728-1 Determination of Stenosis Length by Magnetic Resonance Coronary Angiography

Magnetic resonance coronary angiography (MRA) can identify significant stenoses (>50%) as regions with reduced signal intensity due to disturbed intraluminal flow. To determine whether MRA stenosis length reflects true lesion length by x-ray angiography (XA). 12 patients (10 male and 2 female: age 65±8 years) underwent both MRA and XA with an average of 2.1±1.7 days between procedures. MRA was performed with the patient prone on an elliptical spine coil using a fat suppressed. TurboFlash, breath hold, segmented k-space sequence during late diastole. MRA defects were quantified off-line by manual tracing of digital images. XA stenoses were analyzed from 35 mm cine films using an electronic caliper which reported defect length, stenosis diameter and area. Matched MRA-XA stenoses included 5 in the left anterior descending (LAD), 8 right coronary artery (RCA) and 2 left circumflex (LCX). MRA and XA results were highly correlated (r=0.96). MRA reported a slightly longer stenoses length 9.65±2.0 mm versus 8.32±2.1 mm for XA (p<0.05 paired t-test). The ratio (MRA stenosis length/XA stenosis length) was not dependent on stenosis severity, absolute stenosis lumen diameter or area (MANOVA). Thus, in addition to detecting the presence of coronary lesions. MRA allows quantification of stenosis length

Reduced Sympathetic Innervation Underlies Adjacent Noninfarcted Region Dysfunction During Left Ventricular Remodeling

AbstractObjectives. We examined the association of sympathetic denervation and reduced blood flow with mechanical dysfunction in adjacent noninfarcted regions late after myocardial infarction (MI).Background. Using a well characterized ovine model of left ventricular (LV) remodeling after transmural anteroapical MI, we previously showed that histologically normal adjacent noninfarcted regions demonstrate mechanical dysfunction.Methods. Ten sheep underwent coronary ligation. Magnetic resonance imaging was performed before and 8 weeks after infarction for measurement of LV mass, volumes, ejection fraction and regional intramyocardial circumferential shortening (%S). Iodine-123 metaiodobenzylguanidine (I-123 MIBG) and fluorescent microspheres before and after administration of adenosine were infused before death for measurement of sympathetic innervation, blood flow and blood flow reserve from matched postmortem regions.Results. From baseline to 8 weeks after infarction, LV end-diastolic volume increased from (mean ± SD) 1.5 ± 0.3 to 2.6 ± 0.5 ml/kg (p < 0.001), and LV mass increased from 2.0 ± 0.3 to 2.6 ± 0.5 g/kg (p = 0.001). Regionally, the decline in subendocardial %S was greater in adjacent (19 ± 5% to 8 ± 5%) than in remote noninfarcted regions (20 ± 6% to 19 ± 6%, p < 0.002). No difference in regional blood flow or blood flow reserve was found between adjacent and remote regions, whereas I-123 MIBG uptake was lower in adjacent than in remote myocardium (1.09 ± 0.30 vs. 1.31 ± 0.40 nmol/g, p < 0.003). Topographically, from apex to base at 8 weeks after infarction, %S correlated closely with I-123 MIBG uptake (r = 0.93, p = 0.003).Conclusions. In mechanically dysfunctional noninfarcted regions adjacent to chronic transmural myocardial infarction in the remodeled left ventricle, blood flow and blood flow reserve are preserved, yet sympathetic innervation is reduced. Chronic sympathetic denervation in adjacent noninfarcted regions, in association with regional mechanical dysfunction, may contribute to LV remodeling after infarction

Preventing Perinatal Transmission of HIV Costs and Effectiveness of a Recommended Intervention

In the United States, nearly all new human immunodeficiency virus (HIV) infections in children are acquired through perinatal (mother-to-infant) transmission. Each year, approximately 7000 infants are born to HIV-infected women in the United States.1 Without intervention, an estimated 15-30% of these infants would become infected.2 In 1994, results of the AIDS Clinical Trial Group (ACTG) Protocol 076 showed that treatment of infected pregnant women and their infants with zidovudine (ZDV) reduced the rate of perinatal HIV transmission from 25% to 8%.3,4 Following these findings, the Public Health Service (PHS) issued recommendations for ZDV therapy to prevent perinatal HIV transmission5 and for HIV counseling and voluntary testing of pregnant women.

