Insertion/deletion polymorphism of the angiotensin I-converting enzyme gene in patients with hypertension, non-insulin-dependent diabetes mellitus, and coronary heart disease in Taiwan.

An insertion/deletion (I/D) polymorphism of the angiotensin I-converting enzyme (ACE) gene has been identified that determines most of the plasma ACE activity genetically. Association of the D allele with insulin sensitivity and of the D/D genotype with coronary heart disease (CHD) has been reported in various ethnic populations. To study the role of this genetic polymorphism in patients with hypertension, non-insulin-dependent diabetes mellitus (NIDDM), and NIDDM with CHD in a Taiwanese population, we used a polymerase chain reaction (PCR)-based genotyping technique with an insertion-specific primer for confirmation of the I allele.

Abnormal circadian blood pressure changes in patients with acute cerebrovascular disorders.

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.

Cardiac contractility in noninsulin dependent diabetes mellitus evaluated using the relation between endsystolic wall stress and velocity of circumferential fiber shortening.

The relation between left ventricular (LV) endsystolic wall stress (sigma es) and rate-corrected velocity of circumferential fiber shortening (Vcfc), which is independent of heart rate (HR) and loading conditions has previously been used to assess cardiac contractility in insulin dependent diabetes mellitus (IDDM). This study is the first report in which this relation has been utilized with data obtained by echocardiography in addition to the traditional indices, to evaluate the cardiac function in asymptomatic, middle-aged patients with noninsulin dependent diabetes mellitus (NIDDM) at baseline and during dobutamine stimulation. There were 16 NIDDM patients in our study and these patients were classified into 2 groups.

Congenital mitral stenosis: challenge of percutaneous transvenous mitral commissurotomy.

A 26-year-old woman with congenital mitral stenosis and embolic stroke was referred to our hospital. The echocardiogram showed a hypoplastic posterior mitral valve leaflet with short, unbalanced chordal attachments to the posteromedial papillary muscle. The mitral valve area was 0.

Association of the renin gene polymorphism with essential hypertension in a Chinese population.

To study the association of renin gene polymorphism with essential hypertension in the Chinese population, 86 hypertensive and 107 normotensive subjects were enrolled from an epidemiologic survey. Leukocyte DNA was extracted and digested with Hind III and Bgl I restriction enzymes. Southern hybridization was done with digoxigenin-incorporated renin gene probes generated by polymerase chain reaction.

Molecular variant M235T of the angiotensinogen gene is associated with essential hypertension in Taiwanese.

Objective: To examine the association of the molecular variants of the angiotensinogen (AGT) gene with essential hypertension in Taiwanese.

Methods: We conducted a case-control study concerning 151 subjects, 102 hypertensives and 49 normotensives. We created a rapid mini-sequencing method based on dye-terminator cycle sequencing to simultaneously detect the M235T and T174M variants of the AGT gene for each subject.

Penetration of the interatrial septum: a rare complication of percutaneous transluminal mitral commissurotomy.

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.

Lack of association between angiotensin-converting enzyme gene polymorphism and coronary heart disease in a Chinese population.

Insertion/deletion (I/D) polymorphism of the angiotensin-converting enzyme (ACE) gene has been postulated as a risk factor for coronary heart disease. We conducted a case-control study of 271 Chinese, including 114 subjects with coronary artery disease (CAD), 42 with non-CAD and 115 apparently normal controls to examine the association of I/D polymorphism and CAD. The genotypes were identified by polymerase chain reaction and the plasma ACE activity was assayed by spectrophotometry.

Lack of association of the angiotensin converting enzyme polymorphism with essential hypertension in a Chinese population.

To examine the association between insertion/deletion (I/D) polymorphism of the angiotensin converting enzyme (ACE) gene and essential hypertension in a Chinese population, a case-control study was conducted using 157 hypertensive and 115 normotensive subjects. The I/D polymorphism of the ACE gene was identified by polymerase chain reaction. Plasma ACE activity was determined using spectrophotometry.

Age- and gender-dependent association of the angiotensin-converting enzyme gene with essential hypertension in a Chinese population.

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.

Correlation of bony ingrowth to the distribution of stress and strain parameters surrounding a porous-coated implant.

The ability of shear strains to inhibit bony ingrowth was investigated by use of a transcortical porous-coated cylindrical plug implant in a functionally isolated turkey ulna model in which the mechanical loading environment could be accurately controlled and rigorously defined. The distribution of ingrowth at the bone-implant interface was quantified following 8 weeks of in vivo loading consisting of 100 seconds per day of a 20 Hz sinusoidal stimulus sufficient to cause a local peak strain of approximately 100 microstrain in the cortex at the bone-implant interface in four turkeys. A nonuniform but repeatable pattern of bony ingrowth, from 33 +/- 6 to 72 +/- 6% (mean +/- SE), was observed.

