WorldWideScience

Sample records for acid affording myocardial

  1. Limitations of spontaneous reperfusion and conventional medical therapy to afford myocardial protection through antecedent angina pectoris in acute myocardial infarction

    Hashimoto, Akiyoshi; Nakata, Tomoaki; Wakabayashi, Takeru; Yuda, Satoshi; Eguchi, Mariko; Sasao, Hisataka; Tsuchihashi, Kazufumi; Shimamoto, Kazuaki [Sapporo Medical Univ. (Japan)

    1999-10-01

    Despite the cardioprotective effect of rapid coronary reperfusion, the effects of spontaneous recanalization on myocardial viability and metabolism are unknown. We studied whether preinfarction angina affords cardioprotection when spontaneous coronary reperfusion occurred in acute infarct patients. Myocardial tomographies with thallium and I-123-labeled-{beta}-methyl-p-iodophenyl penta-decanoic acid (BMIPP) were performed in 27 acute myocardial infarct patients treated medically: 15 patients had preexisting angina before infarction (group A) and 12 did not (group B). Thallium and BMIPP abnormalities and regional function were quantified by a polar map and contrast ventriculography, respectively. There was no significant difference between thallium and BMIPP in the severity index in groups A and B (89{+-}97 vs. 85{+-}68, 97{+-}28 vs. 95{+-}27, respectively), and no significant difference between the groups in the thallium or BMIPP severity index. The ratio of the thallium severity index to that of BMIPP and the regional wall-motion abnormality index were identical in groups A and B. Both patient groups were divided into 2 subgroups based on the presence or absence of spontaneous coronary reperfusion: subgroups A1 and A2, and subgroups B1 and B2, respectively. There were no significant differences among the 4 subgroups in severity indexes for both tracers, the thallium/BMIPP ratio, or the asynergy score. The BMIPP severity index correlated significantly with that of thallium in all subgroups, but no significant difference between the regression lines was found. It is therefore unlikely that spontaneous coronary recanalization affords beneficial effects through preservation of myocardial viability in an ischemia-related zone, suggesting that the cardioprotective effect of preinfarction angina is a limited phenomenon in patients undergoing rapid coronary reperfusion. (author)

  2. Involvement of Proteasome and Macrophages M2 in the Protection Afforded by Telmisartan against the Acute Myocardial Infarction in Zucker Diabetic Fatty Rats with Metabolic Syndrome

    C. Di Filippo

    2014-01-01

    Full Text Available This study investigated the involvement of proteasome and macrophages M2 in the protection afforded by telmisartan against the acute myocardial infarction in Zucker diabetic fatty (ZDF rats with metabolic syndrome. ZDF rats were treated for three weeks with telmisartan at doses of 7 and 12 mg/kg/day. After treatment, rats were subjected to a 25 min occlusion of the left descending coronary artery followed by 2 h reperfusion (I/R. At the end of the I/R period, biochemical, immunohistochemical, and echocardiographic evaluations were done. Telmisartan treatment (7 mg/kg and 12 mg/kg reduced the myocardial infarct size, the expression of proteasome subunits 20S and 26S, and the protein ubiquitin within the heart. The compound has led to an increased M2 macrophage phenotype within the cardiac specimens and a modification of the cardiac cytokine and chemokine profile. This was functionally translated in improved cardiac performance as evidenced by echography after 2 h reperfusion. 7 mg/kg/day telmisartan was sufficient to improve the left ventricular ejection fraction LVEF of the rat heart recorded after I/R (e.g., vehicle 38 ± 2.2%; telmisartan 54 ± 2.7% and was sufficient to improve the diastolic function and the myocardial performance index up to values of 0.6 ± 0.01 measured after I/R.

  3. Assessment of myocardial fatty acid metabolism in patients with angina pectoris and diabetes mellitus using {sup 123}I-BMIPP myocardial scintigraphy

    Ito, Kazuki; Tanabe, Takuji; Yuba, Tatsuya; Doue, Tomoki; Adachi, Yoshihiko; Katoh, Shuuji [Asahi Univ., Gifu (Japan). Murakami Memorial Hospital; Sugihara, Hiroki; Azuma, Akihiro; Nakagawa, Masao

    2001-11-01

    We studied the effect of myocardial ischemia and diabetes mellitus (DM) on the myocardial fatty acid metabolism using {sup 123}I-BMIPP myocardial scintigraphy. We performed {sup 123}I-BMIPP myocardial scintigraphy in 50 patients with myocardial ischemia and without DM (AP), in 30 patients with myocardial ischemia and DM (AP+DM), 12 patients with DM and without myocardial ischemia (DM), and in 10 normal subjects (N). Myocardial uptake rate of {sup 123}I-BMIPP was obtained using the time activity curve. Myocardial washout rate of {sup 123}I-BMIPP was calculated using the polar images of early and delayed SPECT images. Myocardial uptake rate of {sup 123}I-BMIPP (%) were AP: 4.9{+-}0.6, AP+DM: 5.5{+-}0.5, DM 5.7{+-}0.5 and N: 5.0{+-}0.4. {sup 123}I-BMIPP myocardial uptake rate was increased in AP+DM and DM. {sup 123}I-BMIPP myocardial washout rate (%) were AP: 30.2{+-}4.3, AP+DM: 24.5{+-}3.9, DM: 16.1{+-}2.8 and N: 19.4{+-}3.2. {sup 123}I-BMIPP myocardial washout rate was increased in AP and AP+DM. {sup 123}I-BMIPP myocardial washout rate was increased particularly in patients with multi-vessels disease. {sup 123}I-BMIPP myocardial washout rate was decreased in DM. The present study suggested that diabetes mellitus increased myocardial fatty acid uptake and decreased myocardial fatty acid washout, and that myocardial ischemia increased myocardial fatty acid washout. (author)

  4. Protective effects of sinapic acid on lysosomal dysfunction in isoproterenol induced myocardial infarcted rats.

    Roy, Subhro Jyoti; Stanely Mainzen Prince, Ponnian

    2012-11-01

    In the pathology of myocardial infarction, lysosomal lipid peroxidation and resulting enzyme release play an important role. We evaluated the protective effects of sinapic acid on lysosomal dysfunction in isoproterenol induced myocardial infarcted rats. Male Wistar rats were treated with sinapic acid (12 mg/kg body weight) orally daily for 10 days and isoproterenol (100 mg/kg body weight) was injected twice at an interval of 24 h (9th and 10th day). Then, lysosomal lipid peroxidation, lysosomal enzymes in serum, heart homogenate, lysosomal fraction and myocardial infarct size were measured. Isoproterenol induced myocardial infarcted rats showed a significant increase in serum creatine kinase-MB and lysosomal lipid peroxidation. The activities of β-glucuronidase, β-galactosidase, cathepsin-B and D were significantly increased in serum, heart and the activities of β-glucuronidase and cathepsin-D were significantly decreased in lysosomal fraction of myocardial infarcted rats. Pre-and-co-treatment with sinapic acid normalized all the biochemical parameters and reduced myocardial infarct size in myocardial infarcted rats. In vitro studies confirmed the free radical scavenging effects of sinapic acid. The possible mechanisms for the observed effects are attributed to sinapic acid's free radical scavenging and membrane stabilizing properties. Thus, sinapic acid has protective effects on lysosomal dysfunction in isoproterenol induced myocardial infarcted rats.

  5. Preventive effects of p-coumaric acid on lysosomal dysfunction and myocardial infarct size in experimentally induced myocardial infarction.

    Jyoti Roy, Abhro; Stanely Mainzen Prince, P

    2013-01-15

    The present study was designed to evaluate the preventive effects of p-coumaric acid on lysosomal dysfunction and myocardial infarct size in isoproterenol induced myocardial infarcted rats. Male albino Wistar rats were pretreated with p-coumaric acid (8 mg/kg body weight) daily for a period of 7 days after which isoproterenol (100mg/kg body weight) was injected subcutaneously into rats twice at an interval of 24h (8th and 9th day).The activity/levels of serum cardiac diagnostic markers, heart lysosomal lipid peroxidation products and the activities of lysosomal enzymes (β-glucuronidase, β-galactosidase, cathepsin-B and cathepsin-D) were significantly (Plysosomal fraction. The pretreatment with p-coumaric acid significantly (Plysosomal lipid peroxidation products and the activities of lysosomal enzymes. In addition, p-coumaric acid greatly reduced myocardial infarct size. p-Coumaric acid pretreatment (8 mg/kg body weight) to normal rats did not show any significant effect. Thus, this study showed that p-coumaric acid prevents lysosomal dysfunction against cardiac damage induced by isoproterenol and brings back the levels of lipid peroxidation products and activities of lysosomal enzymes to near normal levels. The in vitro study also revealed the free radical scavenging activity of p-coumaric acid. Thus, the observed effects are due to p-coumaric acid's free radical scavenging and membrane stabilizing properties.

  6. Pharmacology of radioiodinated hexadecenoic acid - a myocardial imaging agent

    Sun, Q.X.; Zhang, J.; Ji, Q.M.; Wang, Y.C.; Xie, D.F.; Hua, R.L.; He, W.Y.; Shi, X.C.; Li, Y.J.; Jiang, C.J.

    1984-04-01

    /sup 123/I- and /sup 131/I-labelled hexadecenoic acids (IHDA, radiochemical purity over 92%, dissolved in 6% bovine serum albumin solution) was investigated in vivo. ICR mice were administered IHDA via the tail vein. Maximum myocardial uptake (27.3 +- 5.1%) was reached about 0.5 min after the injection. The ratio of uptake in the heart to that in the lungs was 2.3, to that in liver 1.5 and to that in other organs 2.4 to 6.4. The dog myocardium was visualized distinctly within 3-5 min with a gamma camera after i.v. /sup 131/I-IHDA, and not interfered with by activities in the lungs, liver and other organs. The low blood levels at 20 min had little effect on the quality of the heart images.

  7. Perinatal changes in myocardial supply and flux of fatty acids, carbohydrates, and ketone bodies in lambs

    Bartelds, B; Gratama, JWC; Knoester, H; Takens, J; Smid, GB; Aarnoudse, JG; Heymans, HSA; Kuipers, JRG

    1998-01-01

    No information is available on perinatal changes in myocardial metabolism in vivo. We measured myocardial supply and flux of fatty acids, carbohydrates, and ketone bodies in chronically instrumented fetal, newborn (1-4 days), and juvenile (7 wk) lambs, by measuring aorta-coronary sinus concentration

  8. Serum Fatty Acids, Traditional Risk Factors, and Comorbidity as Related to Myocardial Injury in an Elderly Population with Acute Myocardial Infarction

    Laake, Kristian; Seljeflot, Ingebjørg; Schmidt, Erik B;

    2016-01-01

    ), and peak Troponin T (TnT) levels in elderly patients with an acute myocardial infarction (AMI). Materials and Methods. Patients (n = 299) consecutively included in the ongoing Omega-3 fatty acids in elderly patients with myocardial infarction (OMEMI) trial were investigated. Peak TnT was registered during...

  9. Serum fatty acid in patients with acute myocardial infarction in Gorgan

    Abdoljalal Marjani

    2012-10-01

    Full Text Available Introduction: The present study aimed to assess serum fatty acid in patients with acute myocardial infarction in Gorgan, Iran. Material and Methods: The study conducted on the thirty and five subjects with acute myocardial infarction who were referred to the intensive Coronary Care Unit in 5th Azar in Gorgan. Results: The content of palmitoleic acid (16:1 was significantly higher in serum fatty acid of the patients than of the control groups (P=0.019, whereas oleic acid (18:1, linoleic acid (18:2, _-linolenic acid (18:3, arachidonic acid (20:4 and Eicosapentaenoic acid (EPA were significantly higher in the control groups than the patients (P<0.0001, P=0.013, P=0.042, P=0,001 and P=0.022 respectively. Conclusion: This study showed that the content of polyunsaturated fatty acids in serum fatty acid component was decreased in acute myocardial infarction patients. These results suggest that there may be some protective effects of poly unsaturated fatty acid against myocardial infarction.

  10. Uric acid in the early risk stratification of ST-elevation myocardial infarction.

    Lazzeri, Chiara; Valente, Serafina; Chiostri, Marco; Picariello, Claudio; Gensini, Gian Franco

    2012-02-01

    Controversy still exists about uric acid as a potential prognostic risk factor for outcomes in patients with acute myocardial infarction. We prospectively assessed, in 856 patients with ST-elevation myocardial infarction (STMI) consecutively admitted to our Intensive Cardiac Care Unit after primary percutaneous coronary intervention (PCI) whether uric acid (UA) levels are associated with in-hospital mortality and complications. Killip classes III-IV were more frequent in the 3° UA tertile that was associated with the highest values of peak Tn I (p = 0.005), NT-proBNP (p pre-existing risk factors to the degree of myocardial ischemia (as indicated by Killip class, ejection fraction) and to the acute metabolic response (as inferred by glucose levels). Hyperuricemia is not independently associated with early mortality when adjusted for renal function and the degree of myocardial damage.

  11. Effect and mechanism of salvianolic acid B on the myocardial ischemia-reperfusion injury in rats

    Ling Xue; Zhen Wu; Xiao-Ping Ji; Xia-Qing Gao; Yan-Hua Guo

    2014-01-01

    Objective: To investigate the effect of salvianolic acid B on rats with myocardial ischemia-reperfusion injury. Methods: SD rats were randomly divided into five groups (n=10 in each group): A sham operation group, B ischemic reperfusion group model group, C low dose salvianolic acid B group, D median dose salvianolic acid B group, E high dose salvianolic acid B group. One hour after establishment of the myocardial ischemia-reperfusion model, the concentration and the apoptotic index of the plasma level of myocardial enzymes (CTnⅠ, CK-MB), SOD, MDA, NO, ET were measured. Heart tissues were obtained and micro-structural changes were observed. Results: Compared the model group, the plasma CTnⅠ, CK-MB, MDA and ET contents were significantly increased, NO, T-SOD contents were decreased in the treatment group (group C, D, and E) (P<0.05); compared with group E, the plasma CTnⅠ, CK-MB, MDA and ET levels were increased, the NO, T-SOD levels were decreased in groups C and D (P<0.05). Infarct size was significantly reduced, and the myocardial ultrastructural changes were improved significantly in treatment group. Conclusions: Salvianolic acid B has a significant protective effect on myocardial ischemia-reperfusion injury. It can alleviate oxidative stress, reduce calcium overload, improve endothelial function and so on.

  12. Omega-3 fatty acids in adipose tissue and risk of myocardial infarction: The EURAMIC study

    Guallar, E.; Aro, A.; Jiménez, F.J.; Martín-Moreno, J.M.; Salminen, I.; Veer, P. van 't; Kardinaal, A.F.M.; Gömez-Aracena, J.; Martin, B.C.; Kohlmeier, L.; Kark, J.D.; Mazaev, V.P.; Ringstad, J.; Guillén, J.; Riemersma, R.A.; Huttunen, J.K.; Thamm, M.; Kok, F.J.

    1999-01-01

    Omega-3 fatty acids have potential antiatherogenic, antithrombotic, and antiarrhythmic properties, but their role in coronary heart disease remains controversial. To evaluate the association of omega-3 fatty acids in adipose tissue with the risk of myocardial infarction in men, a case-control study

  13. Superiority of zinc complex of acetylsalicylic acid to acetylsalicylic acid in preventing postischemic myocardial dysfunction.

    Korkmaz, Sevil; Atmanli, Ayhan; Li, Shiliang; Radovits, Tamás; Hegedűs, Peter; Barnucz, Enikő; Hirschberg, Kristóf; Loganathan, Sivakkanan; Yoshikawa, Yutaka; Yasui, Hiroyuki; Karck, Matthias; Szabó, Gábor

    2015-09-01

    The pathophysiology of ischemic myocardial injury involves cellular events, reactive oxygen species, and an inflammatory reaction cascade. The zinc complex of acetylsalicylic acid (Zn(ASA)2) has been found to possess higher anti-inflammatory and lower ulcerogenic activities than acetylsalicylic acid (ASA). Herein, we studied the effects of both ASA and Zn(ASA)2 against acute myocardial ischemia. Rats were pretreated with ASA (75 mg/kg) or Zn(ASA)2 (100 mg/kg) orally for five consecutive days. Isoproterenol (85 mg/kg, subcutaneously [s.c.]) was applied to produce myocardial infarction. After 17-22 h, animals were anesthetized with sodium pentobarbital (60 mg/kg, intraperitoneally [i.p.]) and both electrical and mechanical parameters of cardiac function were evaluated in vivo. Myocardial histological and gene expression analyses were performed. In isoproterenol-treated rats, Zn(ASA)2 treatment normalized significantly impaired left-ventricular contractility index (Emax 2.6 ± 0.7 mmHg/µL vs. 4.6 ± 0.5 mmHg/µL, P < 0.05), increased stroke volume (30 ± 3 µL vs. 50 ± 6 µL, P < 0.05), decreased systemic vascular resistance (7.2 ± 0.7 mmHg/min/mL vs. 4.2 ± 0.5 mmHg/min/mL, P < 0.05) and reduced inflammatory infiltrate into the myocardial tissues. ECG revealed a restoration of elevated ST-segment (0.21 ± 0.03 mV vs. 0.09 ± 0.02 mV, P < 0.05) and prolonged QT-interval (79.2 ± 3.2 ms vs. 69.5 ± 2.5 ms, P < 0.05) by Zn(ASA)2. ASA treatment did not result in an improvement of these parameters. Additionally, Zn(ASA)2 significantly increased the mRNA-expression of superoxide dismutase 1 (+73 ± 15%), glutathione peroxidase 4 (+44 ± 12%), and transforming growth factor (TGF)-β1 (+102 ± 22%). In conclusion, our data demonstrate that oral administration of zinc and ASA in the form of bis(aspirinato)zinc(II) complex is superior to ASA in preventing electrical

  14. Defective branched chain amino acid catabolism contributes to cardiac dysfunction and remodeling following myocardial infarction.

    Wang, Wei; Zhang, Fuyang; Xia, Yunlong; Zhao, Shihao; Yan, Wenjun; Wang, Helin; Lee, Yan; Li, Congye; Zhang, Ling; Lian, Kun; Gao, Erhe; Cheng, Hexiang; Tao, Ling

    2016-11-01

    Cardiac metabolic remodeling is a central event during heart failure (HF) development following myocardial infarction (MI). It is well known that myocardial glucose and fatty acid dysmetabolism contribute to post-MI cardiac dysfunction and remodeling. However, the role of amino acid metabolism in post-MI HF remains elusive. Branched chain amino acids (BCAAs) are an important group of essential amino acids and function as crucial nutrient signaling in mammalian animals. The present study aimed to determine the role of cardiac BCAA metabolism in post-MI HF progression. Utilizing coronary artery ligation-induced murine MI models, we found that myocardial BCAA catabolism was significantly impaired in response to permanent MI, therefore leading to an obvious elevation of myocardial BCAA abundance. In MI-operated mice, oral BCAA administration further increased cardiac BCAA levels, activated the mammalian target of rapamycin (mTOR) signaling, and exacerbated cardiac dysfunction and remodeling. These data demonstrate that BCAAs act as a direct contributor to post-MI cardiac pathologies. Furthermore, these BCAA-mediated deleterious effects were improved by rapamycin cotreatment, revealing an indispensable role of mTOR in BCAA-mediated adverse effects on cardiac function/structure post-MI. Of note, pharmacological inhibition of branched chain ketoacid dehydrogenase kinase (BDK), a negative regulator of myocardial BCAA catabolism, significantly improved cardiac BCAA catabolic disorders, reduced myocardial BCAA levels, and ameliorated post-MI cardiac dysfunction and remodeling. In conclusion, our data provide the evidence that impaired cardiac BCAA catabolism directly contributes to post-MI cardiac dysfunction and remodeling. Moreover, improving cardiac BCAA catabolic defects may be a promising therapeutic strategy against post-MI HF.

  15. The affordances of broken affordances

    Grünbaum, Martin Gielsgaard; Simonsen, Jakob Grue

    2015-01-01

    important: how users may (i) achieve their goals in the presence of such broken affordances, and may (ii) repurpose or otherwise interact with artefacts with broken affordances. We argue that (A) thorough analyses of breakdowns of affordances and their associated signifiers and feedbacks have implication...

  16. Plasma fatty acids, oxylipins, and risk of myocardial infarction: the Singapore Chinese health study

    Objective: We aimed to examine the prospective association between plasma fatty acids (FAs), oxylipins and risk of acute myocardial infarction (AMI) in a Singapore Chinese population. Methods: A nested case-control study with 744 incident AMI cases and 744 matched controls aged 47-83 years was condu...

  17. Dietary n-3 fatty acids promote arrhythmias during acute regional myocardial ischemia in isolated pig hearts

    Coronel, R.; Wilms-Schopman, F.J.G.; Ruijter, den H.M.; Belterman, C.N.; Schumacher, C.A.; Opthof, T.; Hovernier, R.; Lemmens, A.G.; Terpstra, A.H.M.; Katan, M.B.; Zock, P.L.

    2007-01-01

    Objective Dietary supplementation with fish oil-derived n-3 fatty acids reduces mortality in patients with myocardial infarction, but may have adverse effects in angina patients. The underlying electrophysiologic mechanisms are poorly understood. We studied the arrhythmias and the electrophysiologic

  18. L-(4-/sup 11/C)aspartic acid: enzymatic synthesis, myocardial uptake, and metabolism

    Barrio, J.R.; Egbert, J.E.; Henze, E.; Schelbert, H.R.; Baumgartner, F.J.

    1982-01-01

    Sterile, pyrogen-free L-(4-/sup 11/C)aspartic acid was prepared from /sup 11/CO/sub 2/ using phosphoenolpyruvate carboxylase and glutamic/oxaloacetic acid transaminase immobilized on Sepharose supports to determine if it is a useful indicator for in vivo, noninvasive determination of myocardial metabolism. An intracoronary bolus injection of L-(4-/sup 11/C)aspartic acid into dog myocardium showed a triexponential clearance curve with maximal production of /sup 11/CO/sub 2/ 100 s after injection. Inactivation of myocardial transaminase activity modified the tracer clearance and inhibited the production of /sup 11/CO/sub 2/. Positron-computed tomography imaging showed that the /sup 11/C activities retained in rhesus monkey myocardium are higher than those observed in dog heart after intravenous injection of L-(4-/sup 11/C)aspartic acid. These findings demonstrated the rapid incorporation of the carbon skeleton of L-aspartic acid into the tricarboxylic acid cycle after enzymatic transamination in myocardium and suggested that L-(4-/sup 11/C)aspartic acid could be of value for in vivo, noninvasive assessment of local myocardial metabolism.

  19. Plasminogen activator inhibitor-1, free fatty acids, and insulin resistance in patients with myocardial infarction

    Gruzdeva O

    2013-08-01

    Full Text Available Olga Gruzdeva, Evgenya Uchasova, Yulia Dyleva, Ekaterina Belik, Ekaterina Shurygina, Olga Barbarash Research Institute for Complex Issues of Cardiovascular Diseases under the Siberian Branch of the Russian Academy of Medical Sciences, Kemerovo, Russian Federation Background: Insulin resistance is known to be a common feature of type 2 diabetes mellitus and is regarded as an important mechanism in the pathogenesis of this disease. The key pathogenetic mechanisms of insulin resistance progression are free fatty acids metabolism impairment and enhanced activity of plasminogen activator inhibitor 1. Both free fatty acids and plasminogen activator inhibitor 1 are recognized as risk factors for coronary heart disease. Methods: The patients were divided into two groups: group 1 included 65 non-diabetic myocardial infarction patients and group 2 enrolled 60 diabetic myocardial infarction patients. The control group consisted of 30 sex- and age-matched volunteers. The concentration of serum free fatty acids, glucose, C-peptide, and insulin were measured on the 1st and 12th days of the study. All the patients had their postprandial glycemia, insulin, and C-peptide concentrations measured 2 hours after a standard carbohydrate breakfast containing 360 kcal (protein 20 g, carbohydrate 57 g, and fat 9 g. Results: Free fatty acids levels in group 1 and in group 2 exceeded the control group values by 7-fold and 11-fold, respectively. Plasminogen activator inhibitor 1 concentration was 2.5-fold higher in group 1 and 4.6-fold higher in group 2 compared to the control group on the 1st day from the myocardial infarction onset. In addition, plasminogen activator inhibitor 1 concentration was significantly reduced in both groups on the 12th day from the myocardial infarction onset; however, it did not achieve the control group values. Conclusion: Increased postprandial glucose level, insulinemia, and elevated levels of free fatty acids and plasminogen activator

  20. Citric Acid Cycle Metabolites Predict the Severity of Myocardial Stunning and Mortality in Newborn Pigs

    Hyldebrandt, Janus Adler; Støttrup, Nicolaj Brejnholt; Frederiksen, Christian Alcaraz;

    2016-01-01

    , which so far are undetermined. DESIGN: A total of 28 newborn pigs were instrumented with a microdialysis catheter in the right ventricle, and intercellular citric acid cycle intermediates and adenosine metabolite concentrations were determined at 20-minute intervals. Stunning was induced by 10 cycles...... animals (n = 8), concentrations of succinate (p citric acid cycle intermediates and adenosine metabolites reflects...... the presence of myocardial stunning and predicts mortality in acute noninfarct right ventricular heart failure in newborn pigs. This phenomenon occurs independently of the type of inotrope, suggesting that citric acid cycle intermediates represent potential markers of acute noninfarct heart failure....

  1. Assessment of coronary reperfusion in patients with myocardial infarction using fatty acid binding protein concentrations in plasma

    M.J.M. de Groot; A.M.M. Muijtjens; M.L. Simoons (Maarten); W.T. Hermens (Wim); J.F.C. Glatz

    2001-01-01

    textabstractOBJECTIVE: To examine whether successful coronary reperfusion after thrombolytic treatment in patients with confirmed acute myocardial infarction can be diagnosed from the plasma marker fatty acid binding protein (FABP), for either acute clinical decision making or retrospective purposes

  2. Myocardial metabolic abnormalities in hypertrophic cardiomyopathy assessed by iodine-123-labeled beta-methyl-branched fatty acid myocardial scintigraphy and its relation to exercise-induced ischemia

    Matsuo, Shinro; Nakamura, Yasuyuki; Takahashi, Masayuki; Mitsunami, Kenichi; Kinoshita, Masahiko [Shiga Univ. of Medical Science, Otsu (Japan)

    1998-03-01

    Reversible thallium-201 ({sup 201}Tl) abnormalities during exercise stress have been used as markers of myocardial ischemia in hypertrophic cardiomyopathy (HCM) and are most likely to identify relatively underperfused myocardium. Although metabolic abnormalities in HCM were reported, the relationship between impaired energy metabolism and exercise-induced ischemia has not been fully elucidated as yet. To assess the relationship between myocardial perfusion abnormalities and fatty acid metabolic abnormalities, 28 patients with HCM underwent exercise {sup 201}Tl and rest {sup 123}I-15-(p-iodophenyl)-3-methyl pentadecanoic acid (BMIPP) scintigraphy. Perfusion abnormalities were observed by exercise {sup 201}Tl in 19/28 patients with HCM. {sup 123}I-BMIPP uptake was decreased compared with delayed {sup 201}Tl in 106/364 (29%) of the total myocardial segments (p<0.01, McNemar symmetry test). Such disparity between {sup 123}I-BMIPP and {sup 201}Tl was observed more often in the 49/75 (65%) segments with reversible exercise {sup 201}Tl defects (p<0.001). Our results indicate that exercise-induced myocardial ischemia exists in HCM, resulting in metabolic abnormalities. The combination of {sup 123}I-BMIPP and {sup 201}Tl suggests that myocardial ischemia may play an important role in metabolic abnormalities in HCM. (author)

  3. Effect of unsaturated fatty acids on myocardial performance, metabolism and morphology

    M.F. Pinotti

    2006-02-01

    Full Text Available Diets rich in saturated fatty acids are one of the most important causes of atherosclerosis in men, and have been replaced with diets rich in unsaturated fatty acids (UFA for the prevention of this disorder. However, the effect of UFA on myocardial performance, metabolism and morphology has not been completely characterized. The objective of the present investigation was to evaluate the effects of a UFA-rich diet on cardiac muscle function, oxidative stress, and morphology. Sixty-day-old male Wistar rats were fed a control (N = 8 or a UFA-rich diet (N = 8 for 60 days. Myocardial performance was studied in isolated papillary muscle by isometric and isotonic contractions under basal conditions after calcium chloride (5.2 mM and ß-adrenergic stimulation with 1.0 µM isoproterenol. Fragments of the left ventricle free wall were used to study oxidative stress and were analyzed by light microscopy, and the myocardial ultrastructure was examined in left ventricle papillary muscle. After 60 days the UFA-rich diet did not change myocardial function. However, it caused high lipid hydroperoxide (176 ± 5 vs 158 ± 5, P < 0.0005 and low catalase (7 ± 1 vs 9 ± 1, P < 0.005 and superoxide-dismutase (18 ± 2 vs 27 ± 5, P < 0.005 levels, and discrete morphological changes in UFA-rich diet hearts such as lipid deposits and mitochondrial membrane alterations compared to control rats. These data show that a UFA-rich diet caused myocardial oxidative stress and mild structural alterations, but did not change mechanical function.

  4. Network Affordances

    Samson, Audrey; Soon, Winnie

    2015-01-01

    This paper examines the notion of network affordance within the context of network art. Building on Gibson's theory (Gibson, 1979) we understand affordance as the perceived and actual parameters of a thing. We expand on Gaver's affordance of predictability (Gaver, 1996) to include ecological...... and computational parameters of unpredictability. We illustrate the notion of unpredictability by considering four specific works that were included in a network art exhibiton, SPEED SHOW [2.0] Hong Kong. The paper discusses how the artworks are contingent upon the parameteric relations (Parisi, 2013......), of the network. We introduce network affordance as a dynamic framework that could articulate the experienced tension arising from the (visible) symbolic representation of computational processes and its hidden occurrences. We base our proposal on the experience of both organising the SPEED SHOW and participating...

  5. Serum Fatty Acids, Traditional Risk Factors, and Comorbidity as Related to Myocardial Injury in an Elderly Population with Acute Myocardial Infarction

    Kristian Laake

    2016-01-01

    Full Text Available Background. Epidemiological and randomized clinical trials indicate that marine polyunsaturated n-3 fatty acids (n-3 PUFAs may have cardioprotective effects. Aim. Evaluate the associations between serum fatty acid profile, traditional risk factors, the presence of cardiovascular diseases (CVD, and peak Troponin T (TnT levels in elderly patients with an acute myocardial infarction (AMI. Materials and Methods. Patients (n=299 consecutively included in the ongoing Omega-3 fatty acids in elderly patients with myocardial infarction (OMEMI trial were investigated. Peak TnT was registered during the hospital stay. Serum fatty acid analysis was performed 2–8 weeks later. Results. No significant correlations between peak TnT levels and any of the n-3 PUFAs were observed. However, patients with a history of atrial fibrillation had significantly lower docosahexaenoic acid levels than patients without. Significantly lower peak TnT levels were observed in patients with a history of hyperlipidemia, angina, MI, atrial fibrillation, intermittent claudication, and previous revascularization (all p<0.02. Conclusions. In an elderly population with AMI, no association between individual serum fatty acids and estimated myocardial infarct size could be demonstrated. However, a history of hyperlipidemia and the presence of CVD were associated with lower peak TnT levels, possibly because of treatment with cardioprotective medications.

  6. N-3 fatty acids, ventricular arrhythmia-related events, and fatal myocardial infarction in postmyocardial infarction patients with diabetes

    Kromhout, D.; Geleijnse, J.M.; Goede, de J.; Oude Griep, L.M.; Mulder, B.J.M.; Boer, de M.J.; Deckers, J.W.; Boersma, E.; Zock, P.L.; Giltay, E.J.

    2011-01-01

    OBJECTIVE We carried out a secondary analysis in high-risk patients with a previous myocardial infarction (MI) and diabetes in the Alpha Omega Trial. We tested the hypothesis that in these patients an increased intake of the n-3 fatty acids eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), an

  7. Affordances revisited

    Dohn, Nina Bonderup

    2009-01-01

    , it is argued, is a problem for both design and empirical research. Because HCI discussions of the concept have informed CSCL, views presented within this discourse are discussed. A Merleau-Pontian account of affordances is developed, building on his view of the human being as always already being-in-the world...... in a non-thematized, pre-reflective correspondence of body and world in the concrete activity. A dynamic, agent-centred, cultural-, experience- and skill-relative, but perception-independent, ontology is proposed for affordances. Toward the end of the article, examples are given of how the Merleau......-Pontian account of affordances may shift the focus of empirical research and of design processes within CSCL....

  8. Touch Affordances

    Slegers, Karin; de Roeck, Dries; Arnall, Timo

    The workshop “Touch Affordances” addresses a concept relevant to human computer interactions based on touch. The main topic is the challenge of applying the notion of affordances to domains related to touch interactions (e.g. (multi)touch screens, RFID & NFC, ubiquitous interfaces). The goals of this workshop are to launch a community of researchers, designers, etc. interested in this topic, to create a common understanding of the field of touch affordances and to generate ideas for new research areas for intuitive touch interactions. The workshop will be highly interactive and will have a creative, generative character.