Polls and the political process: the use of opinion polls by political parties and mass media organizations in European post‐communist societies (1990–95)

Opinion polling occupies a significant role within the political process of most liberal-capitalist societies, where it is used by governments, parties and the mass media alike. This paper examines the extent to which polls are used for the same purposes in the post-communist countries of Central and Eastern Europe, and in particular, for bringing political elites and citizens together. It argues that these political elites are more concerned with using opinion polls for gaining competitive advantage over their rivals and for reaffirming their political power, than for devolving political power to citizens and improving the general processes of democratization

Commercial processing of Oriental lilies affects bud opening and metabolic dynamics

Lilies are a high value cut flower typically producing 4–5 flowers per stem, but the opening of young buds of Oriental hybrid lilies is often affected in cut flowers. Commercial treatment includes harvesting of the stem when the oldest bud is closed and at turning colour, approximately 2 ds before it would open on the plant. Stems are then rehydrated, stored chilled for up to 72 h and transported dry. To understand the effect of commercial treatment onu the nutrient status metabolomes were compared throughout bud opening from different positions on the stem. At each developmental stage the metabolomic profile was affected by bud position and commercial treatment. Starch accumulated as long as buds remain closed; upon bud opening starch content declined. Reciprocally, sugar levels rose during flower opening and were affected by edge/ midrib location and commercial treatment. Glucose, fructose and sucrose levels remained higher in opened flowers still on the plant. AMY2 (amylase) transcript levels rose as did those of two sugar transporters (MST6 and SWEET7). Commercial processing therefore impacts on the metabolome and the ability to accumulate sugars in the opening flower bud. Commercial treatment delayed bud opening and the effect was dependent on the position of the bud on the stem. However, it had little impact on the rate of cell expansion during flower opening. Cell expansion in the different areas of the adaxial epidermis was unaffected by the commercial treatment. Furthermore, edge and adaxial tepal cells expanded faster during opening. Expression of cell expansion related genes (EXPA1 and LoPIP1) fell as flowers opened. This differential cell expansion in the tepal sectors could underpin the transition of a convex to a concave tepal shape during opening. In conclusion, commercial processing mainly affects the early stages of bud opening. Sugar and metabolite accumulation is compromised by commercial treatment, but this did not affect the capacity for cell expansion in the tepal. Furthermore, our data indicate that differential cell expansion in the different sectors of the tepals is important in lily flower opening, and that this is associated with starch breakdown and sugar accumulation

Astrometry and geodesy with radio interferometry: experiments, models, results

Summarizes current status of radio interferometry at radio frequencies between Earth-based receivers, for astrometric and geodetic applications. Emphasizes theoretical models of VLBI observables that are required to extract results at the present accuracy levels of 1 cm and 1 nanoradian. Highlights the achievements of VLBI during the past two decades in reference frames, Earth orientation, atmospheric effects on microwave propagation, and relativity.Comment: 83 pages, 19 Postscript figures. To be published in Rev. Mod. Phys., Vol. 70, Oct. 199

Which symptoms are linked to a delayed presentation among melanoma patients? A retrospective study

Background: The incidence of melanoma is rising. Early detection is associated with a more favourable outcome. The factors that influence the timing of a patient’s presentation for medical assessment are not fully understood. The aims of the study were to measure the nature and duration of melanoma symptoms in a group of patients diagnosed with melanoma within the preceding 18 months and to identify the symptoms and barriers associated with a delay in presentation. Methods: A questionnaire was distributed to a random sample of 200 of the 963 melanoma patients who had participated in the Cancer Patient Experience Survey 2010 and were known to be alive 1 year later. Data were collected on symptoms, duration of symptoms prior to presentation and the reasons for not attending a doctor sooner. Results: A total of 159 patients responded to the questionnaire; 74 (47%) were men; mean age was 62 (range 24–90) years. Of the 149 patients who reported a symptom, 40 (27%) had a delayed presentation (i.e. >3 months). A mole growing bigger was the most common symptom and reporting this symptom was significantly associated with a delayed presentation (odds ratio (OR) 2.04, 95% confidence interval (95% CI) 1.14–5.08). Patients aged ≥65 years were less likely to report a barrier to presentation and were less likely to delay than those under 40, although this was of borderline statistical significance (OR 0.28, 95% CI 0.08–1.00). Conclusions: This study highlights that an enlarging mole is a significant symptom influencing the timing of presentation. Increasing public awareness of the signs of melanoma and of the importance of early presentation is desirable. Health professionals should take advantage of the opportunity to educate patients on such symptoms and signs where feasible. Further exploration of the barriers to presentation in younger people should be considered

In search of the authentic nation: landscape and national identity in Canada and Switzerland

While the study of nationalism and national identity has flourished in the last decade, little attention has been devoted to the conditions under which natural environments acquire significance in definitions of nationhood. This article examines the identity-forming role of landscape depictions in two polyethnic nation-states: Canada and Switzerland. Two types of geographical national identity are identified. The first – what we call the ‘nationalisation of nature’– portrays zarticular landscapes as expressions of national authenticity. The second pattern – what we refer to as the ‘naturalisation of the nation’– rests upon a notion of geographical determinism that depicts specific landscapes as forces capable of determining national identity. The authors offer two reasons why the second pattern came to prevail in the cases under consideration: (1) the affinity between wild landscape and the Romantic ideal of pure, rugged nature, and (2) a divergence between the nationalist ideal of ethnic homogeneity and the polyethnic composition of the two societies under consideration