Value of dobutamine stress echocardiography in determining the prognosis of patients with known or suspected coronary artery disease.

Although the accuracy of dobutamine stress echo (DSE) for detecting coronary artery disease (CAD) has been established, its role in determining prognosis is less well defined. The purpose of this study was to evaluate the prognostic significance of DSE in patients with known or suspected CAD. Follow-up was obtained on 291 patients an average of 15 months after clinically indicated DSE.

Pharmacological dissection of high-voltage-activated Ca2+ current types in acutely dissociated rat supraoptic magnocellular neurons.

1. We used pharmacological blockers and whole cell voltage-clamp recordings from acutely dissociated magnocellular neurons from the rat supraoptic nucleus to test for the presence of L-, N-, P-, Q-, and R-type calcium currents. 2.

"Hibernating" myocardium: asleep or part dead?

Chronic ischemic dysfunction of the left ventricle is commonly presumed to represent "hibernating" myocardium. The implication of this assumption is that with successful reperfusion, systolic function will improve. Several diagnostic techniques including dobutamine stress echocardiography have been used to detect "viable" myocardium in the setting of chronic left ventricular dysfunction.

Breast cancer in New Zealand: trends, patterns, and data quality.

Aims: To determine if incidence of cancer of the female breast in New Zealand is changing by age, ethnic group, and geographic region, and if there are differences in rates for stage of tumour by urban and rural residence.

Methods: Age-adjusted incidence rates for Maori and nonMaori were computed from all primary cancers of the breast registered in the National Cancer Registry, 1978-92. Analyses of time trends and geographic variations were conducted using standard statistical methods.

Two-dimensional and dobutamine stress echocardiography in the preoperative assessment of patients with end-stage liver disease prior to orthotopic liver transplantation.

Orthotopic liver transplantation is an established therapy for end-stage liver disease. This study evaluated the range of cardiovascular abnormalities in patients undergoing evaluation for orthotopic liver transplantation and determined the prognostic implications of abnormal echocardiographic features, including ischemia during dobutamine stress echocardiography, in predicting postoperative cardiac events. Two-dimensional echocardiography was performed in 190 patients for assessment of left ventricular function, valvular pathology, and pulmonary hypertension.

Morphological and electrophysiological classification of hypothalamic supraoptic neurons.

In mammals, the magnocellular neurons of the supraoptic nucleus (SON) have been classified into vasopressin- (VP) and oxytocin- (OT) producing subtypes. The degree to which these neurons have distinguishable characteristics is considered in the present review. Most of the cytoarchitectonic diversity observed in some Golgi studies has yet to be attributed to differences between OT and VP neurons.

Clinical and diagnostic utility of arbutamine for cardiovascular stress testing during echocardiographic monitoring.

Arbutamine (Gensia, Inc., San Diego, CA) is a newly-developed sympathomimetic agent specifically designed for cardiovascular stress testing. It has been successfully used for the detection of coronary artery disease in conjunction with electrocardiography, echocardiographic and radionuclide techniques.

Electrophysiological differences between oxytocin and vasopressin neurones recorded from female rats in vitro.

1. Intracellular recordings in vitro from immunochemically identified oxytocin (OT) and vasopressin (VP) neurones in the supraoptic nucleus (SON) of virgin or lactating female rats revealed no differences between neurone types in membrane potential (Vm), input resistance and current-voltage relationships (I-V), when taken at resting membrane potentials. 2.

Airway obstruction secondary to rhinoscleroma during pregnancy.

Dyspnea is a fairly common complaint during pregnancy. However, if one excludes allergic nasal congestion of pregnancy, upper airway obstruction is a distinctly uncommon cause of dyspnea in the pregnant patient. Three cases of laryngeal rhinoscleroma in pregnant women requiring tracheostomy for airway management are reported.

Arbutamine echocardiography: efficacy and safety of a new pharmacologic stress agent to induce myocardial ischemia and detect coronary artery disease. The International Arbutamine Study Group.

Objectives: This study sought to determine the efficacy and safety of arbutamine echocardiography in inducing myocardial ischemia and detecting coronary artery disease.

Background: Exercise and pharmacologic stress echocardiography are clinically accepted techniques for detecting coronary artery disease. Arbutamine is a new synthetic beta-adrenoceptor agonist developed specifically as a stress agent.

Emerging technology in stress echocardiography.

Stress echocardiography has seen substantial expansion as a clinically useful tool for evaluation of patients with chest pain syndromes, determining the physiological significance of coronary artery lesions and assessing prognosis in patients known to have coronary disease. Several newly developing technologies show promise for enhancing the accuracy and clinical applicability of the examination. These include automatic edge detection systems, intravenous contrast for enhanced endocardial definition, tissue Doppler imaging, and tissue characterization techniques.

Changes in myocardial perfusion abnormalities by positron emission tomography after long-term, intense risk factor modification.