  9. Electrocardiographic left ventricular hypertrophy without echocardiographic abnormalities evaluated by myocardial perfusion and fatty acid metabolic imaging

    Narita, Michihiro; Kurihara, Tadashi [Sumitomo Hospital, Osaka (Japan)

    2000-01-01

    The pathophysiologic process in patients with electrocardiographic left ventricular hypertrophy with ST, T changes but without echocardiographic abnormalities was investigated by myocardial perfusion imaging and fatty acid metabolic imaging. Exercise stress {sup 99m}Tc-methoxy-isobutyl isonitrile (MIBI) imaging and rest {sup 123}I-beta-methyl-p-iodophenyl pentadecanoic acid (BMIPP) imaging were performed in 59 patients with electrocardiographic hypertrophy including 29 without apparent cause including hypertension and echocardiographic hypertrophy, and 30 with essential hypertension. Coronary angiography was performed in 6 patients without hypertension and 4 with hypertension and biopsy specimens were obtained from the left ventricular apex from 6 patients without hypertension. Myocardial perfusion and {sup 123}I-BMIPP images were classified into 3 types: normal, increased accumulation of the isotope at the left ventricular apex (high uptake) and defect. Transient perfusion abnormality and apical defect observed by {sup 123}I-BMIPP imaging were more frequent in patients without hypertension than in patients with hypertension (32% vs. 17%, p=0.04671 in perfusion; 62% vs. 30%, p=0.0236 in {sup 123}I-BMIPP). Eighteen normotensive patients with apical defect by {sup 123}I-BMIPP imaging included 3 of 10 patients with normal perfusion at exercise, 6 of 10 patients with high uptake and 9 of 9 patients with perfusion defect. The defect size revealed by {sup 123}I-BMIPP imaging was greater than that of the perfusion abnormality. Coronary stenoses were not observed and myocardial specimens showed myocardial disarray with hypertrophy. Moreover, 9 patients with hypertension and apical defects by {sup 123}I-BMIPP showed 3 different types of perfusion. Many patients without hypertension show a pathologic process similar to hypertrophic cardiomyopathy. Perfusion and {sup 123}I-BMIPP imaging are useful for the identification of these patients. (author)

  10. Altered maternal thyroid function: Effect of L-carnitine supplementation on fetal and neonatal myocardial free fatty acid oxidation,in vitro

    Kumar, Ratan

    1998-01-01

    Effect of L-carnitine supplementation on myocardial free fatty acid oxidation,in vitro, in offsprings born of hypothyroid and hyperthyroid mothers was studied in rats. L-carnitine supplementation stimulated myocardial fatty acid oxidation during gestational period in offspring born of control and hyperthyroid mothers. In contrast L-carnitine supplementation induced stimulation in myocardial fatty acid oxidation was very less in fetuses born of hypothyroid mothers. However, in neonates born of...

  11. Protective effect of dietary n-3 polyunsaturated fatty acids on myocardial resistance to ischemia-reperfusion injury in rats.

    Zeghichi-Hamri, Sabrina; de Lorgeril, Michel; Salen, Patricia; Chibane, Mohamed; de Leiris, Joël; Boucher, François; Laporte, François

    2010-12-01

    Dietary n-3 polyunsaturated fatty acids (PUFA) reduce coronary heart disease (CHD) complications, such as chronic arrhythmia and sudden cardiac death. Improved myocardial resistance to ischemia-reperfusion injury results in smaller myocardial infarction, which is a major factor in the occurrence of CHD complications. We hypothesized that a specific dietary fatty acid profile (low in saturated and n-6 PUFA but high in plant and marine n-3 PUFA) may improve myocardial resistance to ischemia-reperfusion injury and reduce infarct size. To test this assumption, we used a well-defined rat model of myocardial infarction. Based on our results, in comparison to a diet that is high in either saturated or n-6 PUFA but poor in plant and marine n-3 PUFA, a diet that is low in saturated fats and n-6 PUFA but rich in plant and marine n-3 PUFA results in smaller myocardial infarct size (P fatty acid composition of plasma, erythrocyte cell membranes, and the phospholipids of myocardial mitochondria. The results show a great accumulation of n-3 PUFA and a parallel decrease in arachidonic acid, the main n-6 PUFA, in plasma, cell membranes, and cardiac mitochondria (P < .0001). We conclude that improved myocardial resistance to ischemia-reperfusion may be one of the critical factors explaining the protective effects of dietary n-3 PUFA against CHD complications in humans. In addition to increasing n-3 PUFA intake, an optimal dietary pattern aimed at reducing cardiovascular mortality should include a reduction of the intake of both saturated and n-6 PUFA.

  12. Fatty acid desaturase gene variants, cardiovascular risk factors, and myocardial infarction in the Costa Rica Study

    Stella eAslibekyan

    2012-05-01

    Full Text Available Genetic variation in fatty acid desaturases (FADS has previously been linked to long-chain polyunsaturated fatty acids (PUFAs in adipose tissue and cardiovascular risk. The goal of our study was to test associations between six common FADS polymorphisms (rs174556, rs3834458, rs174570, rs2524299, rs174589, rs174627, adipose tissue fatty acids, intermediate cardiovascular risk factors, and nonfatal myocardial infarction (MI in a matched population based case-control study of Costa Rican adults (n=1756. Generalized linear models and multiple conditional logistic regression models were used to assess the associations of interest. Analyses involving intermediate cardiovascular risk factors and MI were also conducted in two replication cohorts, The Nurses’ Health Study (n=1200 and The Health Professionals Follow-Up Study (n=1295. In the Costa Rica Study, genetic variation in the FADS cluster was associated with a robust linear decrease in adipose gamma-linolenic, arachidonic, and eicosapentaenoic fatty acids, and significant or borderline significant increases in the eicosadienoic, eicosatrienoic, and dihomo-gamma-linolenic fatty acids. However, the associations with adipose tissue fatty acids did not translate into changes in inflammatory biomarkers, blood lipids, or the risk of MI in the discovery or the replication cohorts. In conclusion, fatty acid desaturase polymorphisms impact long-chain PUFA biosynthesis, but their overall effect on cardiovascular health likely involves multiple pathways and merits further investigation.

  13. Affordable Luxuries

    2011-01-01

    Tariff cuts and new trade measures are in the works to make luxury goods more affordable in the Chinese market Where there is luxury,there are Chinese buyers.And when they arrive,cash registers ring incess antly as sale after sale is made.It’s particularly true at luxury shopping outlets worldwide.From Galleries Lafayette in Paris to Harrods in London and premium outlets in New York City,Chinese touristsd escend on these locales,often leaving their

  14. The characteristics of myocardial fatty acid metabolism in patients with left ventricular hypertrophy

    Isobe, Naoki; Toyama, Takuji; Hoshizaki, Hiroshi [Gunma Prefectural Cardiovascular Center (Japan)] (and others)

    1999-09-01

    We evaluated the characteristics of myocardial fatty acid metabolism in patients with left ventricular hypertrophy (LVH). Myocardial imaging with {sup 123}I-beta-methyl iodophenyl pentadecanoic acid (BMIPP) was performed in 28 patients with hypertrophic cardiomyopathy (HCM), 15 patients with hypertensive heart disease (HHD), 13 patients with aortic stenosis (AS) and 8 normal controls (NC). The patients with HCM consisted of 13 patients of asymmetric septal hypertrophy (ASH), 7 patients of diffuse hypertrophy (Diffuse-HCM) and 8 patients of apical hypertrophy (APH). Planar and SPECT images of BMIPP were acquired 15 minutes and 4 hours after tracer injection. Resting {sup 201}Tl SPECT images and echocardiography were also performed on other days. We calculated heart/mediastinum count ratio and washout rate of BMIPP by using planar image. In patients with LVH, the incidence of reduced BMIPP uptake was more frequent than that of reduced {sup 201}Tl uptake. In delayed images, more than 60% of patients with LVH reduced BMIPP uptake, especially remarkable for patients with ASH and APH. The washout rate of all cardiac hypertrophic disorders was tended to be higher than that of normal subjects. Reduced BMIPP uptake was frequently found in septal portion of anterior and inferior wall in patients with ASH, in inferior wall in patients with Diffuse-HCM and HHD, in apex in patients with APH and AS. These results suggest that BMIPP scintigraphy can differentiate three types of cardiac hypertrophy. (author)

  15. Clinical study on myocardial imaging with. beta. -methyl-p-( sup 123 I)-iodophenyl-pentadecanoic acid in patients with mitochondrial myopathy

    Kihara, Koichi; Nakajo, Masayuki; Shono, Hirohisa (Kagoshima Univ. (Japan). Faculty of Medicine) (and others)

    1992-04-01

    Myocardial imaging with {beta}-methyl-p-({sup 123}I)-iodophenyl-pentadecanoic acid ({sup 123}I-BMIPP), a new radiopharmaceutical designed to evaluate myocardial fatty acid metabolism, was performed in 7 patients with mitochondrial myopathy to detect their myocardial damages in comparison with {sup 201}Tl myocardial imaging. These patients were divided into 4 chronic progressive external ophthalmoplegia (CPEO) cases, 2 mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) cases and 1 myoclonus epilepsy with ragged-red fibers (MERRF). In visual assessment, we observed more myocardial segments with decreased uptake of {sup 123}I-BMIPP compared to {sup 201}Tl in MELAS cases than in CPEO cases. The mean myocardial uptake of {sup 123}I-BMIPP was higher than that of {sup 201}Tl in CPEO cases. On the other hand, in MELAS and MERRF cases, the mean myocardial uptake of {sup 123}I-BMIPP was lower than that of {sup 201}Tl. Abnormal findings suggesting myocardial damages were observed in echocardiogram and/or in electrocardiogram in MELAS and MERRF cases, while no such abnormal findings were observed in CPEO cases. Along with the previously reported experimental result that the impairment of rat myocardial mitochondria decreased myocardial uptake of {sup 123}I-BMIPP, these results suggest that {sup 123}I-BMIPP may be useful to detect myocardial damages in patients with mitochondrial myopathy. (author)

  16. Acidic HEPES-KH Reperfusion Enhances Myocardial Protection in Immature Rabbits

    孙忠东; 杨辰垣; 邢建洲; 陈涛; 董念国; 罗军

    2002-01-01

    Summary: To study the effects of different pH HEPES-KH reperfusate solution on immature myocardial protection, isolated perfused Langendorff model from immature rabbit hearts were developed formed. Control group (C) was perfused only with pH 7. 4 HEPES-KH solution for 90 min. Is chemia/reperfusion group (group I/R) was perfused with pH 7. 4 HEPES-KH solution before is chemia or after ischemia. Experimental group (group E), after ischemia, was perfused with pH 6.8,pH 7. 1 and pH7.4 HEPES-KH solutions for 5 min, 5 min, and 20 min, respectively. The left ven tricular function recovery, MWC, LDH and CK leakage, MDA, ATP content, and SOD activity were determined. Our results showed that the left ventricular function recovery, ATP content and SOD activity in group E were higher than those of group I/R (P<0. 05). MWC, MDA content,LDH and CK leakage in group E were lower than those of group I/R (P<0. 05). These findings suggested that pH paradox might be one of important mechanisms for immature myocardial ischemia reperfusion injury, and acidic perfusate, at the beginning of reperfusion, might attenuate pH paradox and ameliorate functional recovery in isolated perfused immature rabbit hearts.

  17. Differential effects of heptanoate and hexanoate on myocardial citric acid cycle intermediates following ischemia-reperfusion.

    Okere, Isidore C; McElfresh, Tracy A; Brunengraber, Daniel Z; Martini, Wenjun; Sterk, Joseph P; Huang, Hazel; Chandler, Margaret P; Brunengraber, Henri; Stanley, William C

    2006-01-01

    In the normal heart, there is loss of citric acid cycle (CAC) intermediates that is matched by the entry of intermediates from outside the cycle, a process termed anaplerosis. Previous in vitro studies suggest that supplementation with anaplerotic substrates improves cardiac function during myocardial ischemia and/or reperfusion. The present investigation assessed whether treatment with the anaplerotic medium-chain fatty acid heptanoate improves contractile function during ischemia and reperfusion. The left anterior descending coronary artery of anesthetized pigs was subjected to 60 min of 60% flow reduction and 30 min of reperfusion. Three treatment groups were studied: saline control, heptanoate (0.4 mM), or hexanoate as a negative control (0.4 mM). Treatment was initiated after 30 min of ischemia and continued through reperfusion. Myocardial CAC intermediate content was not affected by ischemia-reperfusion; however, treatment with heptanoate resulted in a more than twofold increase in fumarate and malate, with no change in citrate and succinate, while treatment with hexanoate did not increase fumarate or malate but increased succinate by 1.8-fold. There were no differences among groups in lactate exchange, glucose oxidation, oxygen consumption, and contractile power. In conclusion, despite a significant increase in the content of carbon-4 CAC intermediates, treatment with heptanoate did not result in improved mechanical function of the heart in this model of reversible ischemia-reperfusion. This suggests that reduced anaplerosis and CAC dysfunction do not play a major role in contractile and metabolic derangements observed with a 60% decrease in coronary flow followed by reperfusion.

  18. Pharmacological Postconditioning with Lactic Acid and Hydrogen Rich Saline Alleviates Myocardial Reperfusion Injury in Rats

    Zhang, Guoming; Gao, Song; Li, Xiaoyan; Zhang, Lulu; Tan, Hong; Xu, Lin; Chen, Yaoyu; Geng, Yongjian; Lin, Yanliang; Aertker, Benjamin; Sun, Yuanyuan

    2015-01-01

    This study investigated whether pharmacological postconditioning with lactic acid and hydrogen rich saline can provide benefits similar to that of mechanical postconditioning. To our knowledge, this is the first therapeutic study to investigate the co-administration of lactic acid and hydrogen. SD rats were randomly divided into 6 groups: Sham, R/I, M-Post, Lac, Hyd, and Lac + Hyd. The left coronary artery was occluded for 45 min. Blood was withdrawn from the right atrium to measure pH. The rats were sacrificed at different time points to measure mitochondrial absorbance, infarct size, serum markers and apoptotic index. Rats in Lac + Hyd group had similar blood pH and ROS levels when compared to the M-Post group. Additionally, the infarct area was reduced to the same extent in Lac + Hyd and M-Post groups with a similar trends observed for serum markers of myocardial injury and apoptotic index. Although the level of P-ERK in Lac + Hyd group was lower, P-p38/JNK, TNFα, Caspase-8, mitochondrial absorbance and Cyt-c were all similar in Lac + Hyd and M-Post groups. The Lac and Hyd groups were able to partially mimic this protective role. These data suggested that pharmacological postconditioning with lactic acid and hydrogen rich saline nearly replicates the benefits of mechanical postconditioning. PMID:25928542

  19. Assessment of myocardial metabolic flexibility and work efficiency in human type 2 diabetes using 16-[18F]fluoro-4-thiapalmitate, a novel PET fatty acid tracer.

    Mather, K J; Hutchins, G D; Perry, K; Territo, W; Chisholm, R; Acton, A; Glick-Wilson, B; Considine, R V; Moberly, S; DeGrado, T R

    2016-03-15

    Altered myocardial fuel selection likely underlies cardiac disease risk in diabetes, affecting oxygen demand and myocardial metabolic flexibility. We investigated myocardial fuel selection and metabolic flexibility in human type 2 diabetes mellitus (T2DM), using positron emission tomography to measure rates of myocardial fatty acid oxidation {16-[(18)F]fluoro-4-thia-palmitate (FTP)} and myocardial perfusion and total oxidation ([(11)C]acetate). Participants underwent paired studies under fasting conditions, comparing 3-h insulin + glucose euglycemic clamp conditions (120 mU·m(-2)·min(-1)) to 3-h saline infusion. Lean controls (n = 10) were compared with glycemically controlled volunteers with T2DM (n = 8). Insulin augmented heart rate, blood pressure, and stroke index in both groups (all P efficiency was lower in T2DM (P = 0.006) and decreased in both groups with the insulin-induced increase in work and shift in fuel utilization (P = 0.01). Augmented fatty acid oxidation is present under baseline and insulin-treated conditions in T2DM, with impaired insulin-induced shifts away from fatty acid oxidation. This is accompanied by reduced work efficiency, possibly due to greater oxygen consumption with fatty acid metabolism. These observations suggest that improved fatty acid suppression, or reductions in myocardial fatty acid uptake and retention, could be therapeutic targets to improve myocardial ischemia tolerance in T2DM.

  20. CD36 abnormality and impaired myocardial long-chain fatty acid uptake in patients with hypertrophic cardiomyopathy

    Okamoto, Fumio; Tanaka, Takao; Sohmiya, Koichi; Kawamura, Keishiro [Osaka Medical Coll., Takatsuki (Japan)

    1998-07-01

    In this study, in order to discover the relationship between hypertrophic cardiomyopathy (HCM) and the CD36 molecular abnormality, the expression level of platelet CD36 and CD36 cDNA in 55 HCM patients was analyzed. Twelve patients showed negligible (<5%) CD36 expression on their platelets. Among them, one was found to be homozygous for the C-478{yields}T substitution and 6 were heterozygous for the C-478{yields}T substitution. In 9 patients, CD36 was expressed by less than 50% of the platelets. One of them was found to be heterozygous for the C-478{yields}T substitution. Two other patients were also found to be heterozygous for this point mutation, although their platelets expressed CD36. Thus, 23 out of 55 (41.8%) HCM patients had negligible (<5%) or reduced (<50%) levels of CD36 expression on platelets, or had a point mutation of CD36 cDNA. These 55 HCM patients were also evaluated with myocardial scintigraphy both for long-chain fatty acid (LCFA) uptake and perfusion, which showed a moderate to severe discrepancy between myocardial LCFA accumulation and myocardial perfusion in 95.5% of the patients (21/23). On the other hand, 70% of the patients with normal (>90%) CD36 expression (14/20) did not show any severe discrepancies between myocardial LCFA accumulation and myocardial perfusion. These data could suggest that abnormal myocardial LCFA metabolism seen in HCM patients may be related to abnormality of the CD36 molecule, and that abnormalities of this molecule may be linked to the cause of some types of HCM. (K.H.)

  1. Myocardial Lipid Profiling During Time Course of High Fat Diet and its Relationship to the Expression of Fatty Acid Transporters

    Ewa Harasim

    2015-09-01

    Full Text Available Background/Aims: It is well documented that increased fatty acids (FA supply causes lipid accumulation and insulin resistance in skeletal muscles. Whether the same mechanism is present in the heart is still unclear. Therefore, the goal of our study was to determine the content of specific myocardial lipid fractions during feeding rats a high fat diet (HFD for 5 weeks. Moreover, the relation between changes in myocardial lipid content, whole body insulin resistance and the expression of fatty acid transporters in each week of HFD was established. Methods: Gas liquid chromatography and high performance liquid chromatography were used to determine the content of lipid fractions in the left ventricle. Expression of selected proteins was estimated by Western blot technique. All measurements were made after each week of HFD. Results: As expected, lipid profile in myocardium was altered by HFD in different weeks of the study with the most intense changes in triacylglycerols, long chain fatty acid-CoA and ceramide. Furthermore, there was a significant elevation of plasmalemmal (the 4th and the 5th week and mitochondrial expression (from the 3rd to the 5th week of fatty acid translocase. Conclusion: High fat diet affects myocardial lipid profile in each week of its duration and causes alternations in FA metabolism in cardiomyocytes.

  2. Myocardial protection during elective coronary artery bypasses grafting by pretreatment with omega-3 polyunsaturated fatty acids

    Veljović Milić

    2013-01-01

    Full Text Available Background/Aim. Despite recent advances in coronary artery bypass grafting (CABG, cardioplegic cardiac arrest and cardiopulmonary bypass (CPB are still associated with myocardial injury. Accordingly, the efforts have been made lately to improve the outcome of CPB by glucose-insulinpotassium, adenosine, Ca2+-channel antagonists, L-arginine, N-acetylcysteine, coenzyme Q10, diazoxide, Na+/H+ exchange inhibitors, but with an unequal results. Since omega-3 polyunsatutated fatty acids (PUFAs have shown remarkable cardioprotection in preclinical researches, the aim of our study was to check their effects in prevention of ischemia reperfusion injury in patients with CPB. Methods. This prospective, randomized, placebo-controlled study was performed with parallel groups. The patients undergoing elective CABG were randomized to receive preoperative intravenous omega-3 PUFAs infusion (n = 20 or the same volume of 0.9% saline solution infusion (n = 20. Blood samples were collected simultaneously from the radial artery and the coronary sinus before starting CPB and at 10, 20 and 30 min after the release of the aortic cross clamp. Lactate extraction/excretion and myocardial oxygen extraction were calculated and compared between the two groups. The levels of troponin I (TnT and creatine kinase-myocardial band (CK-MB were determined before starting CPB and 4 and 24 h postoperatively. Results. Demographic and operative characteristics, including CPB and aortic cross-clamp time, were similar between the two groups of patients. The level of lactate extraction 10 and 20 min after aortic cross-clamp time has shown negative values in the control group, but positive values in the PUFAs group with statistically significant differences (-19.6% vs 7.9%; p < 0.0001 and -19.9% vs 8.2%; p < 0.0008, respectively. The level of lactate extraction 30 minutes after reperfusion was not statistically different between the two groups (6.9% vs 4.2%; p < 0.54. Oxygen extraction in the

  3. Cardioprotective Effects of Salvianolic Acid A on Myocardial Ischemia-Reperfusion Injury In Vivo and In Vitro

    Huaying Fan

    2012-01-01

    Full Text Available Salvianolic acid A (SAA, one of the major active components of Danshen that is a traditional Chinese medicine, has been reported to possess protective effect in cardiac diseases and antioxidative activity. This study aims to investigate the cardioprotection of SAA in vivo and in vitro using the model of myocardial ischemia-reperfusion in rat and hydrogen peroxide (H2O2-induced H9c2 rat cardiomyoblasts apoptosis. It was found that SAA significantly limited infarct size of ischemic myocardium when given immediately prior to reperfusion. SAA also significantly suppressed cellular injury and apoptotic cell death. Additionally, the results of western blot and phospho-specific antibody microarray analysis showed that SAA could up-regulate Bcl-2 expression and increase the phosphorylation of proteins such as Akt, p42/p44 extracellular signal-related kinases (Erk1/2, and their related effectors. The phosphorylation of those points was related to suppress apoptosis. In summary, SAA possesses marked protective effect on myocardial ischemia-reperfusion injury, which is related to its ability to reduce myocardial cell apoptosis and damage induced by oxidative stress. The protection is achieved via up-regulation of Bcl-2 expression and affecting protein phosphorylation. These findings indicate that SAA may be of value in cardioprotection during myocardial ischemia-reperfusion injury, which provide pharmacological evidence for clinical application.

  4. Cardioprotective Effects of Salvianolic Acid A on Myocardial Ischemia-Reperfusion Injury In Vivo and In Vitro

    Fan, Huaying; Yang, Liu; Fu, Fenghua; Xu, Hui; Meng, Qinggang; Zhu, Haibo; Teng, Lirong; Yang, Mingyan; Zhang, Leiming; Zhang, Ziliang; Liu, Ke

    2012-01-01

    Salvianolic acid A (SAA), one of the major active components of Danshen that is a traditional Chinese medicine, has been reported to possess protective effect in cardiac diseases and antioxidative activity. This study aims to investigate the cardioprotection of SAA in vivo and in vitro using the model of myocardial ischemia-reperfusion in rat and hydrogen peroxide (H2O2)-induced H9c2 rat cardiomyoblasts apoptosis. It was found that SAA significantly limited infarct size of ischemic myocardium when given immediately prior to reperfusion. SAA also significantly suppressed cellular injury and apoptotic cell death. Additionally, the results of western blot and phospho-specific antibody microarray analysis showed that SAA could up-regulate Bcl-2 expression and increase the phosphorylation of proteins such as Akt, p42/p44 extracellular signal-related kinases (Erk1/2), and their related effectors. The phosphorylation of those points was related to suppress apoptosis. In summary, SAA possesses marked protective effect on myocardial ischemia-reperfusion injury, which is related to its ability to reduce myocardial cell apoptosis and damage induced by oxidative stress. The protection is achieved via up-regulation of Bcl-2 expression and affecting protein phosphorylation. These findings indicate that SAA may be of value in cardioprotection during myocardial ischemia-reperfusion injury, which provide pharmacological evidence for clinical application. PMID:21789047

  5. Preventive effects of p-coumaric acid on cardiac hypertrophy and alterations in electrocardiogram, lipids, and lipoproteins in experimentally induced myocardial infarcted rats.

    Roy, Abhro Jyoti; Stanely Mainzen Prince, P

    2013-10-01

    The present study evaluated the preventive effects of p-coumaric acid on cardiac hypertrophy and alterations in electrocardiogram, lipids, and lipoproteins in experimentally induced myocardial infarcted rats. Rats were pretreated with p-coumaric acid (8 mg/kg body weight) daily for a period of 7 days and then injected with isoproterenol (100mg/kg body weight) on 8th and 9th day to induce myocardial infarction. Myocardial infarction induced by isoproterenol was indicated by increased level of cardiac sensitive marker and elevated ST-segments in the electrocardiogram. Also, the levels/concentrations of serum and heart cholesterol, triglycerides and free fatty acids were increased in myocardial infarcted rats. Isoproterenol also increased the levels of serum low density and very low density lipoprotein cholesterol and decreased the levels of high density lipoprotein cholesterol. It also enhanced the activity of liver 3-hydroxy-3 methyl glutaryl-Coenzyme-A reductase. p-Coumaric acid pretreatment revealed preventive effects on all the biochemical parameters and electrocardiogram studied in myocardial infarcted rats. The in vitro study confirmed the free radical scavenging property of p-coumaric acid. Thus, p-coumaric acid prevented cardiac hypertrophy and alterations in lipids, lipoproteins, and electrocardiogram, by virtue of its antihypertrophic, antilipidemic, and free radical scavenging effects in isoproterenol induced myocardial infarcted rats.

  6. Metabolomic profiles of myocardial ischemia under treatment with salvianolic acid B

    Lu Yonghai

    2012-03-01

    Full Text Available Abstract Background Radix Salvia miltiorrhiza (Danshen has been used as a principal herb in treating cardiovascular diseases in Chinese medicine. Salvianolic acid B (SA-B, a water-soluble active component of Danshen, was found to have anti-myocardial ischemia (anti-MI effect. This study aims to investigate mechanisms of SA-B on MI. Methods Five conventional Western medicines (isosorbide dinitrate, verapamil, propranolol, captopril and trimethazine with different mechanisms for treating cardiovascular diseases were selected as positive references to compare with SA-B in changing of the metabolomic profiles in MI rats under treatment. Potential mechanisms of SA-B were further investigated in H9C2 cell line. Results The metabolomic profiles between SA-B- and propranolol-treated MI rats were similar, since there was a big overlap between the two groups in the PLS-DA score plot. Finally, it was demonstrated that SA-B exhibited a protective effect on MI mainly by decreasing the concentration of cyclic adenosine monophosphate (cAMP and Ca2+ and inhibiting protein kinase A (PKA. Conclusion SA-B and propanolol exhibited similar metabolomic profiles, indicating that the two drugs might have a similar mechanism.

  7. Metabolomic profiles of myocardial ischemia under treatment with salvianolic acid B

    2012-01-01

    Background Radix Salvia miltiorrhiza (Danshen) has been used as a principal herb in treating cardiovascular diseases in Chinese medicine. Salvianolic acid B (SA-B), a water-soluble active component of Danshen, was found to have anti-myocardial ischemia (anti-MI) effect. This study aims to investigate mechanisms of SA-B on MI. Methods Five conventional Western medicines (isosorbide dinitrate, verapamil, propranolol, captopril and trimethazine) with different mechanisms for treating cardiovascular diseases were selected as positive references to compare with SA-B in changing of the metabolomic profiles in MI rats under treatment. Potential mechanisms of SA-B were further investigated in H9C2 cell line. Results The metabolomic profiles between SA-B- and propranolol-treated MI rats were similar, since there was a big overlap between the two groups in the PLS-DA score plot. Finally, it was demonstrated that SA-B exhibited a protective effect on MI mainly by decreasing the concentration of cyclic adenosine monophosphate (cAMP) and Ca2+ and inhibiting protein kinase A (PKA). Conclusion SA-B and propanolol exhibited similar metabolomic profiles, indicating that the two drugs might have a similar mechanism. PMID:22409910

  8. Prognostic value of fatty acid imaging in patients with angina pectoris without prior myocardial infarction: comparison with stress thallium imaging

    Matsuki, Takayuki; Doi, Atsushi; Takahashi, Hiroshi; Iwata, Michihiro; Sakamoto, Takashi; Yamauchi, Kazuaki; Shimazaki, Masaru [Shin-Nittetsu Muroran General Hospital, Department of Cardiology, Muroran (Japan); Tamaki, Nagara; Morita, Koichi [Hokkaido University Graduate School of Medicine, Department of Nuclear Medicine, Sapporo (Japan); Nakata, Tomoaki; Shimamoto, Kazuaki [Sapporo Medical University, Second Department of Internal Medicine, School of Medicine, Sapporo (Japan)

    2004-12-01

    A fatty acid analogue, {sup 123}I-labelled {beta}-methyl iodophenyl pentadecanoic acid (BMIPP), has been used to identify ischaemic and metabolically impaired myocardium. However, the prognostic value of BMIPP imaging, particularly in relation to stress myocardial perfusion imaging, remains unclear. Data from 167 consecutive patients with angina pectoris but without prior myocardial infarction (MI) who had undergone both BMIPP and stress {sup 201}Tl (sTL) imaging were analysed. Tracer uptake was graded using a 13-segment, 4-point scoring model. Patients were followed up for 48 months with primary end points (cardiac death, non-fatal MI) as hard cardiac events and with secondary end points (late revascularisation, recurrent angina and heart failure) as soft events. For overall cardiac events (5 hard and 29 soft events), Kaplan-Meier analysis revealed significantly lower event rates in subgroups with normal BMIPP uptake, a summed difference score of sTL (SDS) of <3 or absence of diabetes mellitus when compared to each counterpart. Multivariate Cox's analysis revealed reduced BMIPP uptake, SDS {>=}3, diabetes and reduced ejection fraction to be significant predictors. Negative predictive values of normal BMIPP and SDS <3 for all events were 91% and 84%, respectively. No hard event occurred in 66 patients with normal BMIPP uptake, whereas two patients with SDS <3 but impaired BMIPP uptake had hard events. In conclusion, normal BMIPP imaging is an excellent prognostic sign, independently of stress myocardial perfusion imaging, in patients with angina pectoris without prior MI. (orig.)

  9. Influence of retinoic acid on TBX1 expression in myocardial cells induced by Shh and Fgf8

    Miao LIU; Xiaoyan WU; Jiawei XU; Runming JIN

    2009-01-01

    The aim of this study was to explore the regulatory mechanism of retinoic acid (RA) on the TBX1 gene expression in myocardial cells. Ventricular cardio-cytes were isolated from neonatal rats and cultured, and then treated with different concentrations of retinoic acid. The expression of Shh and Fgf8 at mRNA and protein levels in neonatal rat myocardial cells were measured by using RT-PCR and Western blot technique, respectively. There was basal expression of Shh and Fgf8 in the control group. When treated with 3×10-7 mol/L RA, we observed that the expression of Shh mRNA and protein in neonatal rat myocardial cells were up-regulated by 1.51 (P<0.05) and 1.10 times (P<0.05), respectively. In comparison with the control group, under the concentra-tion of 5×10-7 mol/L RA, they were up-regulated by 2.21 (P < 0.05) and 2.38 times (P < 0.05) individually. Mean-while, we could detect that the expression of Fgf8 mRNA and protein were up-regulated by 2.50 times (P < 0.05) and 80% (P<0.05) separately compared with the control group after stimulation of 3×10-7 mol/L RA, and they were up-regulated by 3.48 (P< 0.05) and 2.04 times(P < 0.05) individually after stimulation of 5×10-7 mol/LRA. The results indicated that RA could induce the expression of Shh and Fgf8 in neonatal rat myocardial cells. At the same time, it has shown that Shh and Fgf8 were involved in the regulation process of RA on TBX1 expression.

  10. Effects of exercise training on myocardial fatty acid metabolism in rats with depressed cardiac function induced by transient ischemia

    Chen, Liguang; Nohara, Ryuji; Hirai, Taku [Kyoto Univ. (Japan). Graduate School of Medicine] (and others)

    2001-06-01

    The effects of exercise training on metabolic and functional recovery after myocardial transient ischemia were investigated in a rat model. Male Wistar Kyoto rats were subjected either to a 30-min left coronary artery occlusion followed by reperfusion or to a sham operation. At 4 weeks after operation, the rats were randomly assigned either to sedentary conditions or to exercise training for 6 weeks. In the ischemic rats, pinhole SPECT (single photon emission computed tomography) imaging with thallium-201 ({sup 201}Tl) and {sup 123}I-({rho}-iodophenyl)-3-R,S-methylpentadecanoic acid (BMIPP) showed a reduction of both myocardial perfusion and fatty acid metabolism in the risk zone of the left ventricle (LV). The LV was dilated and the ejection fraction was decreased after ischemic injury. The severity score showed a significant decrease on both {sup 201}Tl and BMIPP ({sup 201}Tl, from 19.9{+-}2.7 to 17.0{+-}2.2, p<0.05; BMIPP, from 21.5{+-}2.4 to 18.6{+-}1.9, p<0.05) after exercise training in the ischemic trained rats, but did not change significantly in their sedentary counterparts. Plasma levels of free fatty acids normalized in the ischemic trained rats, but elevated in the ischemic sedentary rats (0.53{+-}0.05 vs 0.73{+-}0.06 mmol/L, p<0.05). Furthermore, the trained rats had a significant increase in LV stroke volume (0.25{+-}0.02 vs 0.21{+-}0.01 ml/beat, p<0.05) and adaptive cardiac hypertrophy. These findings demonstrate that adaptive improvements in myocardial perfusion, fatty-acid metabolism and LV function were induced by exercise training after transient ischemia. (author)

  11. MRI evaluation of injectable hyaluronic acid-based hydrogel therapy to limit ventricular remodeling after myocardial infarction.

    Dorsey, Shauna M; McGarvey, Jeremy R; Wang, Hua; Nikou, Amir; Arama, Leron; Koomalsingh, Kevin J; Kondo, Norihiro; Gorman, Joseph H; Pilla, James J; Gorman, Robert C; Wenk, Jonathan F; Burdick, Jason A

    2015-11-01

    Injectable biomaterials are an attractive therapy to attenuate left ventricular (LV) remodeling after myocardial infarction (MI). Although studies have shown that injectable hydrogels improve cardiac structure and function in vivo, temporal changes in infarct material properties after treatment have not been assessed. Emerging imaging and modeling techniques now allow for serial, non-invasive estimation of infarct material properties. Specifically, cine magnetic resonance imaging (MRI) assesses global LV structure and function, late-gadolinium enhancement (LGE) MRI enables visualization of infarcted tissue to quantify infarct expansion, and spatial modulation of magnetization (SPAMM) tagging provides passive wall motion assessment as a measure of tissue strain, which can all be used to evaluate infarct properties when combined with finite element (FE) models. In this work, we investigated the temporal effects of degradable hyaluronic acid (HA) hydrogels on global LV remodeling, infarct thinning and expansion, and infarct stiffness in a porcine infarct model for 12 weeks post-MI using MRI and FE modeling. Hydrogel treatment led to decreased LV volumes, improved ejection fraction, and increased wall thickness when compared to controls. FE model simulations demonstrated that hydrogel therapy increased infarct stiffness for 12 weeks post-MI. Thus, evaluation of myocardial tissue properties through MRI and FE modeling provides insight into the influence of injectable hydrogel therapies on myocardial structure and function post-MI.

