Relations of ambulatory blood pressure level and variability to left ventricular and arterial function and to left ventricular mass in normotensive and hypertensive adults.

OBJECTIVE: To assess the relationships between the level and variability of ambulatory blood pressure and left ventricular and arterial function. METHOD: We related 24 h ambulatory systolic blood pressure (SBP) and diastolic blood pressure (DBP), measures of their variability and clinic blood pressures to echocardiographic measures of left ventricle geometry and systolic function, total peripheral resistance, and the pulse pressure: stroke volume ratio as a measure of arterial stiffness in 58 normotensive and 222 unmedicated hypertensive adults. RESULTS: For hypertensive patients and for the entire population, awake and home ambulatory as well as technician-measured DBP were negatively related to left ventricle midwall fractional shortening (MWS) and to MWS as a percentage of the value predicted for end-systolic stress (afterload-corrected MWS), with inconsistent relations with SBP.

Type B aortic dissection and thoracoabdominal aneurysm formation after endoluminal stent repair of abdominal aortic aneurysm.

Endoluminal stent graft repair of abdominal and thoracic aortic aneurysms is being performed in increasing numbers. The long-term benefits of this technology remain to be seen. Reports have begun to appear regarding complications of stent graft application, such as renal failure, intestinal infarction, distal embolization, and rupture.

Depression and dementia: comorbidities, identification, and treatment.

Depression is a highly prevalent concomitant of dementia. Concurrent depression (DD) can meet full criteria for a disorder or take the form of a depressive syndrome. Although phenomenologic overlap can confound diagnosis, careful assessment demonstrates that a true depressive component is present in a substantial percentage of dementia cases.

Adenovirus-mediated expression of interleukin-12 induces natural killer cell activity and complements adenovirus-directed gp75 treatment of melanoma lung metastases.

Based on the knowledge that adenovirus (Ad)-mediated expression of the murine gp75 melanoma antigen (Adgp75) will effectively immunize mice against H2-matched B16 melanoma cells, probably via cell- mediated immune mechanisms, we hypothesized that Ad-mediated delivery of the murine interleukin-12 (IL-12) complementary DNA heterodimer would have independent therapeutic effects on tumor growth, and that the combination of the two vectors would work synergistically to augment the antitumor response. We evaluated the therapeutic effect of each vector alone and in combination for efficacy in C57BL/6 mice with preestablished (2 d) B16 melanoma-derived pulmonary metastases, using the number of lung metastases as the efficacy parameter. Intraperitoneal administration of Adgp75 (10(8) PFU) reduced tumor burden to 45 +/- 7% of controls (P < 0.

Fertilization and pregnancy outcome with intracytoplasmic sperm injection for azoospermic men.

The evident ability of the intracytoplasmic sperm injection (ICSI) procedure to achieve high fertilization and pregnancy rates regardless of semen characteristics has induced its application with spermatozoa surgically retrieved from azoospermic men. Here, ICSI outcome was analysed in 308 cases according to the cause of azoospermia; four additional cycles were with cases of necrozoospermia. All couples were genetically counselled and appropriately screened.

Intravitreal gas injection diminishes hyaluronic acid.

Objectives: To determine if compression of the vitreous by an intraocular gas bubble diminishes the concentration of hyaluronic acid (NaHA).

Materials And Methods: Eighteen albino rabbits had air, xenon or perfluoroethane (C2F6) injected into the vitreous to displace 12.5% to 90% of the vitreous volume.

E1(-)E4(+) adenoviral gene transfer vectors function as a "pro-life" signal to promote survival of primary human endothelial cells.

Although endothelial cells are quiescent and long-lived in vivo, when they are removed from blood vessels and cultured in vitro they die within days to weeks. In studies of the interaction of E1(-)E4(+) replication-deficient adenovirus (Ad) vectors and human endothelium, the cells remained quiescent and were viable for prolonged periods. Evaluation of these cultures showed that E1(-)E4(+) Ad vectors provide an "antiapoptotic" signal that, in association with an increase in the ratio of Bcl2 to Bax levels, induces the endothelial cells to enter a state of "suspended animation," remaining viable for at least 30 days, even in the absence of serum and growth factors.