Coronary artery perforation and delayed cardiac tamponade following balloon coronary angioplasty.

A 62-year-old woman who had coronary artery disease and hypertrophic cardiomyopathy received percutaneous transluminal coronary angioplasty and endomyocardial biopsy. She withstood the procedure well. However, delayed pericardial tamponade occurred 2 hours after discharge from the cardiac catheterization laboratory.

The cause-effect relationship of sympathovagal activity and the outcome of percutaneous transluminal coronary angioplasty.

We studied 25 patients who underwent percutaneous transluminal coronary angioplasty (PTCA) to determine the association of sympathovagal imbalance and the outcome of coronary angioplasty. We examined the profiles of heart rate variability (HRV) using echocardiography, stress thallium scanning and radionuclide angiography before, immediately after and 1 month after the procedure. Coronary angiography was followed up at 6 months or if restenosis was suspected, to determine whether restenosis had occurred.

Ambulatory blood pressure monitoring for evaluation of long-acting beta-blockers in Taiwan.

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).

Fulminant cerebral lymphoma in AIDS.

Three cases of cerebral lymphoma in patients with acquired immunodeficiency syndrome is presented. They are remarkable for their extremely rapid progression, which simulated an infectious processes during trials of antitoxoplasma therapy. Fourteen days of therapy are generally required to assess a negative response.

The mechanism of sympathovagal imbalance in patients with myocardial ischemia.

To investigate the mechanism of sympathovagal imbalance due to myocardial ischemia, we studied 42 consecutive patients undergoing successful percutaneous transluminal coronary angioplasty by correlating frequency domain and time domain measures of heart rate variability with parameters such as echocardiography, stress thallium scanning and radionuclide angiography before, immediately after and 2 months after the procedure. Of these, 20 patients (Group N) had normal and 22 patients (Group A) had abnormal regional wall motion. A control group of 20 healthy subjects (Group C) underwent echocardiography and examination of heart rate variability twice at 2-month intervals to check for spontaneous variations.

Brain lesions in patients with AIDS: H-1 MR spectroscopy.

Purpose: To evaluate the role of proton (hydrogen-1) magnetic resonance (MR) spectroscopy in the differential diagnosis of focal brain lesions in patients with acquired immunodeficiency syndrome (AIDS).

Materials And Methods: Twenty-six men with 35 AIDS-related brain lesions underwent MR imaging and localized H-1 MR spectroscopy. Lesions consisted of 11 toxoplasmic abscesses, 12 progressive multifocal leukoencephalopathic lesions, eight lymphomas, and four cryptococcomas.

Analysis of brain tumors using 1H magnetic resonance spectroscopy.

Background: Magnetic resonance imaging (MRI) is superior in delineating anatomic and pathologic information and has subsequently been married to the ability of magnetic resonance spectroscopy (MRS) to provide insight into the biochemical changes underlying pathology. Proton magnetic resonance spectroscopy (1H MRS) allows the non-invasive in vivo collection and measurement of chemical information from a selected volume of tissue (voxel).

Methods: We conducted a prospective trial in 23 patients with brain mass lesions and 16 normal subjects using proton magnetic resonance spectroscopy (1H MRS).

Anaerobic metabolism in patients undergoing intra-aortic balloon counterpulsation for cardiogenic shock.

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.

Vectorcardiography in experimental myocardial infarction. Serial changes and correlation between QRS loop change and the infarction size.

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.

Aneurysmal bone cyst of the thoracic spine: evolution after particulate embolization.

A case of aneurysmal bone cyst of the thoracic spine treated with serial particulate embolization responded with involution of soft-tissue and cystic components and diffuse ossification of the mass. Reappearance of foci of bony rarefaction or cystic change at 4-year follow-up indicates the need for continued surveillance.

Influence of isolated diastolic hypertension identified by ambulatory blood pressure on target organ damage.

Clinical decisions and controlled studies in regard to hypertension have long emphasized the casual diastolic blood pressure (DBP). The influence of superimposition of high systolic blood pressure (SBP) on the target organ damage has been less studied. To assess the role of isolated diastolic hypertension without interference of superimposition of systolic hypertension, 171 subjects with normal blood pressure, isolated diastolic hypertension (SBP < 140 and DBP > or = 90 mmHg) isolated systolic hypertension (SBP > or = 140 and DBP < 90 mmHg) or combined hypertension (SBP > or = 140 and DBP > or = 90 mmHg) determined by mean 24-h ambulatory blood pressure were compared in relation to target organ damage including ECG abnormality related to hypertension, cardiac enlargement by chest X-ray, proteinuria and retinopathy.