  12. A role for lipid rafts in the protection afforded by docosahexaenoic acid against ethanol toxicity in primary rat hepatocytes.

    Aliche-Djoudi, Fatiha; Podechard, Normand; Collin, Aurore; Chevanne, Martine; Provost, Emilie; Poul, Martine; Le Hégarat, Ludovic; Catheline, Daniel; Legrand, Philippe; Dimanche-Boitrel, Marie-Thérèse; Lagadic-Gossmann, Dominique; Sergent, Odile

    2013-10-01

    Previously, we demonstrated that eicosapentaenoic acid enhanced ethanol-induced oxidative stress and cell death in primary rat hepatocytes via an increase in membrane fluidity and lipid raft clustering. In this context, another n-3 polyunsaturated fatty acid, docosahexaenoic acid (DHA), was tested with a special emphasis on physical and chemical alteration of lipid rafts. Pretreatment of hepatocytes with DHA reduced significantly ethanol-induced oxidative stress and cell death. DHA protection could be related to an alteration of lipid rafts. Indeed, rafts exhibited a marked increase in membrane fluidity and packing defects leading to the exclusion of a raft protein marker, flotillin. Furthermore, DHA strongly inhibited disulfide bridge formation, even in control cells, thus suggesting a disruption of protein-protein interactions inside lipid rafts. This particular spatial organization of lipid rafts due to DHA subsequently prevented the ethanol-induced lipid raft clustering. Such a prevention was then responsible for the inhibition of phospholipase C-γ translocation into rafts, and consequently of both lysosome accumulation and elevation in cellular low-molecular-weight iron content, a prooxidant factor. In total, the present study suggests that DHA supplementation could represent a new preventive approach for patients with alcoholic liver disease based upon modulation of the membrane structures.

  13. Affordable Care Act (ACA)

    Social Security Administration — The Affordable Care Act (ACA) is a federal statute enacted with a goal of increasing the quality and affordability of health insurance. Through a web service, CMS...

  14. Preventive effect of phytic acid on lysosomal hydrolases in normal and isoproterenol-induced myocardial infarction in Wistar rats.

    Brindha, E; Rajasekapandiyan, M

    2015-02-01

    This study was aimed to evaluate the preventive role of phytic acid on lysosomal enzymes in isoproterenol (ISO)-induced myocardial infarction (MI) in male Wistar rats. Rats subcutaneously injected with ISO (85 mg/kg) at an interval of 24 h for two days showed a significant increase in the activities of lysosomal enzymes (glucuronidase, N-acetyl glucosaminidase, galactosidase, cathepsin-B and cathepsin-D) were increased significantly in serum and the heart of ISO-induced rats, but the activities of glucuronidase and cathepsin-D were decreased significantly in the lysosomal fraction of the heart. Pretreatment with phytic acid (25 and 50 mg/kg) daily for a period of 56 d positively altered activities of lysosomal hydrolases in ISO-induced rats. Thus, phytic acid possesses a cardioprotective effect in ISO-induced MI in rats.

  15. Historicizing affordance theory

    Pedersen, Sofie; Bang, Jytte Susanne

    2016-01-01

    The aim of this article is to discuss how mutually enriching points from both affordance theory and cultural-historical activity theory can promote theoretical ideas which may prove useful as analytical tools for the study of human life and human development. There are two issues that need...... to be overcome in order to explore the potentials of James Gibson’s affordance theory: it does not sufficiently theorize (a) development and (b) society. We claim that Gibson’s affordance theory still needs to be brought beyond “the axiom of immediacy.” Ambivalences in Gibson’s affordance theory...... societal character of affordance theory....

  16. Myocardial scintigraphy with iodine-123 phenylpentadecanoic acid and thallium-201 in patients with coronary artery disease: A comparative dual-isotope study

    Zimmermann, R.; Rauch, B.; Kapp, M.; Neumann, F.J.; Seitz, F.; Kuebler, W. (Heidelberg Univ. (Germany). Dept. of Cardiology); Bubeck, B. (Heidelberg Univ. (Germany). Dept. of Nuclear Medicine); Mall, G. (Heidelberg Univ. (Germany). Dept. of Pathology); Tillmanns, H. (Giessen Univ. (Germany). Dept. of Cardiology); Stokstad, P.

    1992-11-01

    To characterise the clinical usefulness of serial myocardial scintigraphy with iodine-123 phenylpentadecanoic acid (IPPA) in comparison with thallium-201, dual-isotope investigations were performed in 41 patients with angiographically documented coronary artery disease. Both tracers were adminstered simultaneously during symptom-limited ergometry. Planar scintigrams were acquired immediately after stress, and delayed imaging was performed after 1 h for IPPA and 4 h for {sup 201}Tl. Scintigrams were evaluated both qualitatively and quantitatively using a newly developed algorithm for automated image superposition. Initial myocardial uptake of both tracers was closely correlated (r=0.75, p<0.001). Both tracers also revealed a similar sensitivity for the identification of individual coronary artery stenoses {>=}75% (IPPA: 70%, {sup 201}Tl: 66.3%, P=NS) with identical specificity (69.8%). The number of persistent defects, however, was significantly higher with IPPA (P=0.021), suggesting that visual analysis of serial IPPA scintigrams may overestimate the presence of myocardial scar tissue. On the other hand, previous Q wave myocardial infarction was associated with a decreased regional IPPA clearance (29%{+-}11% vs 44%{+-}11% in normal myocardium, P<0.05). The data indicate that serial myocardial scintigraphy with IPPA is essentially as sensitive as scintigraphy with {sup 201}Tl for the detection of stress-induced perfusion abnormalities. Quantitative analysis of myocardial IPPA kinetics, however, is required for the evaluation of tissue viability. (orig.).

  17. Prognostic significance of myocardial imaging with iodine-123 beta-methyl-p-iodophenyl-pentadecanoic acid in patients with angina pectoris

    Hatano, Tsuguhisa; Chikamori, Taishiro; Kamada, Tatsuya; Morishima, Takayuki; Hida, Satoshi; Yanagisawa, Hidefumi; Iino, Hitoshi; Yamashina, Akira [Tokyo Medical Coll. (Japan)

    2001-09-01

    To assess the clinical significance of iodine-123 beta-methyl-p-iodophenyl-pentadecanoic acid (BMIPP) single photon emission computed tomography (SPECT), the predictive value of BMIPP imaging in patients with angina pectoris was evaluated. One hundred seventy-four patients who underwent BMIPP imaging in our institution were aged 61.8{+-}11 years. One hundred thirty-five patients had stable angina and 39 had unstable angina at the time of examination. Patients with previous myocardial infarction or myocardial disorders were excluded. Early and delayed images were acquired in BMIPP SPECT, and the images were analyzed visually. Cardiac events were classified into hard and soft events: the former consisted of cardiac death and nonfatal myocardial infarction, and the latter included coronary revascularization and heart failure. The findings of BMIPP imaging were normal in 82 patients and abnormal in 92. During follow-up of 15.5{+-}9.5 months, hard events were observed in 4 patients and soft events in 53. In patients with normal BMIPP imaging, soft events were observed in nine patients, but no hard event was encountered. Furthermore, in patients with both normal BMIPP and stress thallium imagings, no cardiac event was observed during 2 years. In contrast, 4 hard events and 44 soft events occurred in patients with abnormal BMIPP imaging. Patients with abnormal BMIPP imaging had a higher incidence of soft events than those with normal BMIPP imaging, regardless of the type of angina (16/62 vs 3/73, p<0.0005 for stable angina; 28/30 vs 6/9, p<0.0001 for unstable angina). The finding of BMIPP imaging correlates well with the mid-term prognosis of patients with angina pectoris. Since BMIPP SPECT is performed without stress to the patient, this imaging modality is important in evaluating patients with stable or unstable angina. (author)

  18. Administration of zinc complex of acetylsalicylic acid after the onset of myocardial injury protects the heart by upregulation of antioxidant enzymes.

    Korkmaz-Icöz, Sevil; Atmanli, Ayhan; Radovits, Tamás; Li, Shiliang; Hegedüs, Peter; Ruppert, Mihály; Brlecic, Paige; Yoshikawa, Yutaka; Yasui, Hiroyuki; Karck, Matthias; Szabó, Gábor

    2016-03-01

    We recently demonstrated that the pre-treatment of rats with zinc and acetylsalicylic acid complex in the form of bis(aspirinato)zinc(II) [Zn(ASA)2] is superior to acetylsalicylic acid in protecting the heart from acute myocardial ischemia. Herein, we hypothesized that Zn(ASA)2 treatment after the onset of an acute myocardial injury could protect the heart. The rats were treated with a vehicle or Zn(ASA)2 after an isoproterenol injection. Isoproterenol-induced cardiac damage [inflammatory infiltration into myocardial tissue, DNA-strand breakage evidenced by TUNEL-assay, increased 11-dehydro thromboxane (TX)B2-levels, elevated ST-segment, widened QRS complex and prolonged QT-interval] was prevented by the Zn(ASA)2 treatment. In isoproterenol-treated rats, load-independent left ventricular contractility parameters were significantly improved after Zn(ASA)2. Furthermore, Zn(ASA)2 significantly increased the myocardial mRNA-expression of superoxide dismutase-1, glutathione peroxidase-4 and decreased the level of Na(+)/K(+)/ATPase. Postconditioning with Zn(ASA)2 protects the heart from acute myocardial ischemia. Its mechanisms of action might involve inhibition of pro-inflammatory prostanoids and upregulation of antioxidant enzymes.

  19. Attenuation of myocardial apoptosis by alpha-lipoic acid through suppression of mitochondrial oxidative stress to reduce diabetic cardiomyopathy

    LI Chun-jun; ZHANG Qiu-mei; LI Ming-zhen; ZHANG Jing-yun; YU Pei; YU De-min

    2009-01-01

    Background Cardiac failure is a leading cause of the mortality of diabetic patients.In part this is due to a specific cardiomyopathy,referred to as diabetic cardiomyopathy.Oxidative stress is widely considered to be one of the major factors underlying the pathogenesis of the disease.This study aimed to test whether the antioxidant α-lipoic acid(α-LA)could attenuate mitochondrion-dependent myocardial apoptosis through suppression of mitochondrial oxidative stress to reduce diabetic cardiomyopathy.Methods A rat model of diabetes was induced by a single tail intravenous injection of streptozotocin(STZ)45 mg/kg.Experimental animals were randomly assigned to 3 groups:normal control(NC),diabetes(DM)and DM treated with α-LA (α-LA).The latter group was administered with α-LA(100 mg/kg ip per day),the remainder received the same volume vehicle.At weeks 4,8,and 12 after the onset of diabetes,cardiac apoptosis was examined by TUNEL assay.Cardiomyopathy was evaluated by assessment of cardiac structure and function.Oxidative damage was evaluated by the content of malondialdehyde(MDA),reduced glutathione(GSH)and the activity of manganese superoxide diamutase (Mn-SOD)in the myocardial mitochondria.Expression of caspase-9 and caspase-3 proteins was determined by immunohistochemistry and mitochondrial cytochrome c release was detected by Western blottingResults At 4,8,and 12 weeks after the onset of diabetes,significant reductions in TUNEL-positive cells,caspase-9,-3 expression,and mitochondrial cytochrome c release were observed in the α-LA group compared to the DM group.In the DM group,the content of MDA in the myocardial mitochondria was significantly increased,and there was a decrease in both the mitochondrial GSH content and the activities of Mn-SOD.They were significantly improved by α-LA treatment.HE staining displayed structural abnormalities in diabetic hearts,while α-LA reversed this structural derangement.The index of cardiac function(±dp/dtmax)in the diabetes

  20. Thyroid hormone reverses aging-induced myocardial fatty acid oxidation defects and improves the response to acutely increased afterload.

    Dolena Ledee

    Full Text Available BACKGROUND: Subclinical hypothyroidism occurs during aging in humans and mice and may contribute to the development of heart failure. Aging also impairs myocardial fatty acid oxidation, causing increased reliance on flux through pyruvate dehydrogenase (PDH to maintain function. We hypothesize that the metabolic changes in aged hearts make them less tolerant to acutely increased work and that thyroid hormone supplementation reverses these defects. METHODS: Studies were performed on young (Young, 4-6 months and aged (Old, 22-24 months C57/BL6 mice at standard (50 mmHg and high afterload (80 mmHg. Another aged group received thyroid hormone for 3 weeks (Old-TH, high afterload only. Function was measured in isolated working hearts along with substrate fractional contributions (Fc to the citric acid cycle (CAC using perfusate with (13C labeled lactate, pyruvate, glucose and unlabeled palmitate and insulin. RESULTS: Old mice maintained cardiac function under standard workload conditions, despite a marked decrease in unlabeled (presumably palmitate Fc and relatively similar individual carbohydrate contributions. However, old mice exhibited reduced palmitate oxidation with diastolic dysfunction exemplified by lower -dP/dT. Thyroid hormone abrogated the functional and substrate flux abnormalities in aged mice. CONCLUSION: The aged heart shows diminished ability to increase cardiac work due to substrate limitations, primarily impaired fatty acid oxidation. The heart accommodates slightly by increasing efficiency through oxidation of carbohydrate substrates. Thyroid hormone supplementation in aged mice significantly improves cardiac function potentially through restoration of fatty acid oxidation.

  1. Effect of Salvianolic Acid b and Paeonol on Blood Lipid Metabolism and Hemorrheology in Myocardial Ischemia Rabbits Induced by Pituitruin

    Yang, Qian; Wang, Siwang; Xie, Yanhua; Wang, Jianbo; Li, Hua; Zhou, Xuanxuan; Liu, Wenbo

    2010-01-01

    The purpose of this study was to determine the therapeutic effect of salvianolic acid b and paeonol on coronary disease. The ischemia myocardial animal model is induced by administering pituitrin (20 μg·kg−1) intravenously via the abdominal vein. A combination of salvianolic acid b and paeonol (CSAP) (5, 10 and 15 mg/kg BW) was administrated to experimental rabbits. Biochemical indices were evaluated during six weeks of intervention. We found that the compound of salvianolic acid b and paeonol (5, 10 and 15 mg/kg BW) can markedly and dose-dependently reduce fibrinogen and malonaldehyde levels, increase the HDL level, improve blood viscosity and plasma viscosity in rabbits. In addition, the medicine can still reduce the ratio of NO/ET and the contents of lactate dehydrogenase (LDH) and creatine phosphokinase (CPK) in a dose-dependent manner. This study demonstrates that compound of salvianolic acid b and paeonol (5, 10 and 15 mg/kg BW) can improve the blood hemorrheology, decrease oxidative injury and repair the function of blood vessel endothelium, and subsequently prevent the development of Coronary disease. PMID:21152295

  2. Effect of Salvianolic Acid b and Paeonol on Blood Lipid Metabolism and Hemorrheology in Myocardial Ischemia Rabbits Induced by Pituitruin

    Qian Yang

    2010-09-01

    Full Text Available The purpose of this study was to determine the therapeutic effect of salvianolic acid b and paeonol on coronary disease. The ischemia myocardial animal model is induced by administering pituitrin (20 μg·kg−1 intravenously via the abdominal vein. A combination of salvianolic acid b and paeonol (CSAP (5, 10 and 15 mg/kg BW was administrated to experimental rabbits. Biochemical indices were evaluated during six weeks of intervention. We found that the compound of salvianolic acid b and paeonol (5, 10 and 15 mg/kg BW can markedly and dose-dependently reduce fibrinogen and malonaldehyde levels, increase the HDL level, improve blood viscosity and plasma viscosity in rabbits. In addition, the medicine can still reduce the ratio of NO/ET and the contents of lactate dehydrogenase (LDH and creatine phosphokinase (CPK in a dose-dependent manner. This study demonstrates that compound of salvianolic acid b and paeonol (5, 10 and 15 mg/kg BW can improve the blood hemorrheology, decrease oxidative injury and repair the function of blood vessel endothelium, and subsequently prevent the development of Coronary disease.

  3. Relationship between evaluation by quantitative fatty acid myocardial scintigraphy and response to {beta}-blockade therapy in patients with dilated cardiomyopathy

    Ito, Tatsuo; Hoshida, Shiro; Nishino, Masami; Aoi, Toshiyuki; Egami, Yasuyuki; Takeda, Toshihiro; Kawabata, Masayoshi; Tanouchi, Jun; Yamada, Yoshio; Kamada, Takenobu [Div. of Cardiology, Osaka Rosai Hospital (Japan)

    2001-12-01

    Predicting the effect of {beta}-blockade therapy on the clinical outcome of patients with dilated cardiomyopathy (DCM) is difficult prior to the initiation of therapy. Myocardial fatty acid metabolism has been shown to be impaired in patients with DCM. We examined whether the extent of myocardial injury, as assessed by iodine-123 15-(p-iodophenyl)-3-R,S-methylpentadecanoic acid (BMIPP) myocardial scintigraphy, is related to the response of patients with DCM to {beta}-blockade therapy. Thirty-seven patients with DCM were examined using BMIPP myocardial scintigraphy before and after 6 months of treatment with metoprolol. Myocardial BMIPP uptake (%BM uptake) was estimated quantitatively as a percentage of the total injected count ratio. The left ventricular end-diastolic and end-systolic dimensions (LVDd, LVDs) and ejection fraction (LVEF) were also evaluated. The patients were divided into two groups according to their functional improvement (>10% elevation of LVEF) after 6 months of metoprolol therapy. Twenty-eight patients responded to the therapy, while nine did not. Prior to the therapy, no significant differences in LVDd, LVDs or LVEF were observed between the responders and non-responders. However, the %BM uptake was significantly lower in the non-responders than in the responders (1.0%{+-}0.2% vs 2.1%{+-}0.5%, P<0.001). The %BM uptake could be used to distinguish the responders from the non-responders with a sensitivity of 0.93 and a specificity of 1.00 at a threshold value of 1.4. After the metoprolol therapy, the %BM uptake improved significantly in the responders (2.5%{+-}0.5%, P<0.01) but did not change in the non-responders. These results indicate that myocardial BMIPP uptake could predict the response of DCM patients to {beta}-blockade therapy. (orig.)

  4. Association of serum uric acid level with mortality and morbidity of patients with acute ST-elevation myocardial infarction

    Hajizadeh, Reza; Ghaffari, Samad; Salehi, Rezvanieh; Mazani, Sarvin; Aghavali, Sharmin

    2016-01-01

    Introduction: Investigating the clinical impact of serum uric acid (UA) and its lowering agents on the complications and mortality of acute ST-elevation myocardial infarction (STEMI) can open a new era in STEMI treatment. The aim of this study was to evaluate the effect of on admission serum UA level on the mortality and morbidity of patients admitted with STEMI. Methods: A number of 608 patients with STEMI were enrolled in this study from December 21, 2012 until February 19, 2014. Patients were followed for 20 months. Male to female ratio was 2.53, and the mean age of patients was 62.6±13.4. The relationship between the level of UA and patients’ mortality and morbidity, left ventricular ejection fraction (LVEF), atrial and ventricular arrhythmia was analyzed. Results: Patients with high serum UA level had higher Killip class after STEMI (P=0.001). Mean LVEF was measured to be 39.5±9.6 in normal UA group and 34.6±11.6 in high UA group (P=0.001). In comparison with normal UA group, high UA group had significantly higher cTnI (2.68±0.09 vs 4.09±0.42, respectively, P=0.001), increased blood pressure (P=0.009), and higher atrial fibrillation (AF) occurrence (P=0.03), but no association was seen between ventricular tachycardia and serum UA level. Short term and midterm mortality were not different in two groups (P=0.44 and 0.31, respectively). Conclusion: In the current study, high serum UA level in patients with acute myocardial infarction (MI) was not associated with higher in-hospital or midterm mortality, but it was associated with lower LVEF, higher Killip class, elevated cTnI, creatinine, triglyceride, and higher AF. PMID:27489597

  5. THYROID HORMONE REVERSES AGING-INDUCED MYOCARDIAL FATTY ACID OXIDATION DEFECTS AND IMPROVES THE RESPONSE TO ACUTELY INCREASED AFTERLOAD

    Ledee, Dolena; Portman, Michael A.; Kajimoto, Masaki; Isern, Nancy G.; Olson, Aaron

    2013-06-07

    Background: Subclinical hypothyroidism occurs during aging in humans and mice and may contribute to development of heart failure. Aging also impairs myocardial fatty acid oxidation, causing increased reliance on flux through pyruvate dehydrogenase (PDH) to maintain function. We hypothesize that the metabolic changes in aged hearts make them less tolerant to acutely increased work and that thyroid hormone reverses these defects. Methods: Studies were performed on young (Young, 4-6 months) and aged (Old, 22-24 months) C57/BL6 mice at standard (50 mmHg) and high afterload (80 mmHg). Another aged group received thyroid hormone for 3 weeks (Old-TH, high afterload only). Function was measured in isolated working hearts along with substrate fractional contributions (Fc) to the citric acid cycle (CAC) using perfusate with 13C labeled lactate, pyruvate, glucose and unlabeled palmitate and insulin. Results: Cardiac function was similar between Young and Old mice at standard afterload. Palmitate Fc was reduced but no individual carbohydrate contributions differed. CAC and individual substrate fluxes decreased in aged. At high afterload, -dP/dT was decreased in Old versus Young. Similar to low afterload, palmitate Fc was decreased in Old. Thyroid hormone reversed aging-induced changes in palmitate Fc and flux while significantly improving cardiac function. Conclusion: The aged heart shows diminished ability to increase cardiac work due to substrate limitations, primarily impaired fatty acid oxidation. The heart accommodates slightly by increasing efficiency through oxidation of carbohydrate substrates. Thyroid hormone supplementation in aged mice significantly improves cardiac function potentially through restoration of fatty acid oxidation.

  6. Assuring Access to Affordable Coverage

    U.S. Department of Health & Human Services — Under the Affordable Care Act, millions of uninsured Americans will gain access to affordable coverage through Affordable Insurance Exchanges and improvements in...

  7. Fatty acid desaturase gene variants, cardiovascular risk factors, and myocardial infarction in the costa rica study

    Genetic variation in fatty acid desaturases (FADS) has previously been linked to long-chain polyunsaturated fatty acids (PUFAs) in adipose tissue and cardiovascular risk. The goal of our study was to test associations between six common FADS polymorphisms (rs174556, rs3834458, rs174570, rs2524299, r...

  8. Aging Impairs Myocardial Fatty Acid and Ketone Oxidation and Modifies Cardiac Functional and Metabolic Responses to Insulin in Mice

    Hyyti, Outi M.; Ledee, Dolena; Ning, Xue-Han; Ge, Ming; Portman, Michael A.

    2010-07-02

    Aging presumably initiates shifts in substrate oxidation mediated in part by changes in insulin sensitivity. Similar shifts occur with cardiac hypertrophy and may contribute to contractile dysfunction. We tested the hypothesis that aging modifies substrate utilization and alters insulin sensitivity in mouse heart when provided multiple substrates. In vivo cardiac function was measured with microtipped pressure transducers in the left ventricle from control (4–6 mo) and aged (22–24 mo) mice. Cardiac function was also measured in isolated working hearts along with substrate and anaplerotic fractional contributions to the citric acid cycle (CAC) by using perfusate containing 13C-labeled free fatty acids (FFA), acetoacetate, lactate, and unlabeled glucose. Stroke volume and cardiac output were diminished in aged mice in vivo, but pressure development was preserved. Systolic and diastolic functions were maintained in aged isolated hearts. Insulin prompted an increase in systolic function in aged hearts, resulting in an increase in cardiac efficiency. FFA and ketone flux were present but were markedly impaired in aged hearts. These changes in myocardial substrate utilization corresponded to alterations in circulating lipids, thyroid hormone, and reductions in protein expression for peroxisome proliferator-activated receptor (PPAR)α and pyruvate dehydrogenase kinase (PDK)4. Insulin further suppressed FFA oxidation in the aged. Insulin stimulation of anaplerosis in control hearts was absent in the aged. The aged heart shows metabolic plasticity by accessing multiple substrates to maintain function. However, fatty acid oxidation capacity is limited. Impaired insulin-stimulated anaplerosis may contribute to elevated cardiac efficiency, but may also limit response to acute stress through depletion of CAC intermediates.

  9. Phase 3 study of. beta. -methyl-p-( sup 123 I)-iodophenyl-pentadecanoic acid, a myocardial imaging agent for evaluating fatty acid metabolism; A multi-center trial

    Torizuka, Kanji (Fukui Medical School, Matsuoka (Japan)); Yonekura, Yoshiharu; Nishimura, Tsunehiko; Ohtake, Tohru; Bunko, Hisashi; Tamaki, Nagara; Uehara, Toshiisa

    1992-04-01

    A multi-center trial of {beta}-methyl-p-({sup 123}I)-iodophenyl-pentadecanoic acid ({sup 123}I-BMIPP) was performed to assess its clinical usefulness in the evaluation of myocardial fatty acid metabolism in 587 patients with various heart diseases. {sup 123}I-BMIPP showed relatively decreased uptake compared with {sup 201}Tl in the myocardial lesions of 62% of patients with ischemic heart disease (IHD), 39% of those with cardiomyopathy and 32% of those with other heart diseases. In case of myocardial infarction, less uptake of {sup 123}I-BMIPP (Type B) than {sup 201}Tl was more frequently seen in patients with successful recanalization than in those without recanalization. The patients with matched distribution of the two tracers (Type E) increased in the direct proportion to the interval between the onset of myocardial infarction and the radionuclide studies. The uptake of {sup 123}I-BMIPP correlated well with myocardial viability evaluated by {sup 201}Tl exercise-redistribution studies. Type B was frequently seen in the areas with {sup 201}Tl redistribution, while Type E was seen in the fixed defect areas. In the other heart diseases studied, Type E was observed in approximately 60% of patients with dilated or secondary cardiomyopathies. Type B was seen in about 45% of patients with valvular heart diseases and myocarditis. Various types of mismatch between the two tracers were demonstrated in hypertrophic cardiomyopathy and hypertensive heart disease. It is concluded that {sup 123}I-BMIPP is a safe and useful agent for the diagnosis of various heart diseases, since it reflects myocardial fatty acid metabolism. (author)

  10. Biokinetics of radiolabeled Iodophenylpentadecanoic acid (I-123-IPPA) and thallium-201 in a rabbit model of chronic myocardial infarction measured using a series of thermoluminescent dosimeters

    Medich, David Christopher

    1997-09-01

    The biokinetics of Iodophenylpentadecanoic acid (123I-IPPA) during a chronic period of myocardial infarction were determined and compared to 201Tl. IPPA was assessed as a perfusion and metabolic tracer in the scintigraphic diagnosis of coronary artery disease. The myocardial clearance kinetics were measured by placing a series of thermoluminescent dosimeters (TLDs) on normal and infarcted tissue to measure the local myocardial activity content over time. The arterial blood pool activity was fit to a bi-exponential function for 201Tl and a tri-exponential function for 123I-IPPA to estimate the left ventricle contribution to TLD response. At equilibrium, the blood pool contribution was estimated experimentally to be less than 5% of the total TLD response. The method was unable to resolve the initial uptake of the imaging agent due in part to the 2 minute TLD response integration time and in part to the 30 second lag time for the first TLD placement. A noticeable disparity was observed between the tracer concentrations of IPPA in normal and ischemic tissue of approximately 2:1. The fitting parameters (representing the biokinetic eigenvalue rate constants) were related to the fundamental rate constants of a recycling biokinetic model. The myocardial IPPA content within normal tissue was elevated after approximately 130 minutes post injection. This phenomenon was observed in all but one (950215) of the IPPA TLD kinetics curves.

  11. Affordable Vehicle Avionics Overview

    Cockrell, James J.

    2015-01-01

    Public and private launch vehicle developers are reducing the cost of propulsion for small commercial launchers, but conventional high-performance, high-reliability avionics remain the disproportionately high cost driver for launch. AVA technology performs as well or better than conventional launch vehicle avionics, but with a fraction of the recurring costs. AVA enables small launch providers to offer affordable rides to LEO to nano-satellites as primary payloads meaning, small payloads can afford to specify their own launch and orbit parameters

  12. Mechanism-based pharmacokinetic-pharmacodynamic modeling of salvianolic acid A effects on plasma xanthine oxidase activity and uric acid levels in acute myocardial infarction rats.

    Wang, Haidong; Li, Xi; Zhang, Wenting; Liu, Yao; Wang, Shijun; Liu, Xiaoquan; He, Hua

    2017-03-01

    1. Salvianolic acid A (SalA) was found to attenuate plasma uric acid (UA) concentration and xanthine oxidase (XO) activity in acute myocardial infraction (AMI) rats, which was characterized with developed mechanism-based pharmacokinetic-pharmacodynamic (PK-PD) model. 2. AMI was induced in rats by coronary artery ligation. Surviving AMI rats received a single intravenous dose of 5 mg/kg of SalA and normal saline. The plasma SalA concentrations were determined by HPLC-MS/MS method. The plasma UA concentrations were determined by HPLC method and plasma XO activity were measured spectrophotometrically. An integrated mathematical model characterized the relationship between plasma UA and SalA. 3. Pharmacokinetics was described using two-compartment model for SalA with linear metabolic process. In post-AMI rats, XO activity and UA concentrations were increased, while SalA dosing palliated this increase. These effects were well captured by using two series of transduction models, simulating the delay of inhibition on XO driven by SalA and UA elevation resulted from the multiple factors, respectively. 4. The effect was well described by the developed PK-PD model, indicating that SalA can exert cardiovascular protective effects by decreasing elevated plasma UA levels induced by AMI.

  13. Affordances: Ten Years On

    Brown, Jill P.; Stillman, Gloria

    2014-01-01

    Ten years ago the construct, affordance, was rising in prominence in scholarly literature. A proliferation of different uses and meanings was evident. Beginning with its origin in the work of Gibson, we traced its development and use in various scholarly fields. This paper revisits our original question with respect to its utility in mathematics…

  14. Genetic variation in fatty acid elongases is not associated with intermediate cardiovascular phenotypes or myocardial infarction

    Elongases 2, 4 and 5, encoded by genes ELOVL2, ELOVL4 and ELOVL5, have a key role in the biosynthesis of very long chain polyunsaturated fatty acids (PUFAs). To date, few studies have investigated the associations between elongase polymorphisms and cardiovascular health. We investigated whether ELOV...

  15. Myocardial perfusion modeling using MRI

    Larsson, H B; Fritz-Hansen, T; Rostrup, Egill

    1996-01-01

    In the present study, it is shown that it is possible to quantify myocardial perfusion using magnetic resonance imaging in combination with gadolinium diethylenetriaminopentaacetic acid (Gd-DTPA). Previously, a simple model and method for measuring myocardial perfusion using an inversion recovery...

  16. Learning Grasp Affordance Densities

    Detry, Renaud; Kraft, Dirk; Kroemer, Oliver;

    2011-01-01

    We address the issue of learning and representing object grasp affordance models. We model grasp affordances with continuous probability density functions (grasp densities) which link object-relative grasp poses to their success probability. The underlying function representation is nonparametric...... these and records their outcomes. When a satisfactory number of grasp data is available, an importance-sampling algorithm turns these into a grasp density. We evaluate our method in a largely autonomous learning experiment run on three objects of distinct shapes. The experiment shows how learning increases success...... and relies on kernel density estimation to provide a continuous model. Grasp densities are learned and refined from exploration, by letting a robot “play” with an object in a sequence of graspand-drop actions: The robot uses visual cues to generate a set of grasp hypotheses; it then executes...

  17. Clinical usefulness of myocardial iodine-123-15-(p-iodophenyl)-3(R,S)-methyl-pentadecanoic acid distribution abnormality in patients with mitochondrial encephalomyopathy based on normal data file in bull`s-eye polar map

    Takahashi, Nobukazu; Mitani, Isao; Sumita, Shinichi [Yokohama City Univ. (Japan). School of Medicine] [and others

    1998-01-01

    Visual interpretation of iodine-123-beta-15-(p-iodophenyl)-3(R,S)-methyl-pentadecanoic acid ({sup 123}I-BMIPP) myocardial images cannot easily detect mild reduction in tracer uptake. Objective assessment of myocardial {sup 123}I-BMIPP maldistributions at rest was attempted using a bull`s-eye map and its normal data file for detecting myocardial damage in patients with mitochondrial encephalomyopathy. Six patients, two with Kearns-Sayre syndrome and four with mitochondrial myopathy, encephalopathy, lactic acidosis, and strokelike episodes (MELAS), and 10 normal subjects were studied. Fractional myocardial uptake of 1{sup 23}I-BMIPP was also measured by dynamic static imaging to assess the global myocardial free fatty acid. These data were compared with the cardiothoracic ratio measured by chest radiography and left ventricular ejection fraction assessed by echocardiography. Abnormal cardiothoracic ratio and lower ejection fraction were detected in only one patient with Kearns-Sayre syndrome. Abnormal fractional myocardial uptake was detected in two patients (1.61%, 1.91%), whereas abnormal regional {sup 123}I-BMIPP uptake assessed by the bull`s-eye map was detected in five patients (83%). All patients showed abnormal uptake in the anterior portion, and one showed progressive atrioventricular conduction abnormality and systolic dysfunction with extended {sup 123}I-BMIPP abnormal uptake. The results suggest that assessment based on the normal data file in a bull`s-eye polar map is clinically useful for detection of myocardial damage in patients with mitochondrial encephalomyopathy. (author)

  18. Cardioprotective effect of resveratrol analogue isorhapontigenin versus omega-3 fatty acids in isoproterenol-induced myocardial infarction in rats.

