolol was good; no side effects were observed.

The amplitudes and frequencies of the components of the acoustical spectrum of an acoustical wave, generated in a non-viscous liquid filling a cavity, are calculated by solving a boundary value problem. Apart from forced oscillations, the frequencies of the acoustical spectrum are equal to the frequency of the fundamsntal oscillation of the liquid in the cavity and its higher harmonics. If the frequency of the driving acoustical wave coincides with one of these (proper) frequencies, thefractional harmonic components appear. The amplitudes of the component oscillations decrease monotonically as the absolute value of the difference between the frequency of the driving acoustical wave and the frequency of the respective oscillation is increased. The derived relations are compared with the results of some published measurements.

308 patients with the clinical diagnosis of intramural myocardial infarction made elsewhere were re-investigated more than eight weeks after the acute event. ECGs and pulmonary "wedge" pressures were recorded at rest and during exercise and coronary angiography performed (Sones' or Judkin's technique). In the first group (1973/74) of 77 patients, 35 (45.5%) had a normal coronary angiogram, compared with 0.7% in a control group with transmural myocardial infarction. A normal coronary angiogram was found in 85% of the 40 patients who had no angina during exercise. In a second group (1974/77) of 231 patients, there was a steady decrease in the number of patients without angina pectoris during exercise, in parallel with a decrease in the number of those with normal coronary angiograms. This change in pattern was apparently due to improved diagnosis in the referring hospitals. Of the 37 patients (first group) with angina during exercise, all but one were subsequently found to have significant coronary arteriosclerosis. It is suggested that most patients with a normal coronary angiogram had sustained a myocarditis and (or) pericarditis which produced the symptoms and the altered ECGs, leading to the misinterpretation of "intramural myocardial infarction".

Quantification of heart failure is possible with hemodynamic parameters such as cardiac output and filling pressure at rest and during exercise. These parameters can easily but invasively be achieved by floating catheter measurements. In our experience, the risk of this method is low but existent. In greater than 20 000 patients with chronic diseases no death occurred in connection with the procedure; 26 patients developed ventricular fibrillation or ventricular tachycardias which made defibrillation necessary in 10 of these patients. In three patients asystolia demanded resuscitation. Hemoptysis did not occur. In the acute stage of a disease, e.g. in the acute myocardial infarction, the risk may be higher, especially if the catheter remains in the circulation for longer periods. The possibilities and limitations of the method will be discussed for the following patient groups: (1) Patients with acute myocardial infarction, (2) Postinfarction patients, (3) Patients with cardiomyopathies, (4) Patients with valvular heart disease.

Nowadays, the majority of patients undergoing aortocoronary bypass surgery have a history of myocardial infarction. In our first series of 1000 patients operated between 1973 and 1979[1], about two thirds of the patients had suffered myocardial infarction; about 80% of them within the previous three months. The method most frequently used to select post-infarction patients for coronary angiography is a simple exercise test. The post-infarction period in the context of this symposium was defined as the first 12 weeks after infarction. As far as exercise tests are concerned, we may divide this period into three subperiods: 1. the very early post-infarction period, especialy the first week after infarction. Exercise testing does not play a role in this very early period; 2. the second period is the time of an early post-infarction exercise test or the predischarge exercise test (second and third week); 3. from the fourth to the twelfth week in many European countries, rehabilitation measures will follow, usually in a special institution. This is the time of what we will call in short ‘the late post-infarction exercise test ’.