Variability of blood pressure.

INTRODUCTION: The justification for ambulatory blood pressure monitoring is that blood pressure varies, and a better understanding of the causes of such vqariability will greatly improve our knowledge of its consequences. Although it is generally assumed that the average or true level of blood pressure is the main culprit causing vascular damage, it would be surprising if the variability did not also contribute. Variability of blood pressure is a compoex issue, and is the result of internal and external influences acting in various combinations.

Human glucosamine-6-phosphate isomerase, a homologue of hamster oscillin, does not appear to be involved in Ca2+ release in mammalian oocytes.

Injections of cytosolic preparations from mammalian sperm into oocytes have been shown to trigger calcium [Ca2+]i oscillations and initiate activation of development. Recently, a protein isolated from hamster sperm has been suggested to be involved in the generation of these oscillations and it was named "oscillin." The human homologue of hamster oscillin is glucosamine 6-phosphate isomerase (GPI, EC no.

The embryo toxicity of hydrosalpinx fluid is only apparent at high concentrations: an in vitro model that stimulates in vivo events.

Objective: To simulate the in vivo model in studying the effect of hydrosalpinx fluid on embryonic development.

Design: Controlled prospective study.

Setting: Academic research center.

Therapeutic angiogenesis: protein and gene therapy delivery strategies.

Angioplasty and surgical bypass, the primary interventional therapies for the treatment of atherosclerosis, are limited by the development over time of native vessel restenoses and graft occlusions. Furthermore, these therapies are not options for a significant number of individuals in whom the extent of vascular pathology is especially severe or widespread. Angiogenesis, the growth of new vasculature, is a critical biological response to ischemia that provides collateralization, or 'biological revascularization' of vascular obstructions.

Parenchymal and pleural findings in patients with and patients without acute pulmonary embolism detected at spiral CT.

Purpose: To compare the frequencies of parenchymal abnormalities and pleural effusions in patients with and patients without acute pulmonary embolism (PE) detected at spiral computed tomography (CT).

Materials And Methods: Contrast material-enhanced spiral CT scans obtained in 92 patients clinically suspected of having acute PE were retrospectively reviewed. The presence or absence of parenchymal abnormalities and pleural effusions was noted.

The physical, functional, and developmental outcome of pediatric burn survivors from 1 to 12 months postinjury.

Fifty-one children with an average age of 27 months and who had sustained a burn injury were tested at 1, 6, and 12 months postinjury to determine their physical, functional, and developmental outcomes. Most parents were either African-American or Hispanic, lived on public assistance, and had a high school education or less. Most children had normal range of motion and were appropriate for their age in self-care skills.

Differential response to vesnarinone by cardiac fibroblasts isolated from normal and aortic regurgitant hearts.

Vesnarinone, a quinoline derivative with modest positive inotropic action, has been shown in several studies to benefit patients with clinical congestive heart failure. The cellular basis of its clinical benefit is not known, although the drug has several pharmacologic effects demonstrated both in isolated cardiac myocytes and in other noncardiac cell types. To investigate the possibility that the clinical benefit of vesnarinone is based, at least in part, on the inhibition of pathologic myocardial fibrosis, we examined its effects on cultured cardiac fibroblasts isolated from both normal and aortic regurgitant New Zealand White rabbit hearts.

Does vestibular stimulation activate thalamocortical mechanisms that reintegrate impaired cortical regions?

Caloric stimulation induced a transient reversal of multimodal hemispatial cognitive deficits in an 81-year-old woman with an acute left cerebral hemisphere stroke. The patient had unawareness of her right hand (asomatognosia), right-sided visual unawareness (hemineglect), aphasia and right-sided weakness (hemiplegia) prior to the stimulation. Transient improvements in impaired sensory, motor, linguistic and cognitive function developed within 30 s following application of the caloric stimulus and onset of horizontal nystagmus.

Current concepts in imaging of adrenal masses.