    Abbas, Amr M

    2016-09-01

    Myocardial infarction (MI) is a common cause of mortality worldwide. Isorhapontigenin is a derivative of stilbene with chemical structure similar to resveratrol. The omega-3 fatty acids (FA) have beneficial effects on neurodegenerative, inflammatory, and cardiovascular diseases. The aim of this study was to investigate the effects of pretreatment with isorhapontigenin and omega-3 FA on rat model of isoproterenol-induced MI. Fifty-six rats were divided into seven groups: normal, normal + isorhapontigenin, normal + omega-3 FA, MI, MI + isorhapontigenin, MI + omega-3 FA, and MI + isorhapontigenin + omega-3 FA. Serum levels of cardiac marker enzymes [lactate dehydrogenase (LDH) and creatine kinase-MB (CK-MB)], cardiac troponin I (cTnI), inflammatory markers [tumor necrosis factor-alpha (TNF-α) and interleukin-6], and lipid profile [triglycerides, total cholesterol (T.Ch), high and low density lipoproteins (HDL, LDL), and phospholipids] as well as cardiac levels of malondialdehyde and anti-oxidants [reduced glutathione (GSH), superoxide dismutase (SOD), and catalase)] were measured in all rats. ECG and histopathological examination were performed. Isoproterenol caused a significant elevation of ST segment, decreased R wave amplitude, HDL, and anti-oxidants, and increased LDH, CK-MB, cTnI, TNF-α, interleukin-6, malondialdehyde, triglycerides, T.Ch, LDL, and phospholipids. Omega-3 FA or isorhapontigenin significantly decreased the ST segment elevation, LDH, CK-MB, cTnI, TNF-α, interleukin-6, malondialdehyde, and phospholipids and increased R wave amplitude and anti-oxidants. The effects of combined omega-3 FA and isorhapontigenin were more significant than either of them alone. Therefore, we conclude that omega-3 FA and isorhapontigenin have a cardioprotective effect on rats with isoproterenol-induced MI through their anti-oxidant and anti-inflammatory actions.

  19. Myocardial Bridging

    Shi-Min Yuan

    2016-02-01

    Full Text Available Abstract Myocardial bridging is rare. Myocardial bridges are most commonly localized in the middle segment of the left anterior descending coronary artery. The anatomic features of the bridges vary significantly. Alterations of the endothelial morphology and the vasoactive agents impact on the progression of atherosclerosis of myocardial bridging. Patients may present with chest pain, myocardial infarction, arrhythmia and even sudden death. Patients who respond poorly to the medical treatment with β-blockers warrant a surgical intervention. Myotomy is a preferred surgical procedure for the symptomatic patients. Coronary stent deployment has been in limited use due to the unsatisfactory long-term results.

  20. Evaluation of the impact of genetic polymorphisms in glutathione-related genes on the association between methylmercury or n-3 polyunsaturated long chain fatty acids and risk of myocardial infarction: a case-control study

    Norberg Margareta

    2011-04-01

    Full Text Available Abstract Background The n-3 polyunsaturated fatty acids eicosapentaenoic acid and docosahexaenoic acid, which are present in fish, are protective against myocardial infarction. However, fish also contains methylmercury, which influences the risk of myocardial infarction, possibly by generating oxidative stress. Methylmercury is metabolized by conjugation to glutathione, which facilitates elimination. Glutathione is also an antioxidant. Individuals with certain polymorphisms in glutathione-related genes may tolerate higher exposures to methylmercury, due to faster metabolism and elimination and/or better glutathione-associated antioxidative capacity. They would thus benefit more from the protective agents in fish, such as eicosapentaenoic+docosahexaenoic acid and selenium. The objective for this study was to elucidate whether genetic polymorphisms in glutathione-related genes modify the association between eicosapentaenoic+docosahexaenoic acid or methylmercury and risk of first ever myocardial infarction. Methods Polymorphisms in glutathione-synthesizing (glutamyl-cysteine ligase catalytic subunit, GCLC and glutamyl-cysteine ligase modifier subunit, GCLM or glutathione-conjugating (glutathione S-transferase P, GSTP1 genes were genotyped in 1027 individuals from northern Sweden (458 cases of first-ever myocardial infarction and 569 matched controls. The impact of these polymorphisms on the association between erythrocyte-mercury (proxy for methylmercury and risk of myocardial infarction, as well as between plasma eicosapentaenoic+docosahexaenoic acid and risk of myocardial infarction, was evaluated by conditional logistic regression. The effect of erythrocyte-selenium on risk of myocardial infarction was also taken into consideration. Results There were no strong genetic modifying effects on the association between plasma eicosapentaenoic+docosahexaenoic acid or erythrocyte-mercury and risk of myocardial infarction risk. When eicosapentaenoic

  1. OMEGA-3 POLYUNSATURATED FATTY ACIDS IN ATRIAL FIBRILLATION PREVENTION AFTER SURGICAL MYOCARDIAL REVASCULARIZATION

    A. V. Panov

    2008-01-01

    Full Text Available Aim. To estimate an efficacy of therapy with ω-3 polyunsaturated fatty acids (PUFA in patients with ischemic heart disease (IHD before and after coronary artery bypass graft (CABG.Material and methods. 189 patients (125 men, 64 women; aged 64,2±9,4 y.o. with IHD having indications to CABG were enrolled in the study. Patients of the first group (control had standard pre- and postoperative treatment. Patients of the second group received ω-3 PUFA (ОМАCОR, Solvay Pharma 2 g/daily in addition to standard therapy. Both groups were similar in clinical characteristics. ω-3 PUFA therapy started 7±4 day before CABG, renewed in early postoperative period (24-36 hours after surgery and lasted next 14 days. Efficacy of the therapy was estimated by atrial fibrillation frequency in postoperative period and time before hospital discharge after CABG. An automatic complex for transesophageal electrophysiological cardiac examination was used for the estimation of atrial conduction before and after CABG.Results. Omacor therapy in patients with ICD before CABG and in the early postoperative period reduces atrial fibrillation risk. It results in reduction of hemodynamic disorders and time before hospital discharge. Conclusion. Omacor therapy is safe and can be recommended to all patients going through CABG.

  2. Study of Myocardial Involvement and Lactic Acid Production in Perinatal Asphyxia

    Asutosh P Chauhan

    2013-02-01

    Full Text Available Purpose: A Study of newborn infants to evaluate extent of hypoxia from Apgar score and correlate it with biochemistry parameters & to evaluate the presence and extent of cardiac involvement in asphyxiated new born infants along with estimation of the extent of lactic acidosis in asphyxiated new born infants. Methods: A Study of 52 newborn infants, free from congenital heart diseases were included in the study. After their through clinical examination, they were subdivided into three groups according to their Apgar score. Blood was collected from a stasis free vein in plain bulb. Serum separated after centrifugation was used for estimation of CK-MB and LDH activity. Results: serum CK-MB levels in group II as compared to group I was significantly raised (P< 0.0001. Similarly the comparison of CK-MB between group II and group III and also between group I and group III was highly significant with a p value of <0.0001. Serum lactate levels were also significantly elevated in cases as compared with controls with a p value of <0.0001. Conclusions: Our study shows a clear relationship between clinical pattern of asphyxiated newborn infants and alterations of serum cardiac enzymes (CK-MB and LDH and lactic acid production. [Natl J of Med Res 2013; 3(1.000: 76-79

  3. Affordable Care Act and Women

    ... Outcomes Research Trust Fund (PCORTF) Poverty Poverty Guidelines Poverty Analysis Teen Pregnancy Prevention Homelessness MACRA Publications Data and Tools Evaluation Database The Affordable Care Act and Women 03/20/2012 Home The Affordable Care Act ...

  4. Arsenic-induced oxidative myocardial injury: protective role of arjunolic acid

    Manna, Prasenjit; Sinha, Mahua; Sil, Parames C. [Bose Institute, Department of Chemistry, Kolkata, West Bengal (India)

    2008-03-15

    Arsenic, one of the most harmful metalloids, is ubiquitous in the environment. The present study has been carried out to investigate the protective role of a triterpenoid saponin, arjunolic acid (AA) against arsenic-induced cardiac oxidative damage. In the study, NaAsO{sub 2} was chosen as the source of arsenic. The free radical scavenging activity and the effect of AA on the intracellular antioxidant power were determined from its 2,2-diphenyl-1-picryl hydrazyl radical scavenging ability and ferric reducing/antioxidant power assay, respectively. Oral administration of NaAsO{sub 2} at a dose of 10 mg/kg body weight for 2 days caused significant accumulation of arsenic in cardiac tissues of the experimental mice in association with the reduction in cardiac antioxidant enzymes activities, namely superoxide dismutase, catalase, glutathione-S-transferase, glutathione reductase and glutathione peroxidase. Arsenic intoxication also decreased the cardiac glutathione (GSH) and total thiol contents and increased the levels of oxidized glutathione (GSSG), lipid peroxidation end products and protein carbonyl content. Treatment with AA at a dose of 20 mg/kg body weight for 4 days prior to NaAsO{sub 2} intoxication protected the cardiac tissue from arsenic-induced oxidative impairment. In addition to oxidative stress, arsenic administration increased total cholesterol level as well as the reduced high-density lipoprotein cholesterol level in the sera of the experimental mice. AA pretreatment, however, could prevent this hyperlipidemia. Histological studies on the ultrastructural changes in cardiac tissue supported the protective activity of AA also. Combining all, results suggest that AA could protect cardiac tissues against arsenic-induced oxidative stress probably due to its antioxidant property. (orig.)

  5. Post-ischaemic angiogenic therapy using in vivo prevascularized ascorbic acid-enriched myocardial artificial grafts improves heart function in a rat model.

    Martinez, Eliana C; Wang, Jing; Lilyanna, Shera; Ling, Lieng H; Gan, Shu U; Singh, Rajeev; Lee, Chuen N; Kofidis, Theo

    2013-03-01

    Angiogenesis plays a key role in post-ischaemic myocardial repair. We hypothesized that epicardial implantation of an ascorbic acid (AA)-enriched myocardial artificial graft (MAG), which has been prevascularized in the recipients' own body, promotes restoration of the ischaemic heart. Gelatin patches were seeded with GFP-luciferase-expressing rat cardiomyoblasts and enriched with 5 μm AA. Grafts were prevascularized in vivo for 3 days, using a renal pouch model in rats. The MAG patch was then implanted into the same rat's ischaemic heart following myocardial infarction (MI). MAG-treated animals (MAG group, n = 6) were compared to untreated infarcted animals as injury controls (MI group, n = 6) and sham-operated rats as healthy controls (healthy group, n = 7). In vivo bioluminescence imaging indicated a decrease in donor cell survival by 83% during the first week post-implantation. Echocardiographic and haemodynamic assessment 4 weeks after MI revealed that MAG treatment attenuated left ventricular (LV) remodelling (LV end-systolic volume, 0.31 ± 0.13 vs 0.81 ± 0.01 ml, p hearts, attenuated LV remodelling and preserved LV function.

  6. JNK/PI3K/Akt signaling pathway is involved in myocardial ischemia/reperfusion injury in diabetic rats: effects of salvianolic acid A intervention.

    Chen, Qiuping; Xu, Tongda; Li, Dongye; Pan, Defeng; Wu, Pei; Luo, Yuanyuan; Ma, Yanfeng; Liu, Yang

    2016-01-01

    Recent studies have demonstrated that diabetes impairs the phosphatidylinositol 3-kinase/Akt (PI3K/Akt) pathway, while insulin resistance syndrome has been associated with alterations of this pathway in diabetic rats after ischemia/reperfusion (I/R), and activation of C-jun N-terminal kinase (JNK) is involved. The present study was designed to investigate whether inhibiting JNK activity would partially restore the PI3K/Akt signaling pathway and protect against myocardial I/R injury in diabetic rats, and to explore the effect of intervention with salvianolic acid A (Sal A). The inhibitor of JNK (SP600125) and Sal A were used in type 2 diabetic (T2D) rats, outcome measures included heart hemodynamic data, myocardial infarct size, the release of lactate dehydrogenase (LDH), SERCA2a activity, cardiomyocyte apotosis, expression levels of Bcl-2, Bax and cleaved caspase-3, and the phosphorylation status of Akt and JNK. The p-Akt levels were increased after myocardial I/R in non-diabetic rats, while there was no change in diabetic rats. Pretreatment with the SP600125 and Sal A decreased the p-JNK levels and increased the p-Akt levels in diabetic rats with I/R, and heart hemodynamic data improved, infarct size and LDH release decreased, SERCA2a activity increased, Bax and cleaved caspase-3 expression levels decreased, and the expression of Bcl-2 and the Bcl-2/Bax ratio increased. Our results suggest that the JNK/PI3K/Akt signaling pathway is involved in myocardial I/R injury in diabetic rats and Sal A exerts an anti-apoptotic effect and improves cardiac function following I/R injury through the JNK/PI3K/Akt signaling pathway in this model.

  7. Myocardial disease

    1997-01-01

    970309 Myocardial injury of Keshan disease andapoptosis. ZHONG Xuekuan(钟学宽), et al. KeshanDis Instit, Harbin Med Univ, Harbin, 150086. Chin JEndemiol 1997, 16(2): 81-82. Objective: To discuss the relationship between my-ocardial injury Of Keshan disease and apoptosis. Meth-

  8. Association of serum uric acid level with mortality and morbidity of patients with acute ST-elevation myocardial infarction

    Reza Hajizadeh

    2016-06-01

    Conclusion: In the current study, high serum UA level in patients with acute myocardial infarction (MI was not associated with higher in-hospital or midterm mortality, but it was associated with lower LVEF, higher Killip class, elevated cTnI, creatinine, triglyceride, and higher AF.

  9. Time course characterization of serum cardiac troponins, heart fatty acid-binding protein, and morphologic findings with isoproterenol-induced myocardial injury in the rat.

    Clements, Peter; Brady, Sally; York, Malcolm; Berridge, Brian; Mikaelian, Igor; Nicklaus, Rosemary; Gandhi, Mitul; Roman, Ian; Stamp, Clare; Davies, Dai; McGill, Paul; Williams, Thomas; Pettit, Syril; Walker, Dana; Turton, John

    2010-08-01

    We investigated the kinetics of circulating biomarker elevation, specifically correlated with morphology in acute myocardial injury. Male Hanover Wistar rats underwent biomarker and morphologic cardiac evaluation at 0.5 to seventy-two hours after a single subcutaneous isoproterenol administration (100 or 4000 microg/kg). Dose-dependent elevations of serum cardiac troponins I and T (cTnI, cTnT), and heart fatty acid-binding protein (H-FABP) occurred from 0.5 hour, peaked at two to three hours, and declined to baseline by twelve hours (H-FABP) or forty-eight to seventy-two hours (Serum cTns). They were more sensitive in detecting cardiomyocyte damage than other serum biomarkers. The Access 2 platform, an automated chemiluminescence analyzer (Beckman Coulter), showed the greatest cTnI fold-changes and low range sensitivity. Myocardial injury was detected morphologically from 0.5 hour, correlating well with loss of cTnI immunoreactivity and serum biomarker elevation at early time points. Ultrastructurally, there was no evidence of cardiomyocyte death at 0.5 hour. After three hours, a clear temporal disconnect occurred: lesion scores increased with declining cTnI, cTnT, and H-FABP values. Serum cTns are sensitive and specific markers for detecting acute/active cardiomyocyte injury in this rat model. Heart fatty acid-binding protein is a good early marker but is less sensitive and nonspecific. Release of these biomarkers begins early in myocardial injury, prior to necrosis. Assessment of cTn merits increased consideration for routine screening of acute/ongoing cardiomyocyte injury in rat toxicity studies.

  10. Validation of {sup 99m}Tc-labeled '4+1' fatty acids for myocardial metabolism and flow imaging

    Mirtschink, Peter [Institute of Physiology, Technical University Dresden, 01307 Dresden (Germany)], E-mail: peter_mirtschink@web.de; Stehr, Sebastian N. [Department of Anesthesiology, Technical University Dresden, 01307 Dresden (Germany); Walther, Martin; Pietzsch, Jens; Bergmann, Ralf; Pietzsch, Hans-Juergen [Institute of Radiopharmacy, Forschungszentrum Dresden-Rossendorf, 01314 Dresden (Germany); Weichsel, Johannes; Pexa, Annette; Dieterich, Peter [Institute of Physiology, Technical University Dresden, 01307 Dresden (Germany); Wunderlich, Gerd [Department of Nuclear Medicine, Technical University Dresden, 01307 Dresden (Germany); Binas, Bert [Department of Veterinary Pathobiology, Texas A and M University, College Station, TX 77843 (United States); Kropp, Joachim [Department of Nuclear Medicine Carl-Thiem Hospital Cottbus, 03048 Cottbus (Germany); Deussen, Andreas [Institute of Physiology, Technical University Dresden, 01307 Dresden (Germany)

    2009-10-15

    Introduction: {sup 13}C, {sup 18}F and {sup 123}I fatty acids (FA) are used for myocardial imaging. Recently, our group showed that [{sup 99m}Tc]-labeled '4+1' FA are extracted into the rat and guinea pig myocardium. The present study evaluates determinants of myocardial uptake and whole body biodistribution of these FA derivatives. Methods: Studies were performed with isolated perfused hearts of Wistar-Kyoto (WKY) and spontaneously hypertensive rats (SHR) with a FAT/CD36 deficiency, as well as with heart type FA binding protein knockout mice (H-FABP){sup -/-} and H-FABP{sup +/+}. Eight 4+1-{sup 99m}Tc-FA were applied for 3 min followed by 1-min washout. A mathematical model was used to analyze FA dynamics and binding to proteins. Whole-body distribution was studied in rats with and without Tween 80. In vitro fractionation studies with [{sup 99m}Tc]-FA assessed red blood cell uptake as well as association with plasma lipoproteins very low-density lipoprotein (VLDL), low-density lipoprotein (LDL) and high-density lipoprotein (HDL). Results: Myocardial extraction was 19.0-33.0% of the infused dose in isolated WKY and 15.2-26.4% in SHR hearts. However, H-FABP{sup -/-} showed a marked reduction of tracer extraction [2.8{+-}0.6%ID (percent injected dose) vs. 17{+-}2%ID P<.001]. Uptake in red blood cells (<1.2%ID) and incorporation into lipoproteins were negligible. Incubation of {sup 99m}Tc-FA with albumin reduced ventricular extraction (P<.001) into the range of established iodinated FA tracers. polyoxyethylene(20) sorbitan monooleate improved the heart-to-liver ratio in the biodistribution studies. Conclusions: Myocardial uptake of [{sup 99m}Tc]-FA 4+1 derivatives is dependent on H-FABP. These substances may therefore provide a new tool to specifically assess regional myocardial changes of H-FABP.

  11. Advances in β-methyl-p-iodophenyl pentadecanoic acid myocardial imaging%123I-β-甲基-p-碘苯基十五烷酸心肌显像研究进展

    苏云龙; 王雪梅

    2012-01-01

    Fatty acid metabolism is the most efficient mode of myocardial energy production.Alteration of fatty acid metabolism is considered to be a sensitive marker of ischaemia and myocardial damage.After myocardial ischemia,prolonged suppression of fatty acid metabolism may persist despite restoration of blood flow,which is called metabolic stunning or ischemia memory.Assessment of fatty acid metabolism by radionuclide labeled β -methyl-p-iodophenyl pentadecanoic acid (BMIPP) SPECT plays a potential role in the early detection of myocardial ischaemia and the assessment of the severity of ischaemic coronary artery disease and myocardial disease.This article describes recent advances in 123I-BMIPP myocardial imaging.%脂肪酸代谢是心肌中最高效的供能方式.脂肪酸代谢水平的改变被认为是心肌缺血和心肌损伤最敏感的指标.心肌缺血后,尽管血液灌注已恢复,但脂肪酸代谢的长期抑制还会持续,这就是所谓的代谢顿抑或缺血记忆.用放射性核素标记β-甲基-p-碘苯基十五烷酸(BMIPP)SPECT评估脂肪酸的代谢,对早期发现心肌缺血,评估缺血性冠状动脉疾病及心肌病的严重性及预后有重要的作用.该文对123I-BMIPP心肌显像的近期研究进展进行综述.

  12. VO(acac)2 catalyzed condensation of o-phenylenediamine with aromatic carboxylic acids/aldehydes under microwave radiation affording benzimidazoles

    Madhudeepa Dey; Krishnajyoti Deb; Siddhartha Sankar Dhar

    2011-01-01

    Vanadyl acetylacetonate, VO(acac)2, has been found to be very effective catalyst for synthesis of a variety of benzimidazoles under solvent-free condition. The methodology involves the exposure of a mixture of o-phenylenediamine and a selected aromatic carboxylic acid/aldehyde to microwave radiation without the use of any solvent or supporting agents. The benzimidazoles were obtained in quick time with high yields.

  13. Affordances theory in multilingualism studies

    Larissa Aronin

    2012-10-01

    Full Text Available The concept of affordances originating in Gibson’s work (Gibson, 1977 is gaining ground in multilingualism studies (cf. Aronin and Singleton, 2010; Singleton and Aronin, 2007; Dewaele, 2010. Nevertheless, studies investigating affordances in respect of teaching, learning or using languages are still somewhat rare and tend to treat isolated aspects of multilingualism. This is despite the fact that the theory of affordances can actually provide a valuable, supplementary, up-to-date framework within which a clearer, sharper description and explication of the intriguing range of attributes of multilingual communities, educational institutions and individuals, as well as teaching practices, become feasible. It is important that not only researchers and practitioners (teachers, educators, parents, community and political actors but also language users and learners themselves should be aware of how to identify or, if necessary, design new affordances for language acquisition and learning. The aim of this article is to adapt the concept of affordances to multilingualism studies and additional language teaching, and in so doing advance theoretical understanding in this context. To this end the article contains a brief summary of the findings so far available. The article also goes further into defining the ways of how affordances work in relation to multilingualism and second language teaching and puts forward an integrated model of affordances.

  14. Affordable Access to Space (AAS): Affordable Vehicle Avionics Project

    National Aeronautics and Space Administration — Affordable Vehicle Avionics (AVA) is being developed at NASA Ames Research Center and is sponsored by Space Technology Mission Directorate (STMD) Game Changing...

  15. Myocardial disease

    1992-01-01

    920666 Immunocytochemical study ofCuZn superoxide dismutase in the myocardi-um of normal subjects and patients ofrheumatic heart disease.ZHENG Yi(郑毅),et al. Dept Intern Med, Navy General Hosp,PLA, Beijing. 100037. Natl Med J China 1992;72(4): 225-227. By using the methods of immunocytochemistry

  16. Plant Natural Products Calycosin and Gallic Acid Synergistically Attenuate Neutrophil Infiltration and Subsequent Injury in Isoproterenol-Induced Myocardial Infarction: A Possible Role for Leukotriene B4 12-Hydroxydehydrogenase?

    Yuanyuan Cheng

    2015-01-01

    Full Text Available Leukotriene B4 12-hydroxydehydrogenase (LTB4DH catalyzes the oxidation of proinflammatory LTB4 into less bioactive 12-oxo-LTB4. We recently discovered that LTB4DH was induced by two different natural products in combination. We previously isolated gallic acid from Radix Paeoniae through a bioactivity-guided fractionation procedure. The purpose of this study is to test the hypothesis that LTB4DH inducers may suppress neutrophil-mediated inflammation in myocardial infarction. We first isolated the active compound(s from another plant, Radix Astragali, by the similar strategy. By evaluating LTB4DH induction, we identified calycosin and formononetin from Radix Astragali by HPLC-ESI-MS technique. We confirmed that gallic acid and commercial calycosin or formononetin could synergistically induce LTB4DH expression in HepG2 cells and human neutrophils. Moreover, calycosin and gallic acid attenuated the effects of LTB4 on the survival and chemotaxis of neutrophil cell culture. We further demonstrated that calycosin and gallic acid synergistically suppressed neutrophil infiltration and protected cardiac integrity in the isoproterenol-induced mice model of myocardial infarction. Calycosin and gallic acid dramatically suppressed isoproterenol-induced increase in myeloperoxidase (MPO activity and malondialdehyde (MDA level. Collectively, our results suggest that LTB4DH inducers (i.e., calycosin and gallic acid may be a novel combined therapy for the treatment of neutrophil-mediated myocardial injury.

  17. Plant Natural Products Calycosin and Gallic Acid Synergistically Attenuate Neutrophil Infiltration and Subsequent Injury in Isoproterenol-Induced Myocardial Infarction: A Possible Role for Leukotriene B4 12-Hydroxydehydrogenase?

    Cheng, Yuanyuan; Zhao, Jia; Tse, Hung Fat; Le, X Chris; Rong, Jianhui

    2015-01-01

    Leukotriene B4 12-hydroxydehydrogenase (LTB4DH) catalyzes the oxidation of proinflammatory LTB4 into less bioactive 12-oxo-LTB4. We recently discovered that LTB4DH was induced by two different natural products in combination. We previously isolated gallic acid from Radix Paeoniae through a bioactivity-guided fractionation procedure. The purpose of this study is to test the hypothesis that LTB4DH inducers may suppress neutrophil-mediated inflammation in myocardial infarction. We first isolated the active compound(s) from another plant, Radix Astragali, by the similar strategy. By evaluating LTB4DH induction, we identified calycosin and formononetin from Radix Astragali by HPLC-ESI-MS technique. We confirmed that gallic acid and commercial calycosin or formononetin could synergistically induce LTB4DH expression in HepG2 cells and human neutrophils. Moreover, calycosin and gallic acid attenuated the effects of LTB4 on the survival and chemotaxis of neutrophil cell culture. We further demonstrated that calycosin and gallic acid synergistically suppressed neutrophil infiltration and protected cardiac integrity in the isoproterenol-induced mice model of myocardial infarction. Calycosin and gallic acid dramatically suppressed isoproterenol-induced increase in myeloperoxidase (MPO) activity and malondialdehyde (MDA) level. Collectively, our results suggest that LTB4DH inducers (i.e., calycosin and gallic acid) may be a novel combined therapy for the treatment of neutrophil-mediated myocardial injury.

  18. Housing Affordability Data System (HADS)

    Department of Housing and Urban Development — The Housing Affordability Data System (HADS) is a set of files derived from the 1985 and later national American Housing Survey (AHS) and the 2002 and later Metro...

  19. Myocardial scintigraphy using iodine-123 15-(p-Iodophenyl)-3-R, S-methylpentadecanoic acid predicts the response to beta-blocker therapy in patients with dilated cardiomyopathy but does not reflect therapeutic effect

    Yoshinaga, Keiichiro; Tahara, Minoru; Torii, Hiroyuki; Akimoto, Masaki [Kagoshima City Medical Association Hopital (Japan); Kihara, Koichi; Tei, Chuwa

    2000-05-01

    Myocardial fatty acid metabolism is disturbed in patients with idiopathic dilated cardiomyopathy. Myocardial scintigraphy using iodine-123 15-(p-iodophenyl)-3-R, S-methylpentadecanoic acid (BMIPP) was used to assess the response to {beta}-blocker therapy in 19 patients with dilated cardiomyopathy. BMIPP myocardial scintigraphy was performed before and 6 months after initiating {beta}-blocker therapy with metoprolol. Cardiac BMIPP uptake was assessed as the total defect score (TDS) and heart-to-mediastinum activity (H/M) ratio. Patients were classified retrospectively as responders with an improvement of at least one functional class (New York Heart Association) or an increase in ejection fraction of {>=}0.10 at 6 months, or as nonresponders meeting neither criterion. Responders had a significantly better pretreatment TDS (p<0.005) and H/M ratio (p<0.0001) than nonresponders. TDS exhibited no significant changes over 6 months in either group (responders: 13.2{+-}3.7 vs 12.5{+-}3.3; nonresponders: 20.8{+-}6.5 vs 20.5{+-}3.0). Responders showed no significant changes in H/M ratio (2.47{+-}0.28 vs 2.43{+-}0.42); paradoxically, nonresponders showed a significant increase from 1.82{+-}0.11 to 2.10{+-}0.19 (p<0.05), suggesting that {beta}-blocker therapy protected the myocardial fatty acid metabolism even in the absence of clinical improvement. BMIPP myocardial scintigraphy provides a prediction of response to {beta}-blocker treatment, but does not reflect the therapeutic effect in responders at 6 months. (author)

  20. Myocardial Infarction Type 2 and Myocardial Injury

    Sandoval, Yader; Thygesen, Kristian

    2017-01-01

    BACKGROUND: The development and implementation of sensitive and high-sensitivity cardiac troponin assays has not only expedited the early ruling in and ruling out of acute myocardial infarction, but has also contributed to the identification of patients at risk for myocardial injury with necrosis......, as confirmed by the presence of cardiac troponin concentrations above the 99th percentile. Myocardial injury with necrosis may occur either in the presence of overt ischemia from myocardial infarction, or in the absence of overt ischemia from myocardial injury accompanying other conditions. Myocardial...... infarction type 2 (T2MI) has been a focus of attention; conceptually T2MI occurs in a clinical setting with overt myocardial ischemia where a condition other than an acute atherothrombotic event is the major contributor to a significant imbalance between myocardial oxygen supply and/or demand. Much debate...

  1. Malaysian Affordability Housing Policies Revisited

    Samad Diwa

    2016-01-01

    Full Text Available Housing has always been a significant aspiration of family expression and distinctly priciest investment by household. It plays a momentous role in the country’s economy and so central to the societal well-being that is emplaced in the United Nation Universal declaration of Human rights. Yet in developed and developing world alike, cities struggle to provide decent housing for lower and middle income population. The provision of affordable housing is a major policy concern around the world with Malaysia being no exception; rising income hardly keep pace with price hike of housing unit and housing interventions has majorly concentrated on demand side leading to a non-responsive supply sector. Therefore, this paper highlights affordable housing issues pertaining Malaysia. It formulates Malaysian Map of affordability and conducts an evaluation of global housing schemes to better identify policy priorities for Malaysia. It’s significant to harmonize supply and demand side factors in the housing market to ensure that housing supply fits the needs of citizens based on the location, price and target group. In case of Malaysia supply oriented initiative are of urgency in short and medium run. This must be supported by long term demand side schemes in parallel. Convergence of these two factors is essential for a balanced equilibrium and obtaining affordability.

  2. Global affordability of fluoride toothpaste

    Holmgren Christopher J

    2008-06-01

    Full Text Available Abstract Objective Dental caries remains the most common disease worldwide and the use of fluoride toothpaste is a most effective preventive public health measure to prevent it. Changes in diets following globalization contribute to the development of dental caries in emerging economies. The aim of this paper is to compare the cost and relative affordability of fluoride toothpaste in high-, middle- and low-income countries. The hypothesis is that fluoride toothpaste is not equally affordable in high-, middle- and low-income countries. Methods Data on consumer prices of fluoride toothpastes were obtained from a self-completion questionnaire from 48 countries. The cost of fluoride toothpaste in high-, middle- and low-income countries was compared and related to annual household expenditure as well as to days of work needed to purchase the average annual usage of toothpaste per head. Results The general trend seems to be that the proportion of household expenditure required to purchase the annual dosage of toothpaste increases as the country's per capita household expenditure decreases. While in the UK for the poorest 30% of the population only 0.037 days of household expenditure is needed to purchase the annual average dosage (182.5 g of the lowest cost toothpaste, 10.75 days are needed in Kenya. The proportion of annual household expenditure ranged from 0.02% in the UK to 4% in Zambia to buy the annual average amount of lowest cost toothpaste per head. Conclusion Significant inequalities in the affordability of this essential preventive care product indicate the necessity for action to make it more affordable. Various measures to improve affordability based on experiences from essential pharmaceuticals are proposed.

  3. Global analysis of myocardial peptides containing cysteines with irreversible sulfinic and sulfonic Acid post-translational modifications

    Paulech, Jana; Liddy, Kiersten A; Engholm-Keller, Kasper;

    2015-01-01

    Cysteine (Cys) oxidation is a crucial post-translational modification (PTM) associated with redox signaling and oxidative stress. As Cys is highly reactive to oxidants it forms a range of post-translational modifications, some that are biologically reversible (e.g. disulfides, Cys sulfenic acid...

  4. Diagnosis of myocardial involvement in patients with systemic myopathies with 15-(p-[I-123]iodophenyl) pentadecanoic acid (IPPA) SPECT

    Kropp, J.; Briele, B.; Smekal, A.V.; Hotze, A.L.; Biersack, H.J.; Koehler, U.; Zierz, St. [Bonn Univ. (Germany); Knapp, F.F. [Oak Ridge National Lab., TN (United States)

    1992-03-01

    Involvement of the myocardium in non-infectious myopathies presents in most cases as systolic dysfunction or a disturbed cardiac rhythm. We are interested in exploring how often cardiac involvement can be evaluated with various diagnostic techniques in patients with proven myopathy. We investigated 41 patients with myopathies of various etiology, including mitochondrial and congenital myopathies, Curshmann-Steinert disease, muscular dystrophy, and others. Myopathy was proven by muscular biopsy usually from the bicep. Fatty acid imaging was performed with 15-(p-[I-123]iodophenyl)pentadecanoic acid (IP-PA) and sequential SPECT-scintigraphy with a 180 deg. rotation starting at the 45 deg. RAO position. 190 MBq were injected at the maximal stage of a submaximal exercise. Filtered backprojection and reorientation of the slices were achieved by standard techniques. The quantitative comparison of the oblique slices (bulls-eye technique) of the SPECT-studies revealed turnover-rates as a qualitative measure of {beta}-oxidation. Serum levels of lactate (L), pyruvate (P), glucose (G) and triglycerides (TG) were measured at rest and stress. Ventricular function was investigated by radionuclide ventriculography (MUGA) at rest and under stress with Tc-99m labeled red blood cells. In addition, ECG, 24 hour-ECG, and echocardiography were also performed with standard techniques.

  5. Diagnosis of myocardial involvement in patients with systemic myopathies with 15-(p-(I-123)iodophenyl) pentadecanoic acid (IPPA) SPECT

    Kropp, J.; Briele, B.; Smekal, A.V.; Hotze, A.L.; Biersack, H.J.; Koehler, U.; Zierz, St. (Bonn Univ. (Germany)); Knapp, F.F. (Oak Ridge National Lab., TN (United States))

    1992-01-01

    Involvement of the myocardium in non-infectious myopathies presents in most cases as systolic dysfunction or a disturbed cardiac rhythm. We are interested in exploring how often cardiac involvement can be evaluated with various diagnostic techniques in patients with proven myopathy. We investigated 41 patients with myopathies of various etiology, including mitochondrial and congenital myopathies, Curshmann-Steinert disease, muscular dystrophy, and others. Myopathy was proven by muscular biopsy usually from the bicep. Fatty acid imaging was performed with 15-(p-(I-123)iodophenyl)pentadecanoic acid (IP-PA) and sequential SPECT-scintigraphy with a 180 deg. rotation starting at the 45 deg. RAO position. 190 MBq were injected at the maximal stage of a submaximal exercise. Filtered backprojection and reorientation of the slices were achieved by standard techniques. The quantitative comparison of the oblique slices (bulls-eye technique) of the SPECT-studies revealed turnover-rates as a qualitative measure of {beta}-oxidation. Serum levels of lactate (L), pyruvate (P), glucose (G) and triglycerides (TG) were measured at rest and stress. Ventricular function was investigated by radionuclide ventriculography (MUGA) at rest and under stress with Tc-99m labeled red blood cells. In addition, ECG, 24 hour-ECG, and echocardiography were also performed with standard techniques.