Objective: To quantify changes in size and severity of myocardial perfusion abnormalities by positron emission tomography (PET) in patients with coronary artery disease after 5 years of risk factor modification.

Design: Randomized controlled trial.

Setting: Outpatient community setting.

Intracoronary and aortic root myocardial contrast echocardiography: the effect of route, dose, and pharmacologic coronary vasodilation.

Myocardial contrast echocardiography is useful for the assessment of myocardial perfusion but has required direct intracoronary injections. Aortic root myocardial contrast echocardiography has the potential advantage of allowing simultaneous assessment of multiple perfusion beds, as well as evaluating competitive and collateral flows. This study assessed the safety and efficacy of intracoronary and aortic root injections of sonicated 5% human serum albumin (Albunex) with and without concomitant coronary vasodilation.

Intravenous albunex during dobutamine stress echocardiography: enhanced localization of left ventricular endocardial borders.

Albunex is an intravenous contrast agent that opacifies the left ventricle (LV). This study evaluated the effect of Albunex on the enhancement of LV endocardial border localization during dobutamine stress echocardiography (DSE). Albunex was infused in 30 patients at baseline and with low- and high-dosage dobutamine.

Adequacy of low-stress arbutamine to provoke myocardial ischemia during echocardiography. International Arbutamine Study Group.

Arbutamine is a new, potent, short-acting synthetic catecholamine developed specifically for use as a cardiac stress agent. Previous reports on the accuracy of arbutamine for the detection of coronary artery disease have relied on heart rate (HR) increases similar to those seen at peak exercise. This study was undertaken to test the potential to provoke ischemic wall motion abnormalities on echocardiography using arbutamine at a HR below that associated with peak exercise.

Anatomy of the larynx, trachea, and bronchi.

This article reviews the anatomy of the larynx, trachea, and bronchi. It emphasizes the structure of the laryngeal framework, the innervation and blood supply of the larynx and trachea, the anatomic differences between the pediatric and adult larynx and trachea, and the relational anatomy of structures surrounding the trachea and bronchi.

Quantitative Doppler tissue imaging of the left ventricular myocardium: validation in normal subjects.

Doppler tissue imaging (DTI) is a new echocardiographic imaging technique from which quantitative data regarding myocardial velocity can be extracted. The purpose of this study was to compare endocardial velocities determined from DTI with those determined from M-mode echocardiography and to assess the range of myocardial velocities in normal subjects. Nineteen subjects were evaluated by M-mode echocardiography and quantitative DTI for maximal systolic velocities of the anteroseptal and inferoposterior walls.

Machine learning in control of functional electrical stimulation systems for locomotion.

Two machine learning techniques were evaluated for automatic design of a rule-based control of functional electrical stimulation (FES) for locomotion of spinal cord injured humans. The task was to learn the invariant characteristics of the relationship between sensory information and the FES-control signal by using off-line supervised training. Sensory signals were recorded using pressure sensors installed in the insoles of a subject's shoes and goniometers attached across the joints of the affected leg.

Regional heterogeneity on myocardial contrast echocardiography without severe obstructive coronary artery disease.

Myocardial contrast echocardiography (MCE) has been used successfully during cardiac catheterization to assess regional perfusion in patients with coronary artery disease (CAD), although heterogeneity on MCE has been observed without underlying CAD. This study was undertaken to assess regional perfusion patterns on visual assessment of MCE when interpreted without knowledge of coronary anatomy, and to define potential sources of contrast heterogeneity not related to underlying CAD. Forty patients underwent intracoronary or aortic root MCE, or both, with use of 5% sonicated human serum albumin (Albunex) at the time of left heart catheterization.

Heterogeneity of ventricular function and myocardial oxidative metabolism in nonischemic dilated cardiomyopathy.

Objectives: This study was performed to test the hypothesis that regional variation in ventricular function in patients with nonischemic dilated cardiomyopathy is related to regional variation in oxidative metabolism.

Background: Heterogeneity in regional left ventricular function has long been noted in patients with nonischemic dilated cardiomyopathy. Regional variation in wall stress has been proposed as the pathophysiologic mechanism.

Usefulness of dobutamine stress echocardiography in detecting coronary artery disease in end-stage renal disease.

The cardiovascular evaluation of patients with end-stage renal disease (ESRD) has been hampered by the suboptimal sensitivity and specificity of currently employed diagnostic tests. Dobutamine stress echocardiography (DSE) is a recently developed technique which is accurate for the diagnosis of coronary artery disease (CAD) in general populations. The purpose of this study was to assess its diagnostic accuracy and prognostic implications in patients with ESRD.

Electrocardiographic response during dobutamine stress echocardiography.

Studies assessing dobutamine stress (DS) echocardiography (echo) have included 12-lead electrocardiograms (ECG) in their protocol. We retrospectively reviewed the records of 76 patients who were referred for DS echo and coronary angiography to assess the incremental diagnostic value of DS ECG beyond the results of the echocardiographic images of the DS echo. The prevalence of coronary artery disease was 86%.