Adrenal masses are a common entity. With the advent of improved cross-sectional imaging techniques the detection and characterization of adrenal masses has improved dramatically. We review the imaging features of benign and malignant adrenal masses and other entities that may cause mass-like enlargement of the adrenal glands.

Autologous endometrial co-culture in patients with repeated failures of implantation after in vitro fertilization-embryo transfer.

Purpose: Our purpose was to evaluate the effect of coculture on preembryo development and clinical outcome.

Methods: Enrolled patients underwent a luteal-phase endometrial biopsy. The tissue was then enzymatically digested (collagenase) and the stromal and glandular cells were separated by differential sedimentation rates.

Sciatic neuropathy secondary to a uterine fibroid: a case report.

Lesions of the sciatic nerve outside the pelvis have been well described. Lesions within the pelvis, however, are far less common. We report the case of a 55-yr-old woman with a history of chronic low back pain who presented with progressive right buttock and posterolateral right lower limb pain associated with right foot numbness and tingling.

Assessment of arterial compliance by carotid midwall strain-stress relation in hypertension.

To elucidate the relations between arterial hypertrophy and compliance in hypertension, we studied 205 unmedicated hypertensive patients (129 men and 76 women) and 82 normotensive adults (56 men and 26 women) from an employed population by carotid ultrasound, noninvasive applanation tonometry, and echocardiography. Carotid midwall strain and circumferential stress were calculated at end diastole and peak systole. The relations of luminal and midwall strain to the increment in circumferential stress from end diastole to peak systole (Deltacarotid stress in normal subjects) were used to calculate ratios of observed/predicted carotid luminal and midwall strain.

Assessment of arterial compliance by carotid midwall strain-stress relation in normotensive adults.

Examining left ventricular midwall as opposed to endocardial mechanics enhances understanding of left ventricular function in individuals with abnormal cardiac geometry. Accordingly, we used carotid ultrasound and applanation tonometry of arterial pressure to derive carotid midwall strain and its relation to carotid peak-systolic and end-diastolic stresses in 82 apparently normal, employed subjects (56 men, 26 women; median age, 47 years; 70% white; 21% overweight) with no evidence of coronary or valvular heart disease. Regression equations relating carotid luminal and midwall strain to the increment in carotid stress during systole (Deltacarotid stress) were used to predict strain for the observed Deltastress.

Expression of inhibin/activin subunits and their receptors and binding proteins in human preimplantation embryos.

Purpose: Our purpose was to study the role of inhibin/activin during embryogenesis.

Methods: Transcripts of inhibin/activin subunits (alpha, beta A, beta B), activin receptors (types I and II), and follistatin were detected by a reverse transcriptase-polymerase chain reaction in human reproductive cells and preembryos cultured alone or co-cultured with human endometrial cells.

Results: Transcripts of alpha, beta A, beta B subunits were all detected in granulosa luteal cells, but only beta A units were detected in endometrial stromal and decidualized cells.

Prevention of recurrent pulmonary edema in patients with bilateral renovascular disease through renal artery stent placement.

Pulmonary edema and congestive heart failure (both referred to here as PE) have been reported to be complications of bilateral renal artery stenosis or unilateral stenosis in a solitary functioning kidney (both referred to as BRAS). The goals of this study were to determine whether a history of PE was more common in patients with BRAS than in those with unilateral stenosis and a normal contralateral kidney (URAS), and whether recurrent PE could be prevented by renal artery stent placement. We evaluated 90 consecutive patients with renovascular disease who were treated with percutaneous renal artery stent placement.

The nature of spontaneous recovery from mivacurium-induced neuromuscular block.

Unlabelled: The hypothesis of this study was that, in a given patient, recovery from a tracheal intubating dose of mivacurium would indicate the time course of spontaneous recovery after discontinuation of an infusion of mivacurium. Thirty-eight male patients consented to participate in the study. After induction of anesthesia and endotracheal intubation, the ulnar nerve was stimulated with train-of-four (TOF) stimuli at 12-s intervals.