  6. Role of Heart-Type Fatty Acid Binding Protein in Early Detection of Acute Myocardial Infarction in Comparison with cTnI, CK-MB and Myoglobin

    陈莉莉; 郭小梅; 杨霏

    2004-01-01

    Heart fatty acid-binding protein (H-FABP) is supposed to be the most sensitive biomarker of early acute myocardial infarction (AMI). To evaluate the diagnostic value of H-FABP for AMI in the early stage, the plasma levels of H-FABP were measured by sandwich ELISA in 93 patients with suspected AMI at admission within 6 h after onset of chest pain and 69 normal healthy subjects. The plasma concentrations of cardiac troponin-I (cTnI), creatine kinase-MB (CK-MB)and myoglobin (Mb) were assayed at the same time by using corpuscle chemiluminescence for those patients. The patients were classified as AMI group (n= 32) and non-AMI group (n= 61) retrospectively. The diagnostic validity was evaluated in terms of sensitivity, specificity and receiver operating characteristic (ROC) curve analysis. The results showed the cutoff value of H-FABP for AMI was 16.8 ng/ml, and its diagnostic sensitivity for AMI was 64.29 % within 3 h and 84.38 %within 6 h after onset of chest pain, and the diagnostic specificity for non-AMI was 100 % within 3h and 91.8 % within 6 h. H-FABP had higher sensitivity than that of cTnI and CK-MB at all time points (P<0.05), whereas there was no significant difference in specificity among the four markers. But the area under the ROC curve of H-FABP was significantly greater than that of cTnI, CKMB and Mb within 3 h. These results revealed that H-FABP possessed high diagnostic sensitivity and specificity for AMI in early stage, especially within 3 h after onset of persistent angina pectoris.In conclusion, H-FABP can be used as a sensitive marker for AMI in the early stage.

  7. Fisiognomica emozionale. Affordances, estasi, atmosfere

    Tonino Griffero

    2015-06-01

    Full Text Available Through an atmospherological approach, primarily inspired by the so-called Aisthetik or New Aesthetics (Gernot Böhme and the New Phenomenology (Hermann Schmitz, the paper defines the atmospheric perception as a first pathemic impression and investigates the relationship between this kind of perception and the expressive qualities of the surrounding spaces. The aim is to understand atmospheres as (amodal, transmodal, sinaesthetic affordances that permeate the lived space, namely as ‘ecological’ and affective invites or meanings which are ontologically rooted in things and quasi-things.

  8. Classification of myocardial infarction

    Saaby, Lotte; Poulsen, Tina Svenstrup; Hosbond, Susanne Elisabeth;

    2013-01-01

    The classification of myocardial infarction into 5 types was introduced in 2007 as an important component of the universal definition. In contrast to the plaque rupture-related type 1 myocardial infarction, type 2 myocardial infarction is considered to be caused by an imbalance between demand and...

  9. Transient myocardial ischemia after myocardial infarction

    Mickley, H

    1995-01-01

    Ambulatory ST-segment monitoring is a relatively new device in the evaluation of myocardial ischemia. The method is unique in allowing us to continuously examine the patient over an extended period of time in a changing environmental milieu. In survivors of acute myocardial infarction...... the prevalence of ambulatory or transient myocardial ischemia is lower than in patients with chronic, stable coronary artery disease. A greater proportion of ischemic episodes, however, are silent than in other subgroups with ischemic heart disease. Early after the infarction, transient myocardial ischemia...... exhibits a circadian variation with a peak activity occurring in the late evening hours. Patients with non-Q wave infarction have more transient myocardial ischemia, whereas thrombolytic therapy seems to result in less residual ischemia. Exercise testing is more sensitive than ambulatory monitoring...

  10. Dopamine, affordance and active inference.

    Karl J Friston

    2012-01-01

    Full Text Available The role of dopamine in behaviour and decision-making is often cast in terms of reinforcement learning and optimal decision theory. Here, we present an alternative view that frames the physiology of dopamine in terms of Bayes-optimal behaviour. In this account, dopamine controls the precision or salience of (external or internal cues that engender action. In other words, dopamine balances bottom-up sensory information and top-down prior beliefs when making hierarchical inferences (predictions about cues that have affordance. In this paper, we focus on the consequences of changing tonic levels of dopamine firing using simulations of cued sequential movements. Crucially, the predictions driving movements are based upon a hierarchical generative model that infers the context in which movements are made. This means that we can confuse agents by changing the context (order in which cues are presented. These simulations provide a (Bayes-optimal model of contextual uncertainty and set switching that can be quantified in terms of behavioural and electrophysiological responses. Furthermore, one can simulate dopaminergic lesions (by changing the precision of prediction errors to produce pathological behaviours that are reminiscent of those seen in neurological disorders such as Parkinson's disease. We use these simulations to demonstrate how a single functional role for dopamine at the synaptic level can manifest in different ways at the behavioural level.

  11. Clinical usefulness of {sup 123}I-labeled 15-iodophenyl 3-methyl pentadecanoic acid (BMIPP) myocardial SPECT in coronary artery disease

    Ito, Kazuki [Kyoto Prefectural Univ. of Medicine (Japan)

    1998-01-01

    {sup 123}I-BMIPP (BMIPP) myocardial SPECT was carried out in 22 patients with acute myocardial infarction, in 20 patients with unstable angina pectoris, in 80 patients with effort angina pectoris and in 25 patients with vasospastic angina pectoris. In a study of patients with acute myocardial infarction, BMIPP uptake was less than thallium perfusion in areas of myocardial infarction. Such discordant BMIPP/thallium uptake was often observed in areas with recanalized arteries, and in those with abnormal wall motion. In the areas showing discordant BMIPP/thallium uptake, the wall motion abnormalities improved in the chronic phase after recanalization therapy. Therefore, the discordant BMIPP/thallium uptake might represent asynergic but viable regions, and might be valuable in predicting the improvement of wall motion abnormalities. In a study of patients with unstable angina pectoris, the severity of regional wall motion abnormality was significantly correlated with severity of BMIPP uptake. BMIPP imaging well visualized the culprit regions in patients with unstable angina pectoris. In a study of patients with effort angina pectoris, the abnormal BMIPP images were associated with severe coronary artery stenosis of more than 90% and with multivessel stenosis. BMIPP imaging could detect patients with functionally severe coronary artery disease and help to guide coronary angioplasty in patients with effort angina. In a study of patients with vasospastic angina pectoris, metabolic abnormality assessed by BMIPP was associated with left ventricular asynergy and spastic regions. Those abnormalities also correlated inversely with the period from the last attack, and improved after medical treatment. (K.H.)

  12. Refining Grasp Affordance Models by Experience

    Detry, Renaud; Kraft, Dirk; Buch, Anders Glent;

    2010-01-01

    We present a method for learning object grasp affordance models in 3D from experience, and demonstrate its applicability through extensive testing and evaluation on a realistic and largely autonomous platform. Grasp affordance refers here to relative object-gripper configurations that yield stabl...

  13. Section 8: Affordable Housing for Exceptional Families

    Wright, Wesley E.

    2009-01-01

    Shelter is a basic human need. Unfortunately, affordable housing is a need that low income families who are caring for children and adults with disabilities can rarely afford without assistance. Because participating families generally pay rent of no more than 30 percent of their adjusted monthly income, the Section 8 program can provide…

  14. Rethinking Affordable Housing Delivery: An Analytical Insight

    Olanrewaju Abdullateef

    2016-01-01

    Full Text Available Malaysia currently has a housing shortage of 12 million units. Towards the year 2020, this would require an annual supply of a minimum of 2 million homes. With the current production rate, the deficits will remain over the next 100 years. The crisis will lead to poor standards of living, un-affordable rental price, high mortgage payment, abandonment, and dilapidation of the existing housing stock. Lack of affordable housing is already a source of concern among many Malaysians. The middle and lower income earners spend more than 30% of their income on rent or for mortgage payment. Housing rent or mortgage is a basic need like foods, education, clothing and health. The government has introduced various measures to address the housing deficit. Despite these measures, the housing supply and distribution gaps continue to grow. To better understand the issues, there is a need to examine how the procurement planning in the affordable housing delivery supply chain and market is formulated, explore how cost of affordable housing would be reduced, identify the user value systems in affordable housing, and identify the criteria in the current regulatory framework? For these purposes, this paper reviews the relevant literature to reach preliminary findings on the stated issues. Among the factors found accounting for housing shortages, the overwhelming factors were that of poor policies, strategies, practice, management, and finance. The findings are meaningful in framing an affordable housing delivery model. It could also be useful to stakeholders involved in affordable housing delivery in Malaysia and elsewhere.

  15. PERIOPERATIVE MYOCARDIAL INFRACTION

    Ravindra S

    2015-10-01

    Full Text Available Perioperative myocardial ischaemia and infarction (PMI is a major cause of short and long term morbidity and mortality in the surgical population. It is estimated that more than one half of postoperative deaths are caused by cardiac events, most of which are ischaemic in origin. Over 50,000 patients each year sustain a perioperative MI . Thus prevention of a PMI is important to improve overall postoperative outcome. Myocardial ischaemia is a dual state composed of inadequate myocardial oxygenation and accu mulation of anaerobic metabolites and occurs when myocardial oxygen demand exceeds the supply. Myocardial infarction is defined as the death of myocardial myocytes due to prolonged ischaemia. In patients with, or at risk of coronary artery disease (CAD, t he reported incidence of perioperative myocardial ischaemia is 20 - 63%. Various studies have shown that postoperative myocardial ischaemia was consistently found to occur considerably more often than preoperative and intraoperative ischaemia ( R atio approxim ately 3:1 and 5:1 respectively. As more and more patients coming for non - cardiac surgeries who have already undergone coronary intervention such as balloon angioplasty, stenting or CABG, we as anaesthesiologists should have thorough knowledge of the perio perative implications of the same in a day to day practice. Secondly, as the geriatric population is increasing there are more chances of encountering patients with known or unknown ischaemic heart disease both on an emergency and elective basis.

  16. Smoking Bans in Affordable Housing Benefit All

    ... page: https://medlineplus.gov/news/fullstory_160501.html Smoking Bans in Affordable Housing Benefit All: Study Secondhand ... housing properties in Minnesota. All the properties prohibited smoking indoors and three also banned smoking on the ...

  17. Effects of n-3 fatty acids on cognitive decline: A randomized double-blind, placebo-controlled trial in stable myocardial infarction patients

    Geleijnse, J.M.; Giltay, E.J.; Kromhout, D.

    2012-01-01

    Background Epidemiological studies suggest a protective effect of n-3 fatty acids derived from fish (eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]) against cognitive decline. For a-linolenic acid (ALA) obtained from vegetable sources, the effect on cognitive decline is unknown. We exami

  18. Rat myocardial protein degradation.

    Steer, J H; Hopkins, B E

    1981-07-01

    1. Myocardial protein degradation rates were determined by following tyrosine release from rat isolated left hemi-atria in vitro. 2. After two 20 min preincubations the rate of tyrosine release from hemi-atria was constant for 4 h. 3. Skeletal muscle protein degradation was determined by following tyrosine release from rat isolated hemi-diaphragm (Fulks, Li & Goldberg, 1975). 4. Insulin (10(-7) M) inhibited tyrosine release from hemi-atria and hemi-diaphragm to a similar extent. A 48 h fast increased tyrosine release rate from hemi-diaphragm and decreased tyrosine release rate from hemi-atria. Hemi-diaphragm tyrosine release was inhibited by 15 mmol/l D-glucose but a variety of concentrations of D-glucose (0, 5, 15 mmol/l) had no effect on tyrosine release from hemi-atria. Five times the normal plasma levels of the branched-chain amino acids leucine, isoleucine and valine had no effect on tyrosine release from either hemi-atria or hemi-diaphragm.

  19. Rethinking Affordable Housing Delivery: An Analytical Insight

    2016-01-01

    Malaysia currently has a housing shortage of 12 million units. Towards the year 2020, this would require an annual supply of a minimum of 2 million homes. With the current production rate, the deficits will remain over the next 100 years. The crisis will lead to poor standards of living, un-affordable rental price, high mortgage payment, abandonment, and dilapidation of the existing housing stock. Lack of affordable housing is already a source of concern among many Malaysians. The middle and ...

  20. Affordance Learning Based on Subtask's Optimal Strategy

    Huaqing Min

    2015-08-01

    Full Text Available Affordances define the relationships between the robot and environment, in terms of actions that the robot is able to perform. Prior work is mainly about predicting the possibility of a reactive action, and the object's affordance is invariable. However, in the domain of dynamic programming, a robot’s task could often be decomposed into several subtasks, and each subtask could limit the search space. As a result, the robot only needs to replan its sub strategy when an unexpected situation happens, and an object’s affordance might change over time depending on the robot’s state and current subtask. In this paper, we propose a novel affordance model linking the subtask, object, robot state and optimal action. An affordance represents the first action of the optimal strategy under the current subtask when detecting an object, and its influence is promoted from a primitive action to the subtask strategy. Furthermore, hierarchical reinforcement learning and state abstraction mechanism are introduced to learn the task graph and reduce state space. In the navigation experiment, the robot equipped with a camera could learn the objects’ crucial characteristics, and gain their affordances in different subtasks.

  1. Critical review and meta-analysis on the combination of heart-type fatty acid binding protein (H-FABP) and troponin for early diagnosis of acute myocardial infarction.

    Lippi, Giuseppe; Mattiuzzi, Camilla; Cervellin, Gianfranco

    2013-01-01

    An early diagnosis is crucial for effective triage and management of patients with suspected acute myocardial infarction (AMI). Although troponin testing is the cornerstone of diagnosis, the sensitivity of this biomarker is still suboptimal at patient admission. The heart-type fatty acid binding protein (H-FABP) is an early and sensitive biomarker of myocardial ischemia, whose appropriate setting is in combination with troponin testing. We performed a systematic review and meta-analysis of articles that have assessed the combination of troponin and H-FABP in the early diagnosis of AMI. Eight studies, totaling 2735 patients, met the inclusion criteria but none of them used a high-sensitivity troponin immunoassay. The between-study variation was high (98.5%), and attributable to heterogeneity. When considered alone, troponin exhibited a significantly greater pooled area under the curve (AUC) than H-FABP alone (0.820 versus 0.784; ptroponin alone than for H-FABP alone (0.94 versus 0.83; ptroponin than for H-FABP (0.73 versus 0.80; p=0.02). The combination of both biomarkers exhibited a greater AUC than troponin alone (0.881; ptroponin immunoassay seems advantageous for increasing the sensitivity of the former biomarker, at the expense of a lower specificity. The introduction of H-FABP testing would hence require careful assessment of laboratory data or clinical signs and symptoms for excluding sources of elevation different from AMI. Further studies are needed to assess the diagnostic effectiveness of combining H-FABP with a high-sensitivity troponin immunoassay.

  2. Affordances for robots: a brief survey

    Thomas E. Horton

    2012-12-01

    Full Text Available In this paper, we consider the influence of Gibson's affordance theory on the design of robotic agents. Affordance theory (and the ecological approach to agent design in general has in many cases contributed to the development of successful robotic systems; we provide a brief survey of AI research in this area. However, there remain significant issues that complicate discussions on this topic, particularly in the exchange of ideas between researchers in artificial intelligence and ecological psychology. We identify some of these issues, specifically the lack of a generally accepted definition of "affordance" and fundamental differences in the current approaches taken in AI and ecological psychology. While we consider reconciliation between these fields to be possible and mutually beneficial, it will require some flexibility on the issue of direct perception.

  3. The Transformation of Ergonomic Affordances into Cultural Affordances: The Case of the Alnuset System

    Chiappini, Giampaolo

    2012-01-01

    Is it possible to study the ergonomic affordances offered by a system designed for educational aims and their transformation into cultural affordances? To this purpose, what references can we adopt? This work describes the theoretical framework used to realise this study referring to AlNuSet, a system realised within the EC ReMath project to…

  4. Affordances and distributed cognition in museum exhibitions

    Achiam, Marianne; May, Michael; Marandino, Martha

    2014-01-01

    consistent framework. Here, we invoke the notions of affordance and distributed cognition to explain in a coherent way how visitors interact with exhibits and exhibit spaces and make meaning from those interactions, and we exemplify our points using observations of twelve visitors to exhibits at a natural...... history museum. We show how differences in exhibit characteristics give rise to differences in the interpretive strategies used by visitors in their meaning-making process, and conclude by discussing how the notions of affordance and distributed cognition can be used in an exhibit design perspective....

  5. Learning to grasp and extract affordances: the Integrated Learning of Grasps and Affordances (ILGA) model.

    Bonaiuto, James; Arbib, Michael A

    2015-12-01

    The activity of certain parietal neurons has been interpreted as encoding affordances (directly perceivable opportunities) for grasping. Separate computational models have been developed for infant grasp learning and affordance learning, but no single model has yet combined these processes in a neurobiologically plausible way. We present the Integrated Learning of Grasps and Affordances (ILGA) model that simultaneously learns grasp affordances from visual object features and motor parameters for planning grasps using trial-and-error reinforcement learning. As in the Infant Learning to Grasp Model, we model a stage of infant development prior to the onset of sophisticated visual processing of hand-object relations, but we assume that certain premotor neurons activate neural populations in primary motor cortex that synergistically control different combinations of fingers. The ILGA model is able to extract affordance representations from visual object features, learn motor parameters for generating stable grasps, and generalize its learned representations to novel objects.

  6. Progress in Research on the Relationship Between Acute Myocardial Infarction and Acid-Base Imbalance%急性心肌梗死与酸碱失衡关系的研究进展

    郭俊玲

    2011-01-01

    急性心肌梗死是内科常见的危重病,病情变化快,可出现酸碱平衡失调,尤其在心肌梗死后心源性休克的患者中更加常见,临床研究表明酸碱失衡可影响急性心肌梗死患者的短期预后,临床上认知各种酸碱失衡指标对于急性心肌梗死患者的应用价值,可以更准确的判断病情,及时指导治疗.%Acute myocardial infarction (AMI) is a common occurrence. AMI may be followed by metabolic acidosis. Clinical studies have shown that acid-base imbalances can affect the short-term prognosis of patients with AMI. This article examines the value of various acid-base imbalances index for patients with AMI, and discusses whether or not they can assist in making an accurate judgment of the illness and provide timely therapy.

  7. No Role for Motor Affordances in Visual Working Memory

    Pecher, Diane

    2013-01-01

    Motor affordances have been shown to play a role in visual object identification and categorization. The present study explored whether working memory is likewise supported by motor affordances. Use of motor affordances should be disrupted by motor interference, and this effect should be larger for objects that have motor affordances than for…

  8. Affordances of Instrumentation in General Chemistry Laboratories

    Sherman, Kristin Mary Daniels

    2010-01-01

    The purpose of this study is to find out what students in the first chemistry course at the undergraduate level (general chemistry for science majors) know about the affordances of instrumentation used in the general chemistry laboratory and how their knowledge develops over time. Overall, students see the PASCO(TM) system as a useful and accurate…

  9. Pico-hydro for affordable village power

    NONE

    2000-04-15

    This project developed and disseminated 'off-the-shelf' hydro generator units of up to 5kW that are: directly affordable by villagers in remote communities of developing counties; financially viable through fuel savings and income generation; and suitable for local manufacture and use in adverse conditions. Work was undertaken in Nepal, Colombia and Peru. (author)

  10. Diabetes and the Affordable Care Act.

    Burge, Mark R; Schade, David S

    2014-07-01

    The Affordable Care Act--"Obamacare"--is the most important federal medical legislation to be enacted since Medicare. Although the goal of the Affordable Care Act is to improve healthcare coverage, access, and quality for all Americans, people with diabetes are especially poised to benefit from the comprehensive reforms included in the act. Signed into law in 2010, this massive legislation will slowly be enacted over the next 10 years. In the making for at least a decade, it will affect every person in the United States, either directly or indirectly. In this review, we discuss the major changes in healthcare that will take place in the next several years, including (1) who needs to purchase insurance on the Web-based exchange, (2) the cost to individuals and the rebates that they may expect, (3) the rules and regulations for purchasing insurance, (4) the characteristics of the different "metallic" insurance plans that are available, and (5) the states that have agreed to participate. With both tables and figures, we have tried to make the Affordable Care Act both understandable and appreciated. The goal of this comprehensive review is to highlight aspects of the Affordable Care Act that are of importance to practitioners who care for people with diabetes by discussing both the positive and the potentially negative aspects of the program as they relate to diabetes care.

  11. Housing Affordability And Children's Cognitive Achievement.

    Newman, Sandra; Holupka, C Scott

    2016-11-01

    Housing cost burden-the fraction of income spent on housing-is the most prevalent housing problem affecting the healthy development of millions of low- and moderate-income children. By affecting disposable income, a high burden affects parents' expenditures on both necessities for and enrichment of their children, as well as investments in their children. Reducing those expenditures and investments, in turn, can affect children's development, including their cognitive skills and physical, social, and emotional health. This article summarizes the first empirical evidence of the effects of housing affordability on children's cognitive achievement and on one factor that appears to contribute to these effects: the larger expenditures on child enrichment by families in affordable housing. We found that housing cost burden has the same relationship to both children's cognitive achievement and enrichment spending on children, exhibiting an inverted U shape in both cases. The maximum benefit occurs when housing cost burden is near 30 percent of income-the long-standing rule-of-thumb definition of affordable housing. The effect of the burden is stronger on children's math ability than on their reading comprehension and is more pronounced with burdens above the 30 percent standard. For enrichment spending, the curve is "shallower" (meaning the effect of optimal affordability is less pronounced) but still significant.

  12. Effects of broken affordance on visual extinction.

    Wulff, Melanie; Humphreys, Glyn W

    2015-01-01

    Previous studies have shown that visual extinction can be reduced if two objects are positioned to "afford" an action. Here we tested if this affordance effect was disrupted by "breaking" the affordance, i.e., if one of the objects actively used in the action had a broken handle. We assessed the effects of broken affordance on recovery from extinction in eight patients with right hemisphere lesions and left-sided extinction. Patients viewed object pairs that were or were not commonly used together and that were positioned for left- or right-hand actions. In the unrelated pair conditions, either two tools or two objects were presented. In line with previous research (e.g., Riddoch et al., 2006), extinction was reduced when action-related object pairs and when unrelated tool pairs were presented compared to unrelated object pairs. There was no significant difference in recovery rate between action-related (object-tool) and unrelated tool pairs. In addition, performance with action-related objects decreased when the tool appeared on the ipsilesional side compared to when it was on the contralesional side, but only when the tool handle was intact. There were minimal effects of breaking the handle of an object rather than a tool, and there was no effect of breaking the handle on either tools or objects on single item trials. The data suggest that breaking the handle of a tool lessens the degree to which it captures attention, with this attentional capture being strongest when the tool appears on the ipsilesional side. The capture of attention by the ipsilesional item then reduces the chance of detecting the contralesional stimulus. This attentional capture effect is mediated by the affordance to the intact tool.

  13. Effects of broken affordance on visual extinction

    Melanie eWulff

    2015-09-01

    Full Text Available Previous studies have shown that visual extinction can be reduced if two objects are positioned to afford an action. Here we tested if this affordance effect was disrupted by breaking the affordance – if one of the objects actively used in the action had a broken handle. We assessed the effects of broken affordance on recovery from extinction in eight patients with right hemisphere lesions and left-sided extinction. Patients viewed object pairs that were or were not commonly used together and that were positioned for left- or right-hand actions. In the unrelated pair conditions, either two tools or two objects were presented. In line with previous research (e.g., Riddoch et al., 2006, extinction was reduced when action-related object pairs and when unrelated tool pairs were presented compared to unrelated object pairs. There was no significant difference in recovery rate between action-related (object-tool and unrelated tool-tool pairs. In addition, performance with action-related objects decreased when the tool appeared on the ipsilesional side compared to when it was on the contralesional side, but only when the tool handle was intact. There were minimal effects of breaking the handle of an object rather than a tool, and there was no effect of breaking the handle on either tools or objects on single item trials. The data suggest that breaking the handle of a tool lessens the degree to which it captures attention, with this attentional capture being strongest when the tool appears on the ipsilesional side. The capture of attention by the ipsilesional item then reduces the chance of detecting the contralesional stimulus. This attentional capture effect is mediated by the affordance to the intact tool.

  14. Serum content of oleic acid is associated with higher platelet-, endothelial- and leukocyte-derived circulating microparticles in Norwegian normolipidemic elderly patients after an acute myocardial infarction

    Chiva-Blanch, G; Bratseth, V; Laake, K;

    2016-01-01

    OBJECTIVES The content in adipose tissue of marine n-3 polyunsaturated fatty acids (PUFAs) is a marker of long-term fish consumption and data suggest an antiarrhythmic effect of n-3 PUFAs. We investigated the correlation between adipose tissue content of the major n-3 PUFAs, eicosapentaenoic acid...... (EPA) and docosahexaenoic acid (DHA), from three different adipose tissue compartments [epicardial (EAT), pericardial (PAT) and subcutaneous (SAT)]. Furthermore, we studied the correlation between the content of EPA and DHA in these compartments and in atrial tissue (AT). METHODS We obtained AT from...

  15. Evaluation of Myocardial Viability after Myocardial Infarction with Intravenous Real-time Myocardial Contrast Echocardiography

    Weihui SHENTU; Yuhan WU; Youbin DENG; Runqing HUANG; Peng LI; Xiang WEI; Haoyi YANG; Yun ZHANG; Li XIONG; Fen YU

    2008-01-01

    The myocardial viability after myocardial infarction was evaluated by intravenous myocardial contrast echocardiography. Intravenous real-time myocardial contrast echocardiography was performed on 18 patients with myocardial infarction before coronary revascularization. Follow-up echocardiography was performed 3 months after coronary revascularization. Segmental wall motion was assessed using 18-segment LV model and classified as normal, hypokinesis, akinesis and dyskinesis. Viable myocardium was defined by evident improvement of segmental wall motion 3 months after coronary revascularization. Myocardial perfusion was assessed by visual interpretation and divided into 3 conditions: homogeneous opacification; partial or reduced opaciflcation or subendocardial contrast defect; contrast defect. The former two conditions were used as the standard to define the viable myocardium. The results showed that 109 abnormal wall motion segments were detected among 18 patients with myocardial infarction, including 47 segments of hypokinesis, 56 segments of akinesis and 6 segments of dyskinesis. The wall motion of 2 segments with hypokinesis before coronary revascularization which showed homogeneous opacification, 14 of 24 segments with hypokinese and 20 of 24 segments with akinese before coronary revascularization which showed partial or reduced opaciflcation or subendocardial contrast defect was improved 3 months after coronary revascularization. In our study, the sensitivity and specificity of evaluation of myocardial viability after myocardial infarction by intravenous real-time myocardial contrast echocardiography were 94.7% and 78.9%, respectively. It was concluded that intravenous real-time myocardial contrast echocardiography could accurately evaluate myocardial viability after myocardial infarction.

  16. Affordances and the musically extended mind

    Joel eKrueger

    2014-01-01

    Full Text Available I defend a model of the musically extended mind. I consider how acts of musicking grant access to novel emotional experiences otherwise inaccessible. First, I discuss the idea of musical affordances and specify both what musical affordances are and how they invite different forms of entrainment. Next, I argue that musical affordances—via soliciting different forms of entrainment—enhance the functionality of various endogenous, emotion-granting regulative processes, drawing novel experiences out of us with an expanded complexity and phenomenal character. I suggest that music therefore ought to be thought of as part of the vehicle needed to realize these emotional experiences. I appeal to different sources of empirical work to develop this idea.

  17. 脂肪酸逆转局麻药心肌毒性的药理机制研究进展%Progress in Pharmacological Mechanism for the Role of Fatty Acid in Reversal of Myocardial Toxicity of Local Anesthetics

    高晶; 刘超

    2014-01-01

    目前尚没有特异的局麻药解毒剂,严重阻碍了临床治疗效果,寻找有效的局麻药解毒剂日益紧迫。本文从脂肪池、能量代谢、NO、离子通道和增溶作用来诠释脂肪酸逆转局麻药心肌毒性的分子药理学机制,并比较了纳米脂质体与普通脂肪乳剂结构和功能上的不同的特点。%At present, there is no specific antidote for local anesthetic toxicity, which seriously hindered therapeutic efficts of clinical treatment. It is increasingly urgent for finding find the effective antidote to local anesthetic. This article at-tempts to interpret the molecular pharmacological mechanism from fat pool, energy metabolism, NO, ion channel and solubili-zation for the role of fatty acids in reversal of myocardial toxicity of local anesthetics. And the different characteristics of the structure and function of nano liposome and fat emulsion were compared.

  18. Affordability of medicines in the European Union

    Zaprutko, Tomasz; Kopciuch, Dorota; Kus, Krzysztof; Merks, Piotr; Nowicka, Monika; Augustyniak, Izabela; Nowakowska, Elżbieta

    2017-01-01

    Background Medications and their prices are key issues for healthcare. Although access to medicines at affordable prices had been specified as a key objective of the European Health Policy, it seems that these goals have not been achieved. Therefore, we attempted an evaluation of affordability of selected medicines at full prices. Methods The analysis concerned 2012 and was conducted between 2013 and 2015 in all the European Union (EU) countries divided into 3 groups depending on the date of their accession to the EU. Finally, we considered 9 originators used in the treatment of schizophrenia and multiple sclerosis. Information on drug prices were collected from pharmacies. Participation in the study was voluntary and anonymous in order to avoid accusations of advertising. To evaluate affordability, several factors were used (e.g. minimum earnings and Gini coefficient). Due to unavailability in some countries, the exact number of analyzed medicines varies. Results Drug prices vary significantly between EU Member States. Almost eleven fold difference was observed between Germany (EUR 1451.17) and Croatia (EUR 132.77) in relation to Interferone beta-1a 22 μg. Generally, prices were the highest in Germany. The cheapest drugs were found in various countries but never in the poorest ones like Bulgaria or Romania. Discrepancies in wages were observed too (the smallest minimum wage was EUR 138.00 in Bulgaria and the highest EUR 1801.00 in Luxembourg). Full price of olanzapine 5mg, however, was higher in Bulgaria (EUR 64.53) than, for instance, in Belgium (EUR 37.26). Conclusions Analyzed medications are still unaffordable for many citizens of the EU. Besides, access to medicines is also impaired e.g. due to parallel trade. Unaffordability of medications may lead to the patients’ non-compliance and therefore to increased direct and indirect costs of treatment. Common European solutions are needed to achieve a real affordability and accessibility of medications. PMID

  19. Depression after myocardial infarction.

    Ziegelstein, R C

    2001-01-01

    Depression is an independent risk factor for increased postmyocardial infarction morbidity and mortality, even after controlling for the extent of coronary artery disease, infarct size, and the severity of left ventricular dysfunction. This risk factor takes on added significance when one considers that almost half of patients recovering from a myocardial infarction have major or minor depression and that major depression alone occurs in about one in five of these individuals. Despite the well-documented risk of depression, questions remain about the mechanism of the relationship between mood disturbance and adverse outcome. The link may be explained by an association with lower levels of social support, poor adherence to recommended medical therapy and lifestyle changes intended to reduce the risk of subsequent cardiac events, disturbances in autonomic tone, enhanced platelet activation and aggregation, and systemic immune activation. Unfortunately, questions about the pathophysiologic mechanism of depression in this setting are paralleled by uncertainties about the optimal treatment of depression for patients recovering from a myocardial infarction and by a lack of knowledge about whether treating depression lowers the associated increased mortality risk. Ongoing research studies will help to determine the benefits of psychosocial interventions and of antidepressant therapy for patients soon after myocardial infarction. Although the identification of depression as a risk factor may by itself be a reason to incorporate a comprehensive psychological evaluation into the routine care of patients with myocardial infarction, this practice should certainly become standard if studies show that treating depression reduces the increased mortality risk of these patients.

  20. Research Progress of Chinese Medicine in Inhibiting Myocardial Fatty Acid Metabolism%中医药抑制心脏脂肪酸代谢的研究进展

    王通; 李彬; 朱明军; 王永霞; 高原; 谢世阳; 谢航; 郝轩轩

    2016-01-01

    慢性心力衰竭(CHF)是一种由各种心脏疾病导致心功能不全的复杂临床症候群,是各种心脏疾患的终末状态。能量代谢障碍是心衰的原因,也可作为心衰的继发后果。21世纪,以心肌代谢重构为靶点的心肌代谢疗法成为治疗热点,也是治疗理念的一大转变,针对慢性心力衰竭,中医药在控制症状﹑改善预后﹑减少西药毒副反应﹑调整病人机体的免疫功能﹑减少心衰复发和提高病人生活质量等方面具有独特的疗效优势,因此,慢性心衰是心血管领域中医药防治的优势病种,以抑制心脏脂肪酸代谢为切入点,开展中医药调控心肌能量代谢防治慢性心力衰竭具有广阔前景和应用价值。%Chronic heart failure(CHF)is a complex clinical symptom group,which is caused by various heart diseases,and is the end of al kinds of heart diseases.Energy metabolism disorders can be used as the cause of heart failure,but also as a secondary conse-quence of heart failure.In twenty first century,myocardial metabolic therapy,which is the target of myocardial metabolism,has be-come a hot spot for treatment,but also a major change in the concept of treatment,in chronic heart failure,Chinese medicine to con-trol symptoms,improve the prognosis and reduce the drug adverse reaction,adjust the body of the patient's immune function,reduce the recurrence of heart failure,improve the quality of life of patients and has unique advantages in efficacy.CHF is the dominant dis-eases of cardiovascular field of prevention and treatment of Chinese medicine,to inhibit the metabolism of fatty acids as starting point and has a broad prospect and application value to carry out Chinese medicine in regulation of myocardial energy metabolism in pre-vention and treatment of chronic heart failure.

  1. Active Affordance Learning in Continuous State and Action Spaces

    Wang, C.; Hindriks, K.V.; Babuska, R.

    2014-01-01

    Learning object affordances and manipulation skills is essential for developing cognitive service robots. We propose an active affordance learning approach in continuous state and action spaces without manual discretization of states or exploratory motor primitives. During exploration in the action

  2. Experiments on affordance in the journal "ecological psychology"

    Trettvik, Johan

    2009-01-01

    There are two general aims: 1) to review how the concept of affordance is construed, in theory as well as in practice/experiments, and 2) to review the experiments on affordances.......There are two general aims: 1) to review how the concept of affordance is construed, in theory as well as in practice/experiments, and 2) to review the experiments on affordances....

  3. Screening of Bioactive Ingredients in Ligusticum Chuanxiong Hort for Protection against Myocardial Ischemia

    Xu Liu

    2016-12-01

    Full Text Available Background/Aims: To study the spectrum-effect relationship and effective components of Ligusticum Chuanxiong Hort. (LCH on the protection of canine myocardial ischemia. Methods: Fingerprint spectrum of LCH extracts was developed using high performance liquid chromatography (HPLC, and a canine model of acute myocardial ischemia was established by ligating the coronary artery. Bivariate correlation analysis and multivariate regression analysis were used to correlate the pharmacodynamics of LCH extract and its common peaks in HPLC. Results: The bioactive components of LCH were ligustrazine, ferulic acid, cnidilide and ligustilide. Ligustrazine and ferulic acid could significantly reduce serum lactic acid in canine model of acute myocardial ischemia, while ligustilide could significantly reduce the elevation of serum free fatty acid. Conclusions: The spectrum-effect relationship study shows that the effective components of LCH are ligustrazine, ferulic acid, cnidilide and ligustilide, which have protective effect on myocardial ischemia.

  4. The Affordable Care Act and integrated care.

    Kuramoto, Ford

    2014-01-01

    The Patient Protection and Affordable Care Act (ACA) of 2010 offers a comprehensive, integrated health insurance reform program for those who are eligible to enroll. A core feature of the ACA is the integration of primary health, behavioral health, and related services in a new national program for the first time. This article traces the history of past federal services integration efforts and identify varying approaches for implementing them to improve care, especially for underserved populations. The business case for integrated care, reducing escalating health care costs and overcoming barriers to implementation, is also discussed.

  5. Contraceptive Coverage and the Affordable Care Act.

    Tschann, Mary; Soon, Reni

    2015-12-01

    A major goal of the Patient Protection and Affordable Care Act is reducing healthcare spending by shifting the focus of healthcare toward preventive care. Preventive services, including all FDA-approved contraception, must be provided to patients without cost-sharing under the ACA. No-cost contraception has been shown to increase uptake of highly effective birth control methods and reduce unintended pregnancy and abortion; however, some institutions and corporations argue that providing contraceptive coverage infringes on their religious beliefs. The contraceptive coverage mandate is evolving due to legal challenges, but it has already demonstrated success in reducing costs and improving access to contraception.

  6. Breastfeeding and the Affordable Care Act.

    Hawkins, Summer Sherburne; Dow-Fleisner, Sarah; Noble, Alice

    2015-10-01

    Mothers who receive or qualify for the Women, Infants, and Children (WIC) program or have lower income are less likely to start and continue breastfeeding than their more advantaged counterparts. The Patient Protection and Affordable Care Act (ACA) requires employers to provide break time and space to express breast milk and requires insurance companies to cover breastfeeding support, supplies, and counseling at no cost to mothers. This ACA benefit does not extend to all Medicaid recipients or women in the WIC program. Legislative and regulatory efforts are needed to provide comprehensive coverage for all women and reduce disparities in breastfeeding.

  7. 体外循环下低pH液复灌对兔心肌缺血再灌注损伤的影响%Effect of acidic reperfusion on myocardial ischemia/reperfusion injury by cardiopulmonary bypass in rabbits

    杨海燕; 刘新伟; 王群英; 马亚飞; 刘柳

    2011-01-01

    Objective: To determine the effect of acidic reperfusion on myocardial ischemia/reperfusion injury by cardiopulmonary bypass (CPB) and choose the optimum pH of perfusion fluid. Methods: thirty adult New Zealand white rabbits of both sexes weighing 2.5~3.0 kg were randomly divided into 5 groups (n=6 each). In control group, CPB was executed for 180 min without aortic clamping. In the other groups,hearts were subjected to ischemia for 40 min followed by 120 min of reperfusion,and were respectively perfused with Krebs-Henseleit bicarbonate buffer solution at pH 7.4, 7.1, 6.9 and 6.7 in the first 2 min of referfusion. After 2 h reperfusion,the lactate dehydrogenase (LDH) activity was tested with colorimetric method, cardiac troponin Ⅰ (cTnI) concentration was determined with ELISA and myocardial tissues were observed by light microscopy and transmission electron microscope. Results: In the other groups,the LDH activity and cTnI concentration were significantly increased as compared with in the control group (P<0.05). Compared with pH 7.4 group, the LDH activity and cTnI concentration were significantly lower in acidic reperfusion groups (P<0.05),and were lowest in pH 6.9 group. The pH 7.4 group showed the most serious injury while the pH 6.9 group showed the least damage in the acidic reperfusion groups by pathological examination. Conclusion: Acidic reperfusion can attenuate the myocardial ischemia/reperfusion injury by CPB in rabbits and the reperfusion of Krebs-Henseleit bicarbonate buffer solution of pH 6.9 provides best protective effect%目的:探讨体外循环(Cardiopulmonary bypass,CPB)下再灌注初短暂低pH液复灌对兔心肌缺血再灌注损伤的保护作用并确定灌注液的最佳pH值.方法:选择健康成年新西兰大白兔30只,雌雄不拘,体重2.5~3.0 kg,随机分为5组(n=6),对照组不阻断主动脉,单纯转机180 min;其余各组心脏停搏缺血40 min,再灌注120 min,再灌注前2 min分别给予pH值为7.4、7.1、6

  8. [Ability to Overcome the Thrombocyte Resistance to Acetylsalicylic Acid in Patients With Coronary Artery Disease After Myocardial Revascularization With Coronary Stenting].

    Pershukov, I V; Ostaschenko, S L; Kuznetsova, T N; Scherbo, S N; Karben, Z A; Sokryukina, E V; Omarov, A A; Ramazanov, D M; Bosak, N V; Shulzhenko, L V; Kalmatov, R K; Batyraliev, T A; Sidorenko, B A

    2016-07-01

    Resistance to acetylsalicylic acid (ASA) in patients with coronary artery disease is a poor predictor for the development of atherothrombotic complications. In 277 patients with coronary artery disease suffered uncomplicated coronary angioplasty with stent implantation, we was estimated arachidon-induced platelet aggregation during treatment with acetylsalicylic acid by bedside VerifyNow Assay test at 28-90 days after the intervention. It was found that 18.9% of the 144 patients receiving a combination of ASA 75 mg with 15.2 mg of magnesium hydroxide had true (laboratory) resistance to ASA. At the same time on the original enteric coated ASA 100 mg, we can found only 0.8% resistance to ASA among 129 patients. We made switch from combination of ASA 75 mg with 15.2 mg of magnesium hydroxide to original enteric coated ASA 100 mg and repeat VerifyNow Assay test at 2-4 days and found lost of resistance in 92% of 28 patients. Thus, resistance to the ASA is not constant, it depends on the form and the applied dose of ASA, and eliminating more than 92% when ASA changes from ineffective to effective form.

  9. Silent myocardial ischemia.

    Gutterman, David D

    2009-05-01

    Although much progress has been made in reducing mortality from ischemic cardiovascular disease, this condition remains the leading cause of death throughout the world. This might in part be due to the fact that over half of patients have a catastrophic event (heart attack or sudden death) as their initial manifestation of coronary disease. Contributing to this statistic is the observation that the majority of myocardial ischemic episodes are silent, indicating an inability or failure to sense ischemic damage or stress on the heart. This review examines the clinical characteristics of silent myocardial ischemia, and explores mechanisms involved in the generation of angina pectoris. Possible mechanisms for the more common manifestation of injurious reductions in coronary flow; namely, silent ischemia, are also explored. A new theory for the mechanism of silent ischemia is proposed. Finally, the prognostic importance of silent ischemia and potential future directions for research are discussed.

  10. Histochemical and immunohistochemical analyses of the myocardial scar fallowing acute myocardial infarction

    Tatić Vujadin

    2012-01-01

    Full Text Available Background/Aim. The heart has traditionally been considered as a static organ without capacity of regeneration after trauma. Currently, the more and more often asked question is whether the heart has any intrinsic capacities to regenerate myocytes after myocardial infarction. The aim of this study was to present the existence of the preserved muscle fibers in the myocardial scar following myocardial infarction as well as the presence of numerous cells of various size and form that differently reacted to the used immunohistochemical antibodies. Methods. Histological, histochemical and immunohistochemical analyses of myocardial sections taken from 177 patients who had died of acute myocardial infarction and had the myocardial scar following myocardial infarction, were carried out. More sections taken both from the site of acute infarction and scar were examined by the following methods: hematoxylin-eosin (HE, periodic acid schiff (PAS, PAS-diastasis, Masson trichrom, Malory, van Gieson, vimentin, desmin, myosin, myoglobin, alpha actin, smoth muscle actin (SMA, p53, leukocyte common antigen (LCA, proliferating cell nuclear antigen (PCNA, Ki-67, actin HHF35, CD34, CD31, CD45, CD45Ro, CD8, CD20. Results. In all sections taken from the scar region, larger or smaller islets of the preserved muscle fibers with the signs of hypertrophy were found. In the scar, a large number of cells of various size and form: spindle, oval, elongated with abundant cytoplasm, small with one nucleus and cells with scanty cytoplasm, were found. The present cells differently reacted to histochemical and immunohistochemical methods. Large oval cells showed negative reaction to lymphocytic and leukocytic markers, and positive to alpha actin, actin HHF35, Ki-67, myosin, myoglobin and desmin. Elongated cells were also positive to those markers. Small mononuclear cells showed positive reaction to lymphocytic markers. Endothelial and smooth muscle cells in the blood vessel walls

  11. TRIIODOTHYRONINE INCREASES MYOCARDIAL FUNCTION AND PYRUVATE ENTRY INTO THE CITRIC ACID CYCLE AFTER REPERFUSION IN A MODEL OF INFANT CARDIOPULMONARY BYPASS

    Olson, Aaron; Bouchard, Bertrand; Ning, Xue-Han; Isern, Nancy G.; Des Rosiers, Christine; Portman, Michael A.

    2012-03-01

    We utilized a translational model of infant CPB to test the hypothesis that T3 modulates pyruvate entry into the citric acid cycle (CAC) thereby providing the energy support for improved cardiac function after ischemia-reperfusion. Methods and Results: Neonatal piglets received intracoronary [2-13Carbon(13C)]-pyruvate for 40 minutes (8 mM) during control aerobic conditions (Cont) or immediately after reperfusion (IR) from global hypothermic ischemia. A third group (IR-Tr) received T3 (1.2 ug/kg) during reperfusion. We assessed absolute CAC intermediate levels (aCAC) and flux parameters into the CAC through oxidative pyruvate decarboxylation (PDC ) and anaplerotic carboxylation (PC; ) using 13C-labeled pyruvate and isotopomer analysis by gas and liquid chromatography-mass spectrometry and 13C NMR. Neither IR nor IR-Tr modified aCAC. However, compared to IR, T3 (group IR-Tr) increased cardiac power and oxygen consumption after CPB while elevating both PDC and PC (~ four-fold). T3 inhibited IR induced reductions in CAC intermediate molar percent enrichment (MPE) and oxaloacetate(citrate)/malate MPE ratio; an index of aspartate entry into the CAC. Conclusions: T3 markedly enhances PC and PDC thereby providing substrate for elevated cardiac function and work after reperfusion. The increases in pyruvate flux occur with preservation of the CAC intermediate pool. Additionally, T3 inhibition of reductions in CAC intermediate MPEs indicates that T3 reduces the reliance on amino acids (AA) for anaplerosis after reperfusion. Thus, AA should be more available for other functions such as protein synthesis.

  12. Triiodothyronine increases myocardial function and pyruvate entry into the citric acid cycle after reperfusion in a model of infant cardiopulmonary bypass.

    Olson, Aaron K; Bouchard, Bertrand; Ning, Xue-Han; Isern, Nancy; Rosiers, Christine Des; Portman, Michael A

    2012-03-01

    Triiodothyronine (T3) supplementation improves clinical outcomes in infants after cardiac surgery using cardiopulmonary bypass by unknown mechanisms. We utilized a translational model of infant cardiopulmonary bypass to test the hypothesis that T3 modulates pyruvate entry into the citric acid cycle (CAC), thereby providing the energy support for improved cardiac function after ischemia-reperfusion (I/R). Neonatal piglets received intracoronary [2-(13)Carbon((13)C)]pyruvate for 40 min (8 mM) during control aerobic conditions (control) or immediately after reperfusion (I/R) from global hypothermic ischemia. A third group (I/R-Tr) received T3 (1.2 μg/kg) during reperfusion. We assessed absolute CAC intermediate levels and flux parameters into the CAC through oxidative pyruvate decarboxylation (PDC) and anaplerotic carboxylation (PC) using [2-(13)C]pyruvate and isotopomer analysis by gas and liquid chromatography-mass spectrometry and (13)C-nuclear magnetic resonance spectroscopy. When compared with I/R, T3 (group I/R-Tr) increased cardiac power and oxygen consumption after I/R while elevating flux of both PDC and PC (∼4-fold). Although neither I/R nor I/R-Tr modified absolute CAC levels, T3 inhibited I/R-induced reductions in their molar percent enrichment. Furthermore, (13)C-labeling of CAC intermediates suggests that T3 may decrease entry of unlabeled carbons at the level of oxaloacetate through anaplerosis or exchange reaction with asparate. T3 markedly enhances PC and PDC fluxes, thereby providing potential substrate for elevated cardiac function after reperfusion. This T3-induced increase in pyruvate fluxes occurs with preservation of the CAC intermediate pool. Our labeling data raise the possibility that T3 reduces reliance on amino acids for anaplerosis after reperfusion.

  13. What are the affordances of information and communication technologies?

    Grainne Conole

    2004-12-01

    Full Text Available The paper examines the notion that Information and Communication Technologies (ICT have affordances that epitomize the features of our late modern age (Giddens, 1991 and explores whether these affordances (Salomon, 1993, p. 51 can be used to facilitate particular approaches to educational practice. It argues that a clear articulation of these affordances would enable us to understand how these technologies can be most effectively used to support learning and teaching. We believe that any one affordance can be considered to have both positive and negative connotations and the paper draws on social and educational theory to provide an initial taxonomy of these affordances.

  14. Social affordances and the possibility of ecological linguistics.

    Kono, Tetsuya

    2009-12-01

    This paper includes an effort to extend the notion of affordance from a philosophical point of view the importance of ecological approach for social psychology, ethics, and linguistics. Affordances are not always merely physical but also interpersonal and social. I will conceptualize affordance in general and social affordance in particular, and will elucidate the relation between intentional action and affordances, and that between affordances and free will. I will also focus on the relation between social institution and affordance. An extended theory of affordances can provide a way to analyze in concrete ways how social institution works as an implicit background of interpersonal interactions. Ecological approach considers social institution as the producer and maintainer of affordances. Social institutions construct the niches for human beings. Finally, I will argue the possibility of the ecological linguistics. Language is a social institution. The system of signs is the way to articulate and differentiate interpersonal affordances. Language acquires its meaning, i.e. communicative power in the interpersonal interactions, and interpersonal interactions, in turn, develop and are elaborated through the usage of signs. Communication is seen as never aimed to transmit inner ideas to others, but to guide and adjust the behaviors of others thorough articulating the affordance of responsible-ness.

  15. Significance of retardation of abnormal uptake of iodine-123-beta-methyl-p-iodophenyl-pentadecanoic acid myocardial scintigraphy in patients with vasospastic angina

    Inoue, Fumitaka; Hashimoto, Toshio; Uemura, Shiro; Kawamoto, Atsuhiko; Dohi, Kazuhiro [Nara Medical Univ., Kashihara (Japan); Matsushima, Akihiko

    2001-07-01

    This study investigated retardation of abnormal uptake of iodine-123-beta-methyl-p-iodophenyl-pentadecanoic acid (BMIPP) scintigraphy in patients with vasospastic angina. Twenty-three patients with vasospastic angina showed abnormal uptake of BMIPP before medical treatment and had coronary vasospasm induced by acetylcholine. The patients were divided into two groups according to uptake of BMIPP after medical treatment: retardation of abnormal uptake of BMIPP (Group R, n=4) and normal uptake of BMIPP (Group N, n=19). Frequency of chest pain, medical treatment and autonomic nervous activity were compared between the two groups. Furthermore, the frequency of chest pain and uptake of BMIPP in group R were obtained after intensive medical treatment. Autonomic nervous activity was evaluated by heart rate variability on Holter electrocardiography. Heart rate variability contained high-frequency elements (HF; 0.15-0.4 Hz) and low-frequency elements (LF; 0.04-0.15 Hz). LF/HF was estimated for sympathetic nervous activity and HF was estimated for parasympathetic nervous activity. Daytime and nighttime autonomic nervous activity were compared between the two groups. The frequency of chest pain was higher in Group R than in Group N (p<0.05). Medical treatment was not different between the two groups. Circadian variation of sympathetic and parasympathetic nervous activity were absent in Group R. During the nighttime, Group R showed higher sympathetic nervous activity (p<0.05) and lower parasympathetic nervous activity (p<0.01) than Group N. The frequency of chest pain was significantly lower after intensive medical treatment (p<0.05), and uptake of BMIPP returned to normal in Group R. We suspected that the disorder in autonomic nervous activity was more severe in Group R, and thus induced coronary vasospasm. Retardation of abnormal uptake of BMIPP in patients with vasospastic angina indicates poor control of coronary vasospasm. Uptake of BMIPP is useful in the evaluation of

  16. Heart-type Fatty acid-binding protein in Acute Myocardial infarction Evaluation (FAME: Background and design of a diagnostic study in primary care

    Doevendans Pieter A

    2008-04-01

    Full Text Available Abstract Background Currently used biomarkers for cardiac ischemia are elevated in blood plasma after a delay of several hours and therefore unable to detect acute coronary syndrome (ACS in a very early stage. General practitioners (GPs, however, are often confronted with patients suspected of ACS within hours after onset of complaints. This ongoing study aims to evaluate the added diagnostic value beyond clinical assessment for a rapid bedside test for heart-type fatty-acid binding protein (H-FABP, a biomarker that is detectable as soon as one hour after onset of ischemia. Methods Participating GPs perform a blinded H-FABP rapid bedside test (Cardiodetect® in patients with symptoms suggestive of ACS such as chest pain or discomfort at rest. All patients, whether referred to hospital or not, undergo electrocardiography (ECG and venapunction for a plasma troponin test within 12–36 hours after onset of complaints. A final diagnosis will be established by an expert panel consisting of two cardiologists and one general practitioner (blinded to the H-FABP test result, using all available patient information, also including signs and symptoms. The added diagnostic value of the H-FABP test beyond history taking and physical examination will be determined with receiver operating characteristic curves derived from multivariate regression analysis. Conclusion Reasons for presenting the design of our study include the prevention of publication bias and unacknowledged alterations in the study aim, design or data-analysis. To our knowledge this study is the first to assess the diagnostic value of H-FABP outside a hospital-setting. Several previous hospital-based studies showed the potential value of H-FABP in diagnosing ACS. Up to now however it is unclear whether these results are equally promising when the test is used in primary care. The first results are expected in the end of 2008.

  17. Affordable Hybrid Heat Pump Clothes Dryer

    TeGrotenhuis, Ward E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Butterfield, Andrew [Jabil, St. Petersburg, FL (United States); Caldwell, Dustin D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Crook, Alexander [Jabil, St. Petersburg, FL (United States)

    2016-06-30

    This project was successful in demonstrating the feasibility of a step change in residential clothes dryer energy efficiency by demonstrating heat pump technology capable of 50% energy savings over conventional standard-size electric dryers with comparable drying times. A prototype system was designed from off-the-shelf components that can meet the project’s efficiency goals and are affordable. An experimental prototype system was built based on the design that reached 50% energy savings. Improvements have been identified that will reduce drying times of over 60 minutes to reach the goal of 40 minutes. Nevertheless, the prototype represents a step change in efficiency over heat pump dryers recently introduced to the U.S. market, with 30% improvement in energy efficiency at comparable drying times.

  18. Why epidemiologists cannot afford to ignore poverty.

    Krieger, Nancy

    2007-11-01

    Epidemiologists cannot afford to ignore poverty. To do so would, first, wrongly obscure the devastating impact of poverty on population health, and, second, undercut our commitment to scientific rigor. At issue is doing correct science, not "politically correct" science. Blot poverty and inequity from view, and not only will we contribute to making suffering invisible but our understanding of disease etiology and distribution will be marred. To make this case, I address current debates about the causal relationships between poverty and health, and provide examples of how failing to consider the impact of socioeconomic position has biased epidemiologic knowledge and harmed the public's health. By definition, the people we study are simultaneously social beings and biologic organisms-and we cannot study the latter without taking into account the former. It is the responsibility of all epidemiologists, and not only social epidemiologists, to keep in mind the connections between poverty and health.

  19. Affordances of form in stanzaic narrative poetry

    B. McHale

    2010-07-01

    Full Text Available This article develops the notion that poetry is crucially distinguished from other forms of verbal art by its foregrounding of segmentivity, the spacing of language. If a measure is regarded as the smallest unit of resistance to meaning, measure determines where gaps open up in a poetic text. Poetry is, however, not only measured, but typically countermeasured and narrative in poetry can also be countermeasured against the segmentation that is specific to narrative. The present article investigates segmentivity in one particular type of narrative poem, namely poems in discontinuous stanzaic forms. The concept of affordances (referring to different potentials for use is applied to the stanzaic form in Edmund Spenser’s “The faerie queene” (1590; 1596 and to the “ottava rima” stanza, as exemplified by Kenneth Koch’s postmodernist narrative poem, “Seasons on earth” (1960; 1977; 1987.

  20. Visual Descriptor Learning for Predicting Grasping Affordances

    Thomsen, Mikkel Tang

    2016-01-01

    consisting of surface features was performed. Dimensions in the visual space were varied and the effects were evaluated with the task of grasping unknown object. The evaluation was performed using a novel probabilistic grasp prediction approach based on neighbourhood analysis. The resulting success...... by the task of grasping unknown objects given visual sensor information. The contributions from this thesis stem from three works that all relate to the task of grasping unknown objects but with particular focus on the visual representation part of the problem. First an investigation of a visual feature space......-rates for predicting grasps were between 75% and 90% depending on the object class. The investigations also provided insights into the importance of selecting a proper visual feature space when utilising it for predicting affordances. As a consequence of the gained insights, a semi-local surface feature, the Sliced...

  1. Affordable Care Act and Diabetes Mellitus.

    Shi, Qian; Nellans, Frank P; Shi, Lizheng

    2015-12-01

    The Affordable Care Act (ACA) has the potential for great impact on U.S. health care, especially for chronic disease patients requiring long-term care and management. The act was designed to improve insurance coverage, health care access, and quality of care for all Americans, which will assist patients with diabetes mellitus in acquiring routine monitoring and diabetes-related complication screening for better health management and outcomes. There is great potential for patients with diabetes to benefit from the new policy mandating health insurance coverage and plan improvement, Medicaid expansion, minimum coverage guarantees, and free preventative care. However, policy variability among states and ACA implementation present challenges to people with diabetes in understanding and optimizing ACA impact. This paper aims to select the most influential components of the ACA as relates to people with diabetes and discuss how the ACA may improve health care for this vulnerable population.

  2. Myocardial protection from ischemia-reperfusion injury by Salvianolic acid A in rats%丹酚酸A对缺血/再灌注心肌的保护作用研究

    杨秀颖; 强桂芬; 张莉; 杜冠华

    2011-01-01

    Aim To investigate the protective effect of Salvianolic acid A (SalA) on myocardial ischemiareperfusion injury and the related mechanisms. Methods Male Sprague Dawley rats were subjected to 10 min of ischemia induced by ligation of the left coronary artery and followed by 2h of reperfusion. 10 min before ischemia, SalA groups were given SalA( 1.5 mg ·kg-1, 0.5 mg · kg-1 respectively ) by intravenous injection, control group received Lidocaine (5 mg·kg-1 ). The effect of SalA on ischemia-reperfusion induced arrhythmia in vivo was observed. We further investigated the effect of SalA on cultured primary neonatal rats cardiac myocytes exposed to hypoxia-reoxygenation. Results Sal A( 1.5 mg · kg -1 ) decreased the ischemic-reperfusion induced arrhythmia and reduced the blood CK and CK-MB levels. SalA had a protective effect on the hypoxia-reoxygenation injury in cardiac myocytes. SalA increased the intracelluar ATP production, and decreased the KCl-induced intracelluar Ca2+ elevation and mitochondrial membrane potential. Conclusion SalA has a protective effect on the myocardial injury induced by ischemia-reperfusion,which might be attributed to the antioxidant activity,the inhibition of calcium paradox, protection of mitochondrial function, and enhancement of the cardiac myocytes' ATP content.%目的 研究丹酚酸A对缺血/再灌注性心肌的保护作用及机制探讨.方法 采用Sprague Dawley大鼠冠状动脉左前降支结扎10 min,再灌注2 h,评价丹酚酸A (1.5、0.5 mg·kg-1)静脉给药对在体状态下大鼠心律失常的影响.以利多卡因(5 mg·kg-1)为阳性对照,各给药组均为结扎前10 min给药.同时评价丹酚酸A对培养的心肌细胞缺氧-复氧损伤的影响.结果 丹酚酸A 1.5 mg·kg-1剂量组静脉给药可降低由于心肌缺血/再灌注引起的心律失常发生率,减少肌酸激酶和肌酸激酶同工酶MB从胞体中的漏出.另外,丹酚酸A可防止心肌细胞缺氧-复氧损伤,

  3. Imagined Affordance: Reconstructing a Keyword for Communication Theory

    Peter Nagy

    2015-09-01

    Full Text Available In this essay, we reconstruct a keyword for communication—affordance. Affordance, adopted from ecological psychology, is now widely used in technology studies, yet the term lacks a clear definition. This is especially problematic for scholars grappling with how to theorize the relationship between technology and sociality for complex socio-technical systems such as machine-learning algorithms, pervasive computing, the Internet of Things, and other such “smart” innovations. Within technology studies, emerging theories of materiality, affect, and mediation all necessitate a richer and more nuanced definition for affordance than the field currently uses. To solve this, we develop the concept of imagined affordance. Imagined affordances emerge between users’ perceptions, attitudes, and expectations; between the materiality and functionality of technologies; and between the intentions and perceptions of designers. We use imagined affordance to evoke the importance of imagination in affordances—expectations for technology that are not fully realized in conscious, rational knowledge. We also use imagined affordance to distinguish our process-oriented, socio-technical definition of affordance from the “imagined” consensus of the field around a flimsier use of the term. We also use it in order to better capture the importance of mediation, materiality, and affect. We suggest that imagined affordance helps to theorize the duality of materiality and communication technology: namely, that people shape their media environments, perceive them, and have agency within them because of imagined affordances.

  4. Measuring myocardial perfusion

    Qayyum, A A; Kastrup, J

    2015-01-01

    -pass of non-ionic and ionic contrast agents, respectively. Absolute quantification with CMR has yet to be established in routine clinical practice, while CT has yet to prove its diagnostic and prognostic value. The upcoming years may change the way we diagnose and treat patients suspected of having CAD......Recently, focus has changed from anatomical assessment of coronary arteries towards functional testing to evaluate the effect of stenosis on the myocardium before intervention. Besides positron-emission tomography (PET), cardiac MRI (CMR), and cardiac CT are able to measure myocardial perfusion...

  5. An Experimental Study of Myocardial Viability with Myocardial Contrast Echocardiography

    张稳柱; 查道刚; 成官迅; 杨绍青; 刘伊丽

    2001-01-01

    Background Myocardial blood flow(MBF) can be quantified with myocardial contrast echocardiography (MCE) during a venous in fusion of microbubble. A minimal MBF is required to maintain cell membrane integrity and myocardial viability in ischemic condition. Thus, we hypothesized that MCE could be used to assess myocardial viability by the determination of MBF. Methods and Results MCE was performed at 4 hours after ligation of proximal left anterior descending coronary artery in 7dogs with constant venous infusions of microbubbles.The video intensity versus pulsing interval plots derived from each myocardial pixel were fitted to an exponential function: y=A(1-e-βt), where y is Ⅵ at pulsing interval t, A reflects rnicrovascular cross- sectional area (or myocardial blood volume), and β reflects mean myocardial microbubble velocity. The product of A · β represents MBF. MBF was also obtained by radiolabeled microsphere method servered as reference.MBF derived by radiolabeled microsphere- method in the regions of normal, ischemia and infarction was 1.5±0.3, 0.7±0.3, 0.3±0.2mL·min-1· g-1respectively. The product of A · β obtained by MCE in those regions was 52. 46 ± 15.09, 24.36 ± 3.89, 3.74± ± 3.80 respectively. There was good correlation between normalized MBF and the normalized A · β (r =0. 81, P = 0. 001 ). Conclusions MCE has an ability to determine myocardial viability in myocardial in farction canine model.

  6. MYOCARDIAL INFARCTION TYPE 2. MYTH OR REALITY?

    V. V. Zhelnov; N. V. Dyatlov; L. I. Dvoretsky

    2016-01-01

    According to The Third Definition of Myocardial Infarction there are five types of myocardial infarction depending on pathogenesis. This review provides actual data about myocardial infarction type 2 mechanism including diagnosis management, epidemiological characteristic and patient prognosis. Previously published data shows discordant information about myocardial infarction type 2 frequency, treatment and diagnostic options. Our clinical observation illustrates these severities in diagnosis...

  7. 75 FR 32480 - Funding Opportunity: Affordable Care Act Medicare Beneficiary Outreach and Assistance Program...

    2010-06-08

    ... HUMAN SERVICES Administration on Aging Funding Opportunity: Affordable Care Act Medicare Beneficiary...: Availability of funding opportunity announcement. Funding Opportunity Title/Program Name: Affordable Care Act... Protection and Affordable Care Act of 2010 (Affordable Care Act). Catalog of Federal Domestic......

  8. Bootstrapping Relational Affordances of Object Pairs using Transfer

    Fichtl, Severin; Kraft, Dirk; Krüger, Norbert;

    2016-01-01

    leverage past knowledge to accelerate current learning (which we call bootstrapping). We learn Random Forest based affordance predictors from visual inputs and demonstrate two approaches to knowledge transfer for bootstrapping. In the first approach (direct bootstrapping), the state-space for a new...... affordance predictor is augmented with the output of previously learnt affordances. In the second approach (category based bootstrapping), we form categories that capture underlying commonalities of a pair of existing affordances and augment the state-space with this category classifier’s output. In addition....... We also show that there is no significant difference in performance between direct and category based bootstrapping....

  9. Affordable underwater wireless optical communication using LEDs

    Pilipenko, Vladimir; Arnon, Shlomi

    2013-09-01

    In recent years the need for high data rate underwater wireless communication (WC) has increased. Nowadays, the conventional technology for underwater communication is acoustic. However, the maximum data rate that acoustic technology can provide is a few kilobits per second. On the other hand, emerging applications such as underwater imaging, networks of sensors and swarms of underwater vehicles require much faster data rates. As a result, underwater optical WC, which can provide much higher data rates, has been proposed as an alternative means of communication. In addition to high data rates, affordable communication systems become an important feature in the development requirements. The outcome of these requirements is a new system design based on off-the-shelf components such as blue and green light emitting diodes (LEDs). This is due to the fact that LEDs offer solutions characterized by low cost, high efficiency, reliability and compactness. However, there are some challenges to be met when incorporating LEDs as part of the optical transmitter, such as low modulation rates and non linearity. In this paper, we review the main challenges facing the incorporation of LEDs as an integral part of underwater WC systems and propose some techniques to mitigate the LED limitations in order to achieve high data rate communication

  10. Robust, affordable, semi-direct Mars mission

    Salotti, Jean-Marc

    2016-10-01

    A new architecture is proposed for the first manned Mars mission, based on current NASA developments (SLS and Orion), chemical propulsion for interplanetary transit, aerocapture for all vehicles, a split strategy, and a long stay on the surface. Two important choices make this architecture affordable and appropriate for the first mission. The first is splitting the Earth return vehicle into two parts that are launched separately and dock in Mars orbit. This is necessary to make aerocapture feasible and efficient, which considerably reduces mass. The second is reducing the crew to 3 astronauts. This simplifies the mission and reduces the SLS payload mass under the 45-metric ton limit for a direct TMI (trans-Mars injection) burn without LEO assembly. Only 4 SLS launches are required. The first takes the Mars ascent vehicle and in situ resource utilization systems to the planet's surface. The second takes the first part of the Earth return vehicle, the habitat, into Mars orbit. Two years later, two further SLS launches take a dual-use habitat (outbound trip and surface), Orion, and an enhanced service module to LEO, and then into Mars orbit, followed by the landing of the habitat on the surface. Transit time is demonstrated to be easily reduced to less than 6 months, with relatively low impact on propellant mass and none at all on the architecture.

  11. Myocardial perfusion at fatal infarction

    Hvid-Jacobsen, K; Møller, J T; Kjøller, E;

    1992-01-01

    In a consecutive study of myocardial scintigraphy in acute ischemic syndrome, four patients had 99mTc-hexamibi injected intravenously before they developed fatal cardiogenic shock. Planar scintigraphy was performed after death. Slices of the hearts after autopsy were analyzed for scintigraphic......, where 83%-92% of the myocardium showed ischemia as defined by a 99mTc-hexamibi uptake below an arbitrary limit on half maximum uptake. Myocardial hypoperfusion might thus aggravate the functional impairment at myocardial infarction and lead to cardiogenic shock....

  12. Protective Effects of Lipoic Acid on Myocardial Injury in SIRS Rats Induced by Lipopolysaccharide%硫辛酸对内毒素诱导的 SIRS大鼠心肌损伤的保护作用

    范志文; 汤彦

    2015-01-01

    ABSTRACT:Objective To explore the protective effects of different dose of lipoic acid onmyocardial inju-ry rats with systemic inflammatory response syndrome ( SIRS) induced by lipopolysaccharide .Methods A total of 75 healthy SD rats were enrolled .Among them,60 rats were intraperitoneally injected with 25mg/kg LPS to establish SIRS model of myocardial injury ,thenthose rats were divided into negative control group ,LA high-dose group ,LA middle-dose group and LA low-dose group ,15 rats in each group .the other 15 rats were intraperitone-ally injected with saline solution ( normal group ) .The levels of NF-κB and IL-1 in myocardium were detected with real-time PCR after 24h,48h and 72h,respectively,and the level of TNF-αwas measured with ELISA.HE staining was used to observe the microscopical change of myocradium tissue .Results After challenge with LPS , the levels of NF-κB,IL-1 and TNF-αin myocardium in negative control group were the highest at 72h.Com-pared with the negative control group ,the levels of NF-κB,IL-1 and TNF-αin LA high-dose group and LA mid-dle-dose group were decreased after treatment for 24h,48h and 72h(P<0.05).With LA dose increase,myo-cardial tissue inflammation reduced accordingly .Conclusion Lipoic acid has a protective effect on myocardial injury of SIRS rats,and the underlyingmechnism may be correlated with inhibition of NF-κB activation and the down-regulation of IL-1 and TNF-αexpression .%目的:以内毒素( lipopolysaccharide ,LPS)诱导法建立全身炎症反应综合征( SIRS)大鼠心肌损伤模型,探讨不同浓度硫辛酸( lipoic acid,LA)对大鼠心肌损伤的保护作用。方法选择健康SD大鼠75只,其中60只腹腔注射内毒素25mg/kg,构建SIRS大鼠心肌损伤模型,再分为阴性对照组、LA大剂量组、LA中剂量组、LA小剂量组,每组15只;其余15只大鼠为正常组。分别于24、48、72h后采用real-time PCR检测各组每只大鼠心

  13. Commercial Platforms Allow Affordable Space Research

    2013-01-01

    At an altitude of about 240 miles, its orbital path carries it over 90 percent of the Earth s population. It circles the Earth in continuous free fall; its crew of six and one Robonaut pass the days, experiencing 16 sunrises and 16 sunsets every 24 hours, in microgravity, an environment in which everything from bodily functions to the physical behavior of materials changes drastically from what is common on the ground. Outside its shielded confines, temperatures cycle from one extreme to the other, radiation is rampant, and atomic oxygen corrodes everything it touches. A unique feat of engineering, the International Space Station (ISS) also represents the most remarkable platform for scientific research ever devised. In 2005, anticipating the space station s potential for NASA and non-NASA scientists alike, the NASA Authorization Act designated the US segment of the ISS as a national laboratory, instructing the Agency to "increase the utilization of the ISS by other Federal entities and the private sector." With the ISS set to maintain operations through at least 2020, the station offers an unprecedented long-term access to space conditions, enabling research not previously possible. "There will be new drug discoveries, new pharmaceuticals, a better understanding of how we affect the planet and how we can maintain it," says Marybeth Edeen, the ISS National Laboratory manager, based at Johnson Space Center. The ISS, she says, represents a major example of the government s role in making such advancements possible. "The government is key in that researchers cannot afford to build the kind of infrastructure that the government can provide. But we then have to make that infrastructure available at a reasonable cost." Enter Jeff Manber, who saw in the ISS National Lab an extraordinary opportunity to advance science, education, and business in ways never before seen.

  14. Oxytocin ameliorates the immediate myocardial injury in heart transplant through down regulation of the neutrophil dependent myocardial apoptosis

    F Fadhil Al-Amran

    2014-01-01

    Conclusion: Oxytocin ameliorates myocardial injury in heart transplant through down-regulation the myocardial inflammatory response, reactive oxygen species, and neutrophil-dependant myocardial apoptosis.

  15. Depression following myocardial infarction

    Larsen, Karen Kjær

    2013-01-01

    Myocardial infarction (MI) is a severe life event that is accompanied by an increased risk of depression. Mounting evidence suggests that post-MI depression is associated with adverse outcomes, but the underlying mechanisms of this association remain unclear, and no previous studies have examined...... whether the mental burden of MI is so heavy that it increases the risk of suicide. Although post-MI depression is common and burdensome, the condition remains under-recognised and under-treated. The development of new strategies to improve the quality of care for people with post-MI depression requires...... thorough understanding of the mechanisms that influence the prognosis as well as knowledge of the present care provided. The purpose of this PhD thesis is accordingly subdivided into four specific aims: 1. To estimate the prevalence of depression in people with MI after three months, and to estimate...

  16. Affordance Analysis--Matching Learning Tasks with Learning Technologies

    Bower, Matt

    2008-01-01

    This article presents a design methodology for matching learning tasks with learning technologies. First a working definition of "affordances" is provided based on the need to describe the action potentials of the technologies (utility). Categories of affordances are then proposed to provide a framework for analysis. Following this, a…

  17. Facilitating investment in affordable housing: towards an Australian model. Draft

    Lawson, J.M.; Berry, M.; Milligan, V.; Yates, J.

    2009-01-01

    This paper argues that sustainable and affordable finance provides a crucial pillar to support the provision of affordable housing in the long term. This finance can take on a variety of forms, comprising grants, public loans, commercial loans as well as shareholder equity. It can be facilitated by

  18. The Influence of Affordability in Strategic Enrollment Management

    Pugh, Susan L.; Thompson, Roger J.

    2008-01-01

    In state houses around the country, one of the common higher education themes is affordability. As tuition costs have increased at rates exceeding that of inflation, students and families have pressed their legislative representatives to examine these increases. Affordability is a term used by various constituent groups, and its definition varies…

  19. An Affordability Comparison Tool (ACT) for Space Transportation

    McCleskey, C. M.; Bollo, T. R.; Garcia, J. L.

    2012-01-01

    NASA bas recently emphasized the importance of affordability for Commercial Crew Development Program (CCDP), Space Launch Systems (SLS) and Multi-Purpose Crew Vehicle (MPCV). System architects and designers are challenged to come up with architectures and designs that do not bust the budget. This paper describes the Affordability Comparison Tool (ACT) analyzes different systems or architecture configurations for affordability that allows for a comparison of: total life cycle cost; annual recurring costs, affordability figures-of-merit, such as cost per pound, cost per seat, and cost per flight, as well as productivity measures, such as payload throughput. Although ACT is not a deterministic model, the paper develops algorithms and parametric factors that use characteristics of the architectures or systems being compared to produce important system outcomes (figures-of-merit). Example applications of outcome figures-of-merit are also documented to provide the designer with information on the relative affordability and productivity of different space transportation applications.

  20. Utility payments in Ukraine: Affordability, subsidies and arrears

    Fankhauser, Samuel [London School of Economics, London (United Kingdom); Rodionova, Yulia [School of Slavonic and East European Studies, University College London, 16 Taviton street, London WC1H 0BW (United Kingdom)], E-mail: y.rodionova@ssees.ucl.ac.uk; Falcetti, Elisabetta [European Bank for Reconstruction and Development (EBRD), London (United Kingdom)

    2008-11-15

    The transition from a planned economy to a market economy has caused considerable hardship for the people of Eastern Europe. One important aspect of the social costs of transition is access to, and the affordability of, basic services like electricity, heat and water, which under communism had been supplied fairly cheaply and abundantly. This paper provides evidence on this issue from the Ukraine Longitudinal Monitoring Survey (ULMS). The paper identifies considerable differences in both access and affordability between different localities in Ukraine. Social protection measures can help to alleviate affordability constraints, but the analysis finds that social support is not well targeted. The currently low tariffs prevent an escalation of affordability problems but constraints nevertheless exist. Many households have accumulated substantial arrears as a consequence, although non-payment is a complex issue and not solely a function of affordability.

  1. Utility payments in Ukraine. Affordability, subsidies and arrears

    Fankhauser, Samuel [London School of Economics, London (United Kingdom); Rodionova, Yulia [School of Slavonic and East European Studies, University College London, 16 Taviton street, London WC1H 0BW (United Kingdom); Falcetti, Elisabetta [European Bank for Reconstruction and Development (EBRD), London (United Kingdom)

    2008-11-15

    The transition from a planned economy to a market economy has caused considerable hardship for the people of Eastern Europe. One important aspect of the social costs of transition is access to, and the affordability of, basic services like electricity, heat and water, which under communism had been supplied fairly cheaply and abundantly. This paper provides evidence on this issue from the Ukraine Longitudinal Monitoring Survey (ULMS). The paper identifies considerable differences in both access and affordability between different localities in Ukraine. Social protection measures can help to alleviate affordability constraints, but the analysis finds that social support is not well targeted. The currently low tariffs prevent an escalation of affordability problems but constraints nevertheless exist. Many households have accumulated substantial arrears as a consequence, although non-payment is a complex issue and not solely a function of affordability. (author)

  2. 10.11.Myocardial disease

    1992-01-01

    920088 Effect and significance of neuro-peptide Y on synthesis of myocardial pro-tein.WANG Tao (王涛),et al.Cardiovasc Lab,3rd Hosp,Beijing Med Univ.Chin Cir J 1991; 6 (5):354-356.The rate of myocardial protein synthesis andthe cardiac content of neuropeptide Y (NPY) inrats were measured by ~3H-leucine incorporation

  3. Intracoronary adenosine improves myocardial perfusion in late reperfused myocardial infarction

    2008-01-01

    Background Myocardial perfusion associates with clinical syndromes and prognosis.Adenosine could improve myocardial perfusion of acute myocardial infarction within 6 hours,but few data are available on late perfusion of myocardial infarction (MI).This study aimed at quantitatively evaluating the value of intracoronary adenosine improving myocardial perfusion in late reperfused MI with myocardial contrast echocardiography(MCE).Methods Twenty-six patients with anterior wall infarcts were divided randomly into 2 groups:adenosine group(n=12) and normal saline group(n=14).Their history of myocardial infarction was about 3-12 weeks.Adenosine or normalsaline was given when the guiding wire crossed the lesion through percutaneous coronary intervention(PCI),then the balloon was dilated and stent(Cypher/Cypher select)was implanted at the lesion.Contrast pulse sequencing MCE with Sonovue contrast via the coronary route was done before PCI and 30 minutes after PCI.Video densitometry and contrast filled-blank area were calculated with the CUSQ off-line software.Heart function and cardiac events were followed up within 30 days.Results Perfusion in the segments of the criminal occlusive coronary artery in the adenosine group was better than that in the saline group(5.71±0.29 vs 4.95±1.22,P<0.05).Ischemic myocardial segment was deminished significantly afterPCI,but the meliorated area was bigger in the adenosine group than in the saline group((1.56±0.60)cm2 vs(1.02±0.56) cm2,P<0.05).The video densitometry in critical segments was also improved significantly in the adenosine group (5.53±0.36 vs 5.26±0.35,P<0.05).Left ventricular ejection fraction(LVEF)was improved in all patients after PCI,but EF was not significant between the two groups((67±6)% vs(62±7)%,P>0.05).There was no in-hospital or 30-day major adverse cardiac event(MACE)in the adenosine group but 3 MACE in the saline group in 30 days after PCI.Conclusions Adenosine could improve myocardial microvascular

  4. The Affording Mars Workshop: Background and Recommendations

    Thronson, Harley A.; Carberry, Christopher

    2014-01-01

    . The workshop was organized around three topical breakout sessions: 1. The ISS and the path to Mars: The critical coming decade 2. Affordability and sustainability: what does it mean and what are its implications within guidelines established at the start of the workshop? 3. Notional sequence(s) of cost-achievable missions for the 2020s to 2030s, including capability objectives at each stage and opportunities for coordinated robotic partnerships.

  5. Are Americans finding affordable coverage in the health insurance marketplaces? Results from the Commonwealth Fund Affordable Care Act Tracking Survey.

    Rasmussen, Petra W; Collins, Sara R; Doty, Michelle M; Beutel, Sophie

    2014-09-01

    By the end of the first open enrollment period for coverage offered through the Affordable Care Act's marketplaces, increasing numbers of people said they found it easy to find a plan they could afford, according to The Commonwealth Fund's Affordable Care Act Tracking Survey, April-June 2014. Adults with low or moderate incomes were more likely to say it was easy to find an affordable plan than were adults with higher incomes. Adults with low or moderate incomes who purchased a plan through the marketplaces this year have similar premium costs and deductibles as adults in the same income ranges with employer-provided coverage. A majority of adults with marketplace coverage gave high ratings to their insurance and were confident in their ability to afford the care they need when sick.

  6. Etiology of amyloidosis determines myocardial 99mTc-DPD uptake in amyloidotic cardiomyopathy.

    Longhi, Simone; Bonfiglioli, Rachele; Obici, Laura; Gagliardi, Christian; Milandri, Agnese; Lorenzini, Massimiliano; Guidalotti, Pier Luigi; Merlini, Giampaolo; Rapezzi, Claudio

    2015-05-01

    Tc-DPD (Tc-3,3-diphosphono-1,2-propanodicarboxylic acid) has a high affinity for transthyretin (TTR)-infiltrated myocardium, allowing a differential diagnosis with light chain cardiac amyloidosis and other nonamyloidotic cardiomyopathies with a hypertrophic phenotype, in which myocardial tracer uptake is low or absent. Myocardial bone tracer uptake in the rarer forms of amyloidosis (eg, apolipoprotein-related) has been rarely studied. We present 4 cases of cardiac amyloidosis that underwent Tc-DPD scintigraphy; myocardial DPD uptake was present in patients with ATTR, wtTTR and apolipoprotein AI and negative in cases with AL and apolipoprotein AII-related disease.

  7. Scintigraphic Assessment of Myocardial Viability

    Bom, Hee Seung [Chonnam University Hospital, Kwangju (Korea, Republic of)

    1993-07-15

    The identification of viable myocardium in patients with coronary artery disease and left ventricular dysfunction is an issue of increasing clinical relevance in the current era of myocardial revascularization. There are at least two forms of reversible myocardial dysfunction. Early reperfusion does not always lead to immediate functional improvement; rather, the return of contractility in tissue salvaged by reperfusion is delayed for hours, days or even weeks, a phenomenon that has been termed {sup s}tunned myocardium{sup .} Some patients with coronary artery disease show myocardial dysfunction ar rest which are associated with reduced perfusion, and which disappear after revascularization; this phenomenon has been termed {sup h}ibernating myocardium{sup .} Recently, cardiac imaging techniques that evaluate myocardial viability on the basis of perfusion contraction mismatch and inotropic reserve have gained substantial popularity and clinical success. This review focus on the application of {sup 201}T1 and {sup 99m}Tc-MIBI to address myocardial viability in patients with hibernating and stunned myocardium. It is clear that 4-hour redistribution images of {sup 201}T1 underestimate ischemia and overestimate scar. Delayed imaging and reinjection imaging have been developed for the assessment of viability. Among many protocols suggested, stress-redistribution-reinjection imaging gained most popularity. Although {sup 99m}Tc- MIBI could identify myocardial viability, {sup 201}T1 reinjection technique was regarded as superior to it. In conclusion, {sup 201}T1 stress, 4-hr rest redistribution, and reinjection imaging technique may be the most preferable method for evaluation of myocardial viability.

  8. Can consumers make affordable care affordable? The value of choice architecture.

    Eric J Johnson

    Full Text Available Tens of millions of people are currently choosing health coverage on a state or federal health insurance exchange as part of the Patient Protection and Affordable Care Act. We examine how well people make these choices, how well they think they do, and what can be done to improve these choices. We conducted 6 experiments asking people to choose the most cost-effective policy using websites modeled on current exchanges. Our results suggest there is significant room for improvement. Without interventions, respondents perform at near chance levels and show a significant bias, overweighting out-of-pocket expenses and deductibles. Financial incentives do not improve performance, and decision-makers do not realize that they are performing poorly. However, performance can be improved quite markedly by providing calculation aids, and by choosing a "smart" default. Implementing these psychologically based principles could save purchasers of policies and taxpayers approximately 10 billion dollars every year.

  9. Regional Myocardial Substrate Uptake in Hypertensive Rats: A Quantitative Autoradiographic Measurement

    Yonekura, Yoshiharu; Bertrand Brill, A.; Som, Prantika; Yamamoto, Kazutaka; Srivastava, Suresh C.; Iwai, Junichi; Elmaleh, David R.; Livni, Eli; Strauss, H. William; Goodman, Mark M.; Knapp, Furn F.

    1985-03-01

    Severe hypertension causes global and regional changes in myocardial perfusion and substrate utilization. Regional perfusion and fatty acid utilization were evaluated by dual-tracer autoradiography in normotensive and hypertensive rats of the Dahl strain. The regional distributions of perfusion and fatty acid utilization were homogeneous in normotensive rats. Severe hypertension was associated with a homogeneous pattern of regional perfusion, but fatty acid utilization was focally decreased in the free wall of the left ventricle. The decrease in fatty acid uptake was associated with a concomitant increase in glucose utilization. These findings suggest that severe hypertension is associated with uniform myocardial perfusion and focal alterations in the substrates used for the performance of myocardial work.

  10. Developing an Assessment Framework for Affordable and Sustainable Housing

    Stephen Pullen

    2010-07-01

    Full Text Available Sustainable housing has been subject to research, practice and policy making for some considerable time. More recently attention has been drawn to the separate problem of declining affordability in housing. This paper describes research aimed at developing an assessment framework for both affordability and sustainability as part of the effort to incorporate both of these features into new housing projects. The research has a particular focus on developments aimed at urban densification. Background literature on both affordability and sustainability is reviewed as well as emerging schemes aimed at dealing with both aspects of housing developments. Performance indicators are identified and these are incorporated in an interim assessment framework which is tested using a group of industry experts. The research has highlighted areas where further development is required to attain quantitative assessments of affordable and sustainable housing developments

  11. Practical measurement of affordability: An application to medicines

    L.M. Niëns (Laurens); E. Van de Poel (Ellen); A. Cameron; M. Ewen; R. Laing; W.B.F. Brouwer (Werner)

    2012-01-01

    textabstractObjective: To develop two practical methods for measuring the affordability of medicines in developing countries. Methods The proposed methods - catastrophic and impoverishment methods - rely on easily accessible aggregated expenditure data and take into account a country's income distri

  12. Heart-type fatty acid binding protein in the early diagnosis of myocardial infarction after off-pump coronary artery bypass%心肌型脂肪酸结合蛋白早期快速诊断OPCAB术后心肌梗死

    孟冬梅; 李培军; 刘子后; 李杰; 孙静; 郭志刚; 刘建实

    2012-01-01

    目的 探讨心肌型脂肪酸结合蛋白(H-FABP)对非体外循环不停跳冠状动脉旁路移植术(OPCAB)术后心肌梗死的早期快速诊断价值.方法 2009年3月至7月,59例患者行首次单纯OPCAB.根据围手术期肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白Ⅰ(cTnI)值及心电图、超声心动图的变化将患者分为正常组(Ⅰ组)、心肌损伤组(Ⅱ组)和心肌梗死组(Ⅲ组),分析各组H-FABP、CK-MB、cTnI含量的变化,并应用ROC曲线分析H-FABP诊断术后急性心肌梗死的诊断截断点和应用价值.结果 Ⅲ组的H-FABP水平显著高于Ⅱ组及Ⅰ组(P<0.01),H-FABP峰值出现时间早(人ICU 2 h即达到高峰),维持时间短(入ICU 4 h即开始下降),术后1天回到基线水平.经ROC曲线检验,以H-FABP 22μg/L为心肌梗死的诊断截断点,入ICU即刻诊断灵敏度为90.9%,特异性为77.1%.入ICU 2 h的H-FABP值灵敏度为72.7%,特异性为75.0%.结论 H-FABP有助于OPCAB术后心肌梗死的早期快速诊断.%Objective To evaluate the early diagnostic value of Heart-type fatty acid-binding protein(H-FABP) for myocardial infarction in patients post off-pump coronary artery bypass (OPCAB).Methods Between March 2009 and July 2009,59 patients had been undergone OPCAB for the first time.They were divided into 3 groups (normal group,myocardial injury group and myocardial infarction group) by myocardial-bound creatiue kinase (CK-MB) 、cardiac troponio Ⅰ (cTnI) 、electrocardiogram (ECG) and echocardiogram.Serial blood samples were taken during perioperation to quantify blood levels of H-FABP,CK-MB,cTnI.Results The average H-FABP value for the patients in the myocardial infarction group is higher than the others ( P < 0.01 ).H-FABP reached the peak valve at 2 hours and decreased at 4 hours after the patients arrived at ICU.H-FABP got back to the baseline one day postoperation.Receiver operating characteristic curves( ROC curve) demonstrated that H-FABP had greater diagnostic

  13. Myocardial protection during heart surgery in China

    Bingyang Ji; Jinping Liu

    2007-01-01

    @@ Myocardial protection (MP) is the key for cardiopulmonary bypass (CPB) heart surgery. MP during cardiac surgery (CS) aims to preserve myocardial function while providing a bloodless and motionless operating field. Strategies on how to attenuate or prevent post-ischemic myocardial dysfunction that occurs intra-operatively during CS have been discussed for more than half a century. In 1950, Bigelow et al1 first reported to decrease myocardial oxygen demand by means of hypothermia.

  14. Dietary palm olein oil augments cardiac antioxidant enzymes and protects against isoproterenol-induced myocardial necrosis in rats.

    Narang, D; Sood, S; Thomas, M; Dinda, A K; Maulik, S K

    2005-11-01

    Wistar rats, 150-200 g, of either sex, were fed daily with commercial rat diet supplemented with palm olein oil in two doses (5% v/w (n = 16) and 10% v/w (n = 16) of diet) for 30 days. Control rats (n = 16) were fed with normal diet. On the 29(th) and 30(th) days, 8 rats from each group were administred isoproterenol (85 mg/kg, s.c., 24-h interval). On the 31(st) day, all rats were sacrificed and myocardial tissues were studied for thiobarbituric acid reactive substances (TBARS), antioxidant enzymes and light microscopic changes, along with the ferric-reducing ability of plasma (FRAP). A significant rise in myocardial superoxide dismutase (SOD), catalase and glutathione peroxidase (GPx) activity and FRAP level were observed in rats fed with palm olein oil. Isoproterenol caused an increase in myocardial oxidative stress in control rats, as evidenced by an increase in myocardial TBARS level, reduction in FRAP and myocardial SOD, catalase and GPx activity, along with focal necrosis of cardiac muscle fibres on light microscopy. The rise in myocardial TBARS and depletion of SOD and catalase activity following isoproterenol administration were prevented in palm-olein-oil-supplemented diet-fed rats at both doses. Isoproterenol-induced myocardial light-microscopic changes were also prevented in the treated groups. The results suggest that dietary palm olein oil caused augmentation of myocardial antioxidant enzymes and protected against isoproterenol-induced myocardial necrosis and associated oxidative stress.

  15. Affordability of alcohol and alcohol-related mortality in Belarus.

    Razvodovsky, Yury E

    2013-01-01

    Alcohol abuse has numerous adverse health and social consequences. The consumer response to changes in alcohol affordability is an important issue on alcohol policy debates. Studies from many countries have shown an inverse relationship between alcohol prices and alcohol consumption in the population. There are, however, suggestions that increasing the price of alcohol by rising taxes may have limited effect on alcohol-related problems, associated with long-term heavy drinking. The aim of the present study was to evaluate the relationship between alcohol affordability and alcohol-related mortality rates in post-Soviet Belarus. For this purpose trends in alcohol-related mortality rates (mortality from liver cirrhosis, pancreatitis, alcoholism and alcohol psychoses) and affordability of vodka between 1990 and 2010 were compared. The time series analysis revealed that 1% increase in vodka affordability is associated with an increase in liver cirrhosis mortality of 0,77%, an increase in pancreatitis mortality of 0.53%, an increase in mortality from alcoholism and alcohol psychoses of 0,70%. The major conclusion emerging from this study is that affordability of alcohol is one of the most important predictor of alcohol-related problems in a population. These findings provide additional evidence that decreasing in affordability of alcohol is an effective strategy for reducing alcohol consumption and alcohol-related harm.

  16. Affordable Window Insulation with R-10/inch Rating

    Jenifer Marchesi Redouane Begag; Je Kyun Lee; Danny Ou; Jong Ho Sonn; George Gould; Wendell Rhine

    2004-10-15

    During the performance of contract DE-FC26-00-NT40998, entitled ''Affordable Window Insulation with R-10/inch Value'', research was conducted at Aspen Aerogels, Inc. to develop new transparent aerogel materials suitable for window insulation applications. The project requirements were to develop a formulation or multiple formulations that have high transparency (85-90%) in the visible region, are hydrophobic (will not opacify with exposure to water vapor or liquid), and have at least 2% resiliency (interpreted as recoverable 2% strain and better than 5% strain to failure in compression). Results from an unrelated project showed that silica aerogels covalently bonded to organic polymers exhibit excellent mechanical properties. At the outset of this project, we believed that such a route is the best to improve mechanical properties. We have applied Design of Experiment (DOE) techniques to optimize formulations including both silica aerogels and organically modified silica aerogels (''Ormosils''). We used these DOE results to optimize formulations around the local/global optimization points. This report documents that we succeeded in developing a number of formulations that meet all of the stated criteria. We successfully developed formulations utilizing a two-step approach where the first step involves acid catalyzed hydrolysis and the second step involves base catalyzed condensation to make the gels. The gels were dried using supercritical CO{sub 2} and we were able to make 1 foot x 1 foot x 0.5 inch panels that met the criteria established.

  17. Experimental Approaches to Acute Myocardial Infarction

    D.B. Uitterdijk (André)

    2015-01-01

    markdownabstractAbstract This thesis is dedicated to i) novel methods and optimization studies to improve the diagnosis of myocardial ischemia and myocardial infarction as well as fundamental studies that precede novel therapies for myocardial infarction. In part ii) 2 novel, adjunctive therapies f

  18. Early diagnosis of interferon-induced myocardial disorder in patients with chronic hepatitis C. Evaluation by myocardial imaging with {sup 123}I-BMIPP

    Kondo, Yuki; Yukinaka, Michiko; Nomura, Masahiro; Nakaya, Yutaka; Ito, Susumu [Tokushima Univ. (Japan). School of Medicine

    2000-02-01

    Interferon (IFN) therapy for chronic hepatitis C is sometimes associated with cardiac complications. In the present study, we performed myocardial imaging with {sup 123}I-labeled {beta}-methyl-p-iodophenylpentadecanoic acid ({sup 123}I-BMIPP) in order to evaluate myocardial disorders caused by IFN. We studied 40 healthy subjects (H group) and 25 patients with chronic hepatitis C who had been treated with IFN (IFN group). A Holter electrocardiogram (ECG) was performed and the autonomic nervous function was assessed by analyzing the spectral variability and 1/f fluctuation of heart rate. Myocardial planner imaging with {sup 123}I-BMIPP was performed to obtain the time activity curve for 20 min immediately after administration of {sup 123}I-BMIPP (dynamic study). Early and delayed myocardial single photon emission computed tomography (SPECT) images were expressed as Bull's eyes and the myocardium was divided into four segments to calculate the washout rate for each segment on early and late SPECT images (early and late SPECT study). No significant differences in autonomic nervous function were observed between the two groups in heart rate variability. In a dynamic study, the reduction rate from the time activity curve was significantly higher in the IFN group compared with the H group (reduction rate, IFN group, 5.3{+-}3.7% vs H group, 1.2{+-}3.3%; P<0.05). In the early and delayed myocardial SPECT study, the washout rate for the IFN group was significantly increased in all myocardial areas compared to that in the H group. However, the metabolic disorder of fatty acids caused by IFN was reversed on the second {sup 123}I-BMIPP myocardial scintigraphy examination several months after IFN therapy. These results indicate that metabolic disorders of fatty acids caused by IFN therapy can be detected before abnormalities are observed by Holter-ECG or echocardiography. (author)

  19. Morphological aspects of myocardial bridges.

    Lujinović, Almira; Kulenović, Amela; Kapur, Eldan; Gojak, Refet

    2013-11-01

    Although some myocardial bridges can be asymptomatic, their presence often causes coronary disease either through direct compression of the "tunnel" segment or through stimulation and accelerated development of atherosclerosis in the segment proximally to the myocardial bridge. The studied material contained 30 human hearts received from the Department of Anatomy. The hearts were preserved 3 to 5 days in 10% formalin solution. Thereafter, the fatty tissue was removed and arterial blood vessels prepared by careful dissection with special reference to the presence of the myocardial bridges. Length and thickness of the bridges were measured by the precise electronic caliper. The angle between the myocardial bridge fibre axis and other axis of the crossed blood vessel was measured by a goniometer. The presence of the bridges was confirmed in 53.33% of the researched material, most frequently (43.33%) above the anterior interventricular branch. The mean length of the bridges was 14.64 ± 9.03 mm and the mean thickness was 1.23 ± 1.32 mm. Myocardial bridge fibres pass over the descending blood vessel at the angle of 10-90 degrees. The results obtained on a limited sample suggest that the muscular index of myocardial bridge is the highest for bridges located on RIA, but that the difference is not significant in relation to bridges located on other branches. The results obtained suggest that bridges located on other branches, not only those on RIA, could have a great contractive power and, consequently, a great compressive force, which would be exerted on the wall of a crossed blood vessel.

  20. Dynamic CT myocardial perfusion imaging.

    Caruso, Damiano; Eid, Marwen; Schoepf, U Joseph; Jin, Kwang Nam; Varga-Szemes, Akos; Tesche, Christian; Mangold, Stefanie; Spandorfer, Adam; Laghi, Andrea; De Cecco, Carlo N

    2016-10-01

    Non-invasive cardiac imaging has rapidly evolved during the last decade due to advancements in CT based technologies. Coronary CT angiography has been shown to reliably assess coronary anatomy and detect high risk coronary artery disease. However, this technique is limited to anatomical assessment, thus non-invasive techniques for functional assessment of the heart are necessary. CT myocardial perfusion is a new CT based technique that provides functional assessment of the myocardium and allows for a comprehensive assessment of coronary artery disease with a single modality when combined with CTA. This review aims to discuss dynamic CT myocardial perfusion as a new technique in the assessment of CAD.

  1. PPARs: Protectors or Opponents of Myocardial Function?

    Christine J. Pol

    2015-01-01

    Full Text Available Over 5 million people in the United States suffer from the complications of heart failure (HF, which is a rapidly expanding health complication. Disorders that contribute to HF include ischemic cardiac disease, cardiomyopathies, and hypertension. Peroxisome proliferator-activated receptors (PPARs are members of the nuclear receptor family. There are three PPAR isoforms: PPARα, PPARγ, and PPARδ. They can be activated by endogenous ligands, such as fatty acids, as well as by pharmacologic agents. Activators of PPARs are used for treating several metabolic complications, such as diabetes and hyperlipidemia that are directly or indirectly associated with HF. However, some of these drugs have adverse effects that compromise cardiac function. This review article aims to summarize the current basic and clinical research findings of the beneficial or detrimental effects of PPAR biology on myocardial function.

  2. Myocardial uptake of cocaine and effects of cocaine on myocardial substrate utilization and perfusion in hypertensive rats

    Som, P.; Wang, G.J. [Brookhaven National Lab., Upton, NY (United States); Oster, Z.H. [State Univ. of New York, Stony Brook, NY (United States); Knapp, F.F. Jr. [Oak Ridge National Lab., TN (United States); Yonekura, Y. [Kyoto Univ. (Japan). Faculty of Medicine; Fujibayashi, Y. [Kyoto Univ. (Japan). Hospital; Yamamoto, K. [Fukui Univ. (Japan). Medical School; Kubota, K. [Tohoku Univ., Sendai (Japan)

    1992-12-31

    Cocaine abuse is a problem causing world-wide concern and the number of deaths following cocaine use is increasing. Cardiovascular complications following cocaine include severe tachyarrythmias, pulmonary edema, myocardial infarction, and acute renal failure, which are major problems confronting emergency facilities. While the studies of cocaine effects on the brain have been given the most attention, it is clear that the effects of cocaine on the cardiovascular system are of great importance, given the increasing number of reports on sudden death and myocardial infarctions in young adults related to cocaine use. The precise mechanisms of cardiotoxic actions of cocaine are unclear. We investigated the whole-body distribution of C-14-labeled cocaine to determine the cocaine-binding sites, including blocking experiments to determine the nature of regional binding sites, and differential response of the normal vs. diseased heart (hypertensive cardiomyopathy) in an animal model to mimic a potentially high risk population. We investigated the acute effects of cocaine on myocardial metabolism using two myocardial energy substrate analogs, fatty acid and glucose with comparison with regional perfusion.

  3. Myocardial uptake of cocaine and effects of cocaine on myocardial substrate utilization and perfusion in hypertensive rats

    Som, P.; Wang, G.J. (Brookhaven National Lab., Upton, NY (United States)); Oster, Z.H. (State Univ. of New York, Stony Brook, NY (United States)); Knapp, F.F. Jr. (Oak Ridge National Lab., TN (United States)); Yonekura, Y. (Kyoto Univ. (Japan). Faculty of Medicine); Fujibayashi, Y. (Kyoto Univ. (Japan). Hospital); Yamamoto, K. (Fukui Univ. (Japan). Medical School); Kubota, K. (Tohoku Univ., Sendai

    1992-01-01

    Cocaine abuse is a problem causing world-wide concern and the number of deaths following cocaine use is increasing. Cardiovascular complications following cocaine include severe tachyarrythmias, pulmonary edema, myocardial infarction, and acute renal failure, which are major problems confronting emergency facilities. While the studies of cocaine effects on the brain have been given the most attention, it is clear that the effects of cocaine on the cardiovascular system are of great importance, given the increasing number of reports on sudden death and myocardial infarctions in young adults related to cocaine use. The precise mechanisms of cardiotoxic actions of cocaine are unclear. We investigated the whole-body distribution of C-14-labeled cocaine to determine the cocaine-binding sites, including blocking experiments to determine the nature of regional binding sites, and differential response of the normal vs. diseased heart (hypertensive cardiomyopathy) in an animal model to mimic a potentially high risk population. We investigated the acute effects of cocaine on myocardial metabolism using two myocardial energy substrate analogs, fatty acid and glucose with comparison with regional perfusion.

  4. The Value of Heart Fatty Acid Binding Protein in Early Diagnosis of Kawasaki Disease with Myocardial Ischemia%心肌脂肪酸结合蛋白在川崎病心肌缺血损伤早期诊断中的应用价值

    段庆宁

    2013-01-01

    目的:探讨心肌脂肪酸结合蛋白(h-FABP)在川崎病患儿心肌缺血损伤早期诊断中的应用价值。方法分别测定54例川崎病患儿在急性期、亚急性期、恢复期的h-FABP,并选择50例健康患儿为对照组。应用SPSS13.0软件对结果进行统计学分析。结果川崎病患儿各期h-FABP水平均明显高于对照组(P<0.05)。结论h-FABP可作为川崎病心肌缺血损伤早期判断指标。%Objective To investigate the value of heart fat y acid binding protein in early diagnosis of kawasaki disease (KD) complicated with myocardial ischemia. Methods Heart fat y acid binding protein (h-FABP) levels were measured in acute stage, subacute stage and recovery stage of KD Patients, and 50 healthy controls as wel .The results were analyzed by statistical package for the social science 13.0 (SPSS 13.0). Results The h-FABP levels of al stages in KD were obviously higher than control group (P<0.05). Conclusion H-FABP can be used in early diagnosis of myocardial ischemia in KD.

  5. Object affordance and spatial-compatibility effects in Parkinson's disease.

    Galpin, Adam; Tipper, Steven P; Dick, Jeremy P R; Poliakoff, Ellen

    2011-03-01

    Movement in Parkinson's disease (PD) is strongly influenced by sensory stimuli. Here, we investigated two features of visual stimuli known to affect response times in healthy individuals; the spatial location of an object (the spatial effect) and its action-relevance (the 'affordance' effect). Poliakoff et al. (2007) found that while PD patients show normal spatial effects, they do not show an additional affordance effect. Here we investigated whether these effects are driven by facilitation or inhibition, and whether the affordance effect emerges over a longer time-course in PD. Participants (24 PD and 24 controls) viewed either a lateralised door handle (affordance condition), a lateralised abstract stimulus (spatial condition), or a centrally presented baseline stimulus (baseline condition), and responded to a colour change in the stimulus occurring after 0 msec, 500 msec or 1000 msec. The colour change indicated whether to respond with the left or right hand, which were either spatially compatible or incompatible with the lateralised stimulus orientation in the affordance and spatial conditions. The baseline condition allowed us to assess whether compatibility effects were driven by facilitation of the compatible response or inhibition of the incompatible response. The results indicate that stimulus orientation elicited faster responses from the nearest hand. For controls, the affordance effect was stronger and driven by facilitation, whilst the spatial condition was driven by inhibition. In contrast, the affordance and spatial-compatibility effects did not differ between conditions in the PD group and both were driven by facilitation. This suggests that the PD group responded as if all stimuli were action-relevant, and may have implications for understanding the cueing of movement in PD.

  6. Dosimetry in myocardial perfusion imaging

    Toledo, Janine M.; Trindade, Bruno; Ribeiro, Tarcisio P.C. [Universidade Federal de Minas Gerais (DEN/UFMG), Belo Horizonte (Brazil). Dept. de Engenharia Nuclear. Programa de Pos-Graduacao em Ciencias e Tecnicas Nucleares

    2011-07-01

    This paper conducts a dosimetric investigation on the myocardial perfusion image protocol, together with a literature reviewing, motivated by the significant statistic increasing on mortality, morbidity and disability associated with cardiovascular disease, surpassing infectious diseases. Nuclear Cardiology plays a role n the diagnostic functional evaluation of the heart and in the prognostic of patients with suspected or known cardiac ischemia. In the context of unstable myocardial ischemic syndrome, myocardial perfusion scintigraphy is a non-invasive procedure performed by administering a radiopharmaceutical targeted to the heart. As tool for this study are that the images obtained by thoracic angiotomography and abdominal aorta as a anatomic and functional information for model reproduction in SISCODES - System of Codes for Absorbed Dose Calculations based on Stochastic Methods. Data were manipulated in order to create a voxel computational model of the heart to be running in MCNP - Monte Carlo Neutron Particle Code. . It was assumed a homogeneous distribution of Tl-201 in cardiac muscle. Simulations of the transport of particles through the voxel and the interaction with the heart tissue were performed. As a result, the isodose curves in the heart model are displayed as well as the dose versus volume histogram of the heart muscle. We conclude that the present computational tools can generate doses distributed in myocardial perfusion. (author)

  7. Neonatal Myocardial Infarction or Myocarditis?

    de Vetten, Leanne; Bergman, Klasien A.; Elzenga, Nynke J.; van Melle, Joost P.; Timmer, Albertus; Bartelds, Beatrijs

    2011-01-01

    We report a 29 week-gestation preterm infant who presented during his second week of life with cardiogenic shock. Clinical presentation and first diagnostics suggested myocardial infarction, but echocardiographic features during follow-up pointed to a diagnosis of enteroviral myocarditis. The child

  8. Spousal Adjustment to Myocardial Infarction.

    Ziglar, Elisa J.

    This paper reviews the literature on the stresses and coping strategies of spouses of patients with myocardial infarction (MI). It attempts to identify specific problem areas of adjustment for the spouse and to explore the effects of spousal adjustment on patient recovery. Chapter one provides an overview of the importance in examining the…

  9. The Orchestra of Myocardial Regeneration

    Siddiqi, S.

    2014-01-01

    A glimpse on previous and current literature ignites the recognition of the luxurious era that cardiac science has reached. In particular, the past fifteen years have provided tremendous advancements in the field of myocardial biology with the characterization of cardiac stem cells, reprogramming of

  10. The Affordable Care Act: a primer for plastic surgeons.

    Chen, Jenny T; Israel, Jacqueline S; Poore, Samuel O; Rao, Venkat K

    2014-11-01

    The Patient Protection and Affordable Care Act, sometimes referred to as Obamacare, was signed into law on March 23, 2010. It represents the most extensive overhaul of the country's health care system since the passage of Medicare and Medicaid in 1965. The Affordable Care Act has two goals. The first goal is to reduce the uninsured population in the United States. Key elements to covering the uninsured include the following: (1) expanding Medicaid coverage for low-income individuals and (2) establishing health insurance marketplaces for moderate-income individuals with subsidies and tax cuts in an effort to make health insurance more affordable. The second goal of the Affordable Care Act is to address concerns about quality and the overall cost of U.S. health care. It is imperative that plastic surgeons thoroughly understand the impact that the Affordable Care Act will undoubtedly have on the country, on our patients, and on our clinical practices. Plastic surgery will see many changes in the future. This will include an overall increase in the number of insured patients, a push toward joining accountable care organizations, and a shift in payment systems to bundled reimbursement for episodes of care. In this article, the authors describe how these changes are likely to occur and what plastic surgeons must do to be part of the change.

  11. The Affordance Template ROS Package for Robot Task Programming

    Hart, Stephen; Dinh, Paul; Hambuchen, Kimberly

    2015-01-01

    This paper introduces the Affordance Template ROS package for quickly programming, adjusting, and executing robot applications in the ROS RViz environment. This package extends the capabilities of RViz interactive markers by allowing an operator to specify multiple end-effector waypoint locations and grasp poses in object-centric coordinate frames and to adjust these waypoints in order to meet the run-time demands of the task (specifically, object scale and location). The Affordance Template package stores task specifications in a robot-agnostic XML description format such that it is trivial to apply a template to a new robot. As such, the Affordance Template package provides a robot-generic ROS tool appropriate for building semi-autonomous, manipulation-based applications. Affordance Templates were developed by the NASA-JSC DARPA Robotics Challenge (DRC) team and have since successfully been deployed on multiple platforms including the NASA Valkyrie and Robonaut 2 humanoids, the University of Texas Dreamer robot and the Willow Garage PR2. In this paper, the specification and implementation of the affordance template package is introduced and demonstrated through examples for wheel (valve) turning, pick-and-place, and drill grasping, evincing its utility and flexibility for a wide variety of robot applications.

  12. 血清尿酸与急性心肌梗死合并慢性肾功能不全患者预后的关系%Association between serum uric acid level and prognosis of patients with acute myocardial infarction andchronic renal dysfunction

    赵宇飞; 程自平; 王麟

    2016-01-01

    Objective To determine the association between serum uric acid level and prognosis of patients withacute myocardial infarc-tion and chronic renal dysfunction.Methods Totally 512 acute myocardial infarction patients with chronic renal dysfunction were en-rolled in this study.These patients were assigned into two groups:high uric acid group(n =200)and low uric acid group(n =312). Basic clinical characters were analyzed and major adverse cardiovascular events(MACEs)were observed during 48-month follow-up. Results The results showed that during 48-month follow-up,death of any cause occurred in 1.0% patients(2 of 200)in low uric acid group,as compared with 5.3% in the high uric acid group (17 of 312)(hazard ratio,5.379;95% confidence interval,1.204 to 24.035;P =0.028).The incidences of stroke,heart failure and revascularization weresignificantly higher in high uric acidgroup.Con-clusions High serum uric acid level increases the incidences of death,revascularization,stroke and heart failure in acute myocardial infarction patients with chronic renal dysfunction.%目的:探讨血清尿酸水平对合并有慢性肾功能不全的急性心肌梗死患者远期预后的影响。方法选取512例合并有慢性肾功能不全的急性心肌梗死患者,按血清尿酸水平分为低尿酸组(n =200)和高尿酸组(n =312),分析各组病变血管、临床生化指标、合并症以及治疗情况,并对所有患者进行48个月随访,观察各组远期严重心血管不良事件。结果低尿酸组中共有2例患者死亡,高尿酸组中17例患者死亡(风险比:5.379;95%置信区间,1.204~24.035;P =0.028)。高尿酸组卒中、心衰和血运重建发生率均高于低尿酸组,且差异有统计学意义。结论合并有慢性肾功能不全的急性心肌梗死患者血清尿酸水平升高会导致患者远期死亡率、卒中发生率、心衰发生率和血运重建发生率增加。

  13. 慢性肾脏病心肌损害与心型脂肪酸结合蛋白及心肌钙蛋白的相关性分析%Correlation Analysis of Heart Type Fatty Acid Binding Protein and Cardiac Troponin with Myocardial Damage in Chronic Kidney Disease

    谢瑜; 沈颖; 罗惠民; 周晓萍; 江勇

    2015-01-01

    分析心型脂肪酸结合蛋白(HFABP)及心肌钙蛋白(cTnI)对慢性肾脏病(CKD)患者缺血性心肌损害的评估应用价值.选取非透析的慢性肾脏病患者,进行腺苷负荷心肌灌注显像检查,同时检测 HFABP、cTnI,并与腺苷负荷试验结果进行对比分析,明确 HFABP 及 cTnI 对缺血性心肌损害的评估价值.结果发现 HFABP 与 eGFR 负相关,与 CREA、BUN 正相关,cTnI 与 IVST、LVPWT 正相关,有31.1%的患者腺苷负荷心肌灌注显像试验阳性,HFABP 在腺苷负荷试验阳性组及阴性组患者间的差异无统计学意义,cTnI 的差异有统计学意义,腺苷负荷试验阳性结果与HFABP 不相关(r =0.041,P =0.654),与 cTnI 正相关(r =0.649,P <0.01).结果表明:HFABP受肾小球滤过率的影响较大,不是反映慢性肾脏病患者缺血性心脏损害的理想指标,cTnI 不受年龄和肾功能的直接影响,是腺苷负荷心肌灌注缺损的独立危险因素,腺苷负荷核素心肌灌注显像是评估 CKD 患者冠状动脉疾病的有效手段.%The ischemic myocardial damage evaluation value of heart type fatty acid binding protein and cardiac troponin I in CKD patients is explored in this paper.Adenosine stress myocardial perfusion imaging is performed to all patients whose levels of HFABP and cTnI are also measured and compared with adenosine stress test results to assess the ischemic myocardial damage evaluation value of HFABP and cTnI.It is observed that HFABP is negatively correlated with eGFR,and positively correlated to CREA and BUN,and that cTnI is positive corre-lated with IVST and LVPWT.31.1% patients have positive results in adenosine stress test,the positive results being positively correlated with cTnI(r =0.649,P <0.01),and having no correlation with HFABP (r =0.041, P =0.654).The results show that HFABP is strongly influenced by glomerular filtration rate,and thus not an i-deal index of

  14. The role of affordances in Libras acquisition as second language

    Jéssica Puhl

    2016-05-01

    Full Text Available Libras is a visual-spatial language used by the Brazilian deaf community. Following the principles of spatiality and vision, the user of the sign language resorts more easily to stimuli from the environment than the user of the oral language. Thus, the hypothesis of this research is that the affordances (environmental properties that enable psychologically possible actions would be a facilitator element in the process of Libras acquisition. In this paper we use the narrative and interpretive-qualitative research to discuss the role of affordances in the listener perception, interpretation and action cycle in Libras acquisition as second language. Results show that the Libras’ iconic signs can be considered important affordances in the early stages of the acquisition. It is also observed the importance of the permanence in the niche where Libras is used for the sign language development.

  15. Exploring Affordances of Social Media Use in Election Campaigns

    Dyrby, Signe; Jensen, Tina Blegind

    In recent years, social media have become omnipresent and highly important for social networking and content sharing. Lately we have witnessed how also political parties adopt social media as part of their political campaign strategy. The purpose of this work-in-progress paper is to investigate...... this tendency by posing two research questions: 1) what do political parties perceive as affordances of social media use in their campaign strategy? And 2) how are these affordances reflected in the political parties’ actual actions during the campaign? To address the two questions, we conducted a qualitative...... interaction and involvement is limited by their actions as most of them do not engage with the users’ posts and comments. The tensions between perceived affordances and actual use prompt further investigation of what political parties should consider when engaging in social media activities as part...

  16. The affordances and use of green citizen engagement web tools

    Scheele, Christian Elling; Hoff, Jens Villiam

    2015-01-01

    The purpose of this paper is to analyse if and how three different green web applications create the basis for different levels of environmental citizen participation. This is relevant in both an e-governance context and an environmental policy context, as it is normally assumed that ICT......, these differences seem to hinge at least as much on the activities of skilled actors such as involved civil servants, web- and game administrators than on the affordances of the web applications. Keywords: green web applications, citizen participation, affordances, contextual new medium theory, case study...... as such can be used to strengthen such participation, without looking neither at the special opportunity structure that the applications offer (their affordance) nor the actual use of the applications. This is all the more surprising as recent stage models in e-governance (i.e. Lee 2010) implies...

  17. The affordable care act: the value of systemic disruption.

    Shaffer, Ellen R

    2013-06-01

    It is important to recognize the political and policy accomplishments of the Patient Protection and Affordable Care Act (ACA), anticipate its limitations, and use the levers it provides strategically to address the problems it does not resolve. Passage of the ACA broke the political logjam that long stymied national progress toward equitable, quality, universal, affordable health care. It extends coverage for the uninsured who are disproportionately low income and people of color, curbs health insurance abuses, and initiates improvements in the quality of care. However, challenges to affordability and cost control persist. Public health advocates should mobilize for coverage for abortion care and for immigrants, encourage public-sector involvement in negotiating health care prices, and counter disinformation by opponents on the right.

  18. Rhythm as an affordance for the entrainment of movement.

    Cummins, Fred

    2009-01-01

    A general account of rhythm in human behaviour is provided, according to which rhythm inheres in the affordance that a signal provides for the entrainment of movement on the part of a perceiver. This generic account is supported by an explication of the central concepts of affordance and entrainment. When viewed in this light, rhythm appears as the correct explanandum to account for coordinated behaviour in a wide variety of situations, including such core senses as dance and the production of music. Speech may appear to be only marginally rhythmical under such an account, but several experimental studies reveal that speech, too, has the potential to entrain movement.

  19. Approach to an Affordable and Sustainable Space Transportation System

    McCleskey, Caey M.; Rhodes, R. E.; Robinson, J. W.; Henderson, E. M.

    2012-01-01

    This paper describes an approach and a general procedure for creating space transportation architectural concepts that are at once affordable and sustainable. Previous papers by the authors and other members of the Space Propulsion Synergy Team (SPST) focused on a functional system breakdown structure for an architecture and definition of high-payoff design techniques with a technology integration strategy. This paper follows up by using a structured process that derives architectural solutions focused on achieving life cycle affordability and sustainability. Further, the paper includes an example concept that integrates key design techniques discussed in previous papers. !

  20. [The effect of metformin on myocardial tolerance to ischemia in rats with diabetes mellitus type 2].

    Kravchuk, E N; Grineva, E N; Galagudza, M M; Bairamov, A A

    2013-01-01

    The effect of metformin on myocardial sensitivity to ischemia in rats with neonatal streptozotocin T2DM was investigated using the model of global ischemia-reperfusion in the isolated perfused heart. Metformin administration had no effect on infarct size. At the same time, infarct size in T2DM was significantly lower than in controls, which is indicative of the phenomenon of metabolic preconditioning in T2DM. The protocol of metformin administration used in this study had not afforded a significant cardioprotective effect in animals with T2DM.

  1. Value of heart-type fatty acid-binding protein to the early diagnosis of acute myocardial infarction%心型脂肪酸结合蛋白在急性心肌梗死早期诊断中价值

    马春华; 王文红; 曲淑杰; 张彦宗; 秦笛

    2012-01-01

    Objective To investigate the value of heart-type fatty acid-binding protein (H-FABP) to the early diagnosis of acute myocardial infarction. Methods A total of 83 patients were suspected acute myocardial infarction at admission in 6 hours after onset of acute chest pain. They were randomly divided into AMI group (n = 32) and non-AMI group (n = 51) including 33 patients with unstable angina pectoris (UAP group) and 18 patients with non-cardiogenic chest pain (NCCP group). Another 40 healthy volunteers were as controls (control group). The plasma level of H-FABP was measured with ELISA, and compared with the traditional cardiac markers. Results The H-FABP level was significantly higher in AMI group than that in the other three groups (P<0. 01). ROC curve showed AUC of H-FABP was 0. 954 (95%CI: 0. 912 to 0. 997). The optimum cut-off point of H-FABP for diagnosing AMI was 6. 65 ng/mL. The sensitivity, specificity, negative prediction value and accuracy of H-FABP for diagnosing AMI in 6 hours were 90. 26%, 80.39%, 93.18% and 84. 34% respectively. The sensitivity, negative prediction value and accuracy of H-FABP were significantly higher than those of the traditional cardiac markers as myoglobin, creatine kinase-myocardial band and cardiac troponin I (P<0. 05). Conclusion H-FABP has better value to diagnosing AMI in the early stage.%目的 探讨血浆心型脂肪酸结合蛋白(heart-type fatty acid-binding protein,H-FABP)对早期诊断急性心肌梗死(acute myocardial infarction,AMI)的意义.方法 发病6h内以急性胸痛就诊的疑似AMI患者83例,根据出院诊断分为AMI组32例与非AMI组51例,非AMI组又分为不稳定型心绞痛33例(UAP组)与非心源性胸痛18例(NCCP组),选择体检健康者40名为对照组,采用ELISA法检测各组血清H-FABP水平,并与传统心肌标志物的诊断效能进行比较.结果 AMI组血清H-FABP水平明显高于非AMI组和对照组(P均<0.01);ROC曲线显示,H-FABP的AUC为0.954(95%CI:0.912~0

  2. 心型脂肪酸结合蛋白在心梗患者行介入治疗中的意义%Significance of Heart-type Fatty Acid Binding Protein in Interventional Therapy for Patients With Myocardial Infarction

    刘伟忠

    2015-01-01

    Objective To study the applications of heart-type fatty acid binding protein in interventional treatment for patients with myocardial infarction, to explore the change of heart-type fatty acid binding protein(H-FABP)in patients with percutaneous coronary intervention(PCI). Methods 178 cases of ST-segment elevation myocardial infarction patients were selected for research and analysis. After coronary intervention in patients with ST fall down as the ST group,the other for non-ST group. For patients with H-FABP and troponin(cTnI)were measured, observed ST decline rate after two hours. Results There was no statistical difference between two groups,H-FABP after six hours was better than before surgery. H-FABP within 24 hours of ST group patients to return to a normal state,non-ST group did not fall back to normal state. Conclusion H-FABP of ST elevation myocardial infarction is directly linked to the severity of coronary artery disease. Surgery will affect the H-FABP levels in patients. The patients of ST fal by more than 50%and H-FABP decreased to normal status,clinical myocardial injury lighter, reperfusion effect was better.%目的:研究分析心型脂肪酸结合蛋白对心梗患者介入治疗的应用情况,探讨患者使用经皮冠脉介入治疗对患者心型脂肪酸结合蛋白变化的影响。方法选取我院178例ST段抬高型心肌梗死患者来进行研究分析,将冠脉介入治疗后ST回落患者作为ST回落组,其余为ST无回落组。对患者的心型脂肪酸结合蛋白以及心肌肌钙蛋白进行测定,观察术后2小时ST回落幅度。结果两组患者术前无统计学差异性,术后6 h的心型脂肪酸结合蛋白均要优于术前。ST回落组患者的心型脂肪酸结合蛋白在24 h内恢复到正常状态,ST无回落组没有恢复正常状态。结论 ST抬高型心肌梗死患者的心型脂肪酸结合蛋白和冠脉病变程度有直接联系,手术会影响患者的心型脂肪酸结合蛋

  3. 78 FR 7348 - Patient Protection and Affordable Care Act; Exchange Functions: Eligibility for Exemptions...

    2013-02-01

    ... HUMAN SERVICES 45 CFR Parts 155 and 156 RIN 0938-AR68 Patient Protection and Affordable Care Act... title I of the Patient Protection and Affordable Care Act of 2010, as amended by the Health Care and... Abbreviations Affordable Care Act--the Affordable Care Act of 2010 (which is the collective term for the...

  4. Affordable comfort 95 - investing in our energy future

    NONE

    1995-12-31

    This report describes the topics from the conference on Affordable Comfort, held March 26-31, 1995. Topics are concerned with energy efficiency in homes, retrofitting, weatherization, and monitoring of appliances, heating, and air conditioning systems for performance, as well as topics on electric utilities.

  5. Teaching Text Structure: Examining the Affordances of Children's Informational Texts

    Jones, Cindy D.; Clark, Sarah K.; Reutzel, D. Ray

    2016-01-01

    This study investigated the affordances of informational texts to serve as model texts for teaching text structure to elementary school children. Content analysis of a random sampling of children's informational texts from top publishers was conducted on text structure organization and on the inclusion of text features as signals of text…

  6. 12 CFR 1282.14 - Special Affordable Housing Goal.

    2010-01-01

    ... Special Affordable Housing Goal for the purchase or refinancing of existing seasoned portfolios of loans... Insurance Fund; and (C) Subject to, and have received at least a satisfactory performance evaluation rating... the refinancing of an Enterprise's existing mortgages or mortgage-backed securities portfolios...

  7. Learning Affordances of Language and Communication National Curricula

    Scott, David

    2016-01-01

    This article focuses on the learning affordances of different language and communication curricula in the world. For reasons of space, only two national education systems (Finland and Singapore) and their language and communication curricula are referred to. The accounts of national education systems consist of the identification of mechanisms…

  8. Pedagogical Affordances of Multiple External Representations in Scientific Processes

    Wu, Hsin-Kai; Puntambekar, Sadhana

    2012-12-01

    Multiple external representations (MERs) have been widely used in science teaching and learning. Theories such as dual coding theory and cognitive flexibility theory have been developed to explain why the use of MERs is beneficial to learning, but they do not provide much information on pedagogical issues such as how and in what conditions MERs could be introduced and used to support students' engagement in scientific processes and develop competent scientific practices (e.g., asking questions, planning investigations, and analyzing data). Additionally, little is understood about complex interactions among scientific processes and affordances of MERs. Therefore, this article focuses on pedagogical affordances of MERs in learning environments that engage students in various scientific processes. By reviewing literature in science education and cognitive psychology and integrating multiple perspectives, this article aims at exploring (1) how MERs can be integrated with science processes due to their different affordances, and (2) how student learning with MERs can be scaffolded, especially in a classroom situation. We argue that pairing representations and scientific processes in a principled way based on the affordances of the representations and the goals of the activities is a powerful way to use MERs in science education. Finally, we outline types of scaffolding that could help effective use of MERs including dynamic linking, model progression, support in instructional materials, teacher support, and active engagement.

  9. Affordance, Learning Opportunities, and the Lesson Plan Pro Forma

    Anderson, Jason

    2015-01-01

    This article argues that the most commonly used lesson plan pro formas in language teacher education are inappropriately premised on an outcomes-based approach to teaching, one that is in conflict with what we know about how languages are learnt and how experienced teachers teach. It proposes an alternative, affordance-based approach to lesson…

  10. Material Affordances: The Potential of Scrapbooks in the Composition Classroom

    Alexander, Kara Poe

    2013-01-01

    A multiliteracies pedagogy has renewed our interest in materiality, or how the physical text interacts with the author's choices and the context to contribute to the message, yet little attention has been paid to materiality in analog texts, such as the scrapbook, even though this medium contains affordances (capabilities and limitations) that…

  11. Federal Home Visiting under the Affordable Care Act

    Strader, Kathleen; Counts, Jacqueline; Filene, Jill

    2013-01-01

    The Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program is part of The Patient Protection and Affordable Care Act and provides $1.5 billion over 5 years to states, territories, and tribes with the goal of delivering evidence-based home visiting services as part of a high-quality, comprehensive early childhood system that promotes…

  12. 78 FR 39644 - Information Reporting for Affordable Insurance Exchanges

    2013-07-02

    ... Marketplaces). Section 1401 of the Affordable Care Act enacted section 36B, allowing a refundable premium tax... of the advance payment with the amount of the premium tax credit computed on the taxpayer's income... payments also may claim the premium tax credit on the income tax return. Section 36B(f)(3)...

  13. Ubiquitous Knowledge and Experiences to Foster EFL Learning Affordances

    García-Sánchez, Soraya; Luján-García, Carmen

    2016-01-01

    This article explores the implementation of experiential learning affordances to improve skills in English as a Foreign Language (EFL) in higher education. The administration of an online anonymous survey to 100 students of different undergraduate degrees presents current learning reflections from EFL students at the Universidad de Las Palmas de…

  14. The ICCE Framework: Framing Learning Experiences Afforded by Games

    Foster, Aroutis; Shah, Mamta

    2015-01-01

    There is a need for game-based learning frameworks that provide a lens for understanding learning experiences afforded in digital games. These frameworks should aim to facilitate game analyses, identification of learning opportunities, and support for learner experiences. This article uses the inquiry, communication, construction, and expression…

  15. A typology of affordances: untangling sociomaterial interactions through video analysis

    van Osch, W.; Mendelson, O.

    2011-01-01

    In this study we untangle the sociomaterial interactions between developers, users, and artifacts by analyzing what types of affordances occur in the interactions between actors and artifacts in the context of group generativity. Hereto, we conducted an in-depth ethnographic and interaction analysis

  16. Affordances for Second Language Learning in "World of Warcraft"

    Rama, Paul S.; Black, Rebecca W.; van Es, Elizabeth; Warschauer, Mark

    2012-01-01

    What are the affordances of online gaming environments for second language learning and socialization? To answer this question, this qualitative study examines two college-age Spanish learners' experiences participating in the Spanish language version of the massively multi-player online game "World of Warcraft." Using data culled from participant…

  17. Mortality rate in type 2 myocardial infarction

    Saaby, Lotte; Poulsen, Tina Svenstrup; Diederichsen, Axel Cosmus Pyndt

    2014-01-01

    , all hospitalized patients having cardiac troponin I measured were considered. The diagnosis of a myocardial infarction was according to the universal definition, and specified criteria were used in the classification of type 2 myocardial infarction. Follow-up was at least 1 year, with mortality......BACKGROUND: The classification of myocardial infarction into 5 types was introduced in 2007. The prognostic impact of this universal definition, with particular focus on type 2 myocardial infarction, has not been studied prospectively in unselected hospital patients. METHODS: During a 1-year period...... as the end point. RESULTS: A total of 3762 consecutive patients were studied, of whom 488 (13%) had a myocardial infarction. In 119 patients a type 2 myocardial infarction was diagnosed. After a median of 2.1 years (interquartile range, 1.6-2.5 years), 150 patients had died, with a mortality rate of 49% (58...

  18. Novel adjunctive treatments of myocardial infarction

    Schmidt, Michael Rahbek; Pryds, Kasper; Bøtker, Hans Erik

    2014-01-01

    Myocardial infarction is a major cause of death and disability worldwide and myocardial infarct size is a major determinant of prognosis. Early and successful restoration of myocardial reperfusion following an ischemic event is the most effective strategy to reduce final infarct size and improve...... by endovascular infusion of cold saline all reduce infarct size and may confer clinical benefit for patients admitted with acute myocardial infarcts. Equally promising, three follow-up studies of the effect of remote ischemic conditioning (RIC) show clinical prognostic benefit in patients undergoing coronary...... clinical outcome, but reperfusion may induce further myocardial damage itself. Development of adjunctive therapies to limit myocardial reperfusion injury beyond opening of the coronary artery gains increasing attention. A vast number of experimental studies have shown cardioprotective effects of ischemic...

  19. [Myocardial infarction caused by exertion].

    Bernard, F; Weber, S

    1997-01-01

    Myocardial infarction is the main cause of sudden death during physical exercise, particularly in subjects over 40 and may even occur in high-performance young athletes. Sports and physical activity have a beneficial effect in preventing cardiovascular diseases, but certain rules of prudence must be followed to avoid the risk of a severe coronary event. Myocardial infarction always occurs in particularly susceptible subjects with several risk factors, predominantly smoking, hypercholesterolemia, family history of atherosclerosis. Dietary factors, either before, during or after the exercise, are always found. Distribution of coronary lesions differs with age. Before 40 years, the coronary network is normal in 40% of the cases. The infarction is partially explained by platelet hyperaggregahility and coronary spasms at exercise or in the post-exercise period.

  20. 急性心肌梗死疾病实施心型脂肪酸结合蛋白浓度水平检测意义的探讨%To explore the clinical significance of the early Acute myocardial infarction diagnosis by the Heart-type Fatty Acid-Binding Protein testing

    陈明; 韩帅

    2014-01-01

    Objective To explore the clinical significance of the early Acute myocardial infarction diagnosis by the Heart-type Fatty Acid-Binding Protein testing.Methods Choosing 86 cases of patients with Acute myocardial infarc-tion disease for the experimental group,according to the time we can be divided for the (0-3 h)group of 30 cases,the (3-6 h)group of 28 cases and(≥6 h)group of 28 cases,and 30 cases of healthy check-up for the control group,testing the Heart-type Fatty Acid-Binding Protein and Ischemia Modified Albumin,analyze the results comprehensively.Results Compared with the control group,there were significantly higher of the experimental group of the Heart-type Fatty Acid-Binding Protein and Ischemia Modified Albumin results(P0.05).Clinical specimens correlation analysis results show that the Heart-type Fatty Acid-Binding Protein and the correlation of clinical diagnosis result is good(Kappa=0.81).Conclusion There is a good indicators for the early Acute myocardial infarction diagnosis which as same as to the Ischemia Modified Albumin,and worthy to clin-ical promotion.%目的:探讨检测心型脂肪酸结合蛋白浓度水平对于早期诊断急性心肌梗死疾病的应用价值。方法选择86例确诊为急性心肌梗死的患者设为试验组,根据疾病发作时间可分为(0-3 h)组30例、(3-6 h)组28例和(≥6 h)组28例,并选择同期进行健康体检且结果为健康的人30例设为参照组,所以纳入对象均进行心型脂肪酸结合蛋白浓度水平的检测,同时进行缺血修饰白蛋白浓度水平检测,对结果进行综合分析。结果与参照组比较,(0-3 h)组、(3-6 h)组和(≥6 h)组的患者检测心型脂肪酸结合蛋白浓度水平和缺血修饰白蛋白浓度水平均有显著性升高,差异有统计学意义(P<0.05);阳性检出率分析可见,试验各组的心型脂肪酸结合蛋白和缺血修饰白蛋白的阳性检出率均在80.00%以上且两

  1. Myocardial structure and matrix metalloproteinases.

    Aggeli, C; Pietri, P; Felekos, I; Rautopoulos, L; Toutouzas, K; Tsiamis, E; Stefanadis, C

    2012-01-01

    Metalloproteinases (MMPs) are enzymes which enhance proteolysis of extracellular matrix proteins. The pathophysiologic and prognostic role of MMPs has been demonstrated in numerous studies. The present review covers a wide a range of topics with regards to MMPs structural and functional properties, as well as their role in myocardial remodeling in several cardiovascular diseases. Moreover, the clinical and therapeutic implications from their assessment are highlighted.

  2. Myocardial infarction in young adults

    Egred, M; Viswanathan, G; Davis, G.

    2005-01-01

    Although myocardial infarction (MI) mainly occurs in patients older than 45, young men or women can suffer MI. Fortunately, its incidence is not common in patients younger than 45 years. However, the disease carries a significant morbidity, psychological effects, and financial constraints for the person and the family when it occurs at a young age. The causes of MI among patients aged less than 45 can be divided into four groups: (1) atheromatous coronary artery disease; (2) non-atheromatous ...

  3. Myocardial infarction and subsequent pregnancy

    Tedoldi Citânia Lúcia

    2000-01-01

    Full Text Available We report the case of a 40-year-old woman with 2 previous myocardial infarctions, revascularization surgery, and an ongoing pregnancy complicated with preeclampsia and fetal hypoxia. Her follow-up performed by a multidisciplinary team made possible the birth through cesarean section of a premature infant of the female sex with a very low birth weight, but without severe respiratory distress of the hyaline membrane disease type. Three months after the delivery, mother and daughter were healthy.

  4. MicroRNA-24 Regulates Vascularity After Myocardial Infarction

    Fiedler, Jan; Jazbutyte, Virginija; Kirchmaier, Bettina C.; Gupta, Shashi K.; Lorenzen, Johan; Hartmann, Dorothee; Galuppo, Paolo; Kneitz, Susanne; Pena, John T. G.; Sohn-Lee, Cherin; Loyer, Xavier; Soutschek, Juergen; Brand, Thomas; Tuschl, Thomas; Heineke, Joerg; Martin, Ulrich; Schulte-Merker, Stefan; Ertl, Georg; Engelhardt, Stefan; Bauersachs, Johann; Thum, Thomas

    2011-01-01

    Background-Myocardial infarction leads to cardiac remodeling and development of heart failure. Insufficient myocardial capillary density after myocardial infarction has been identified as a critical event in this process, although the underlying mechanisms of cardiac angiogenesis are mechanistically

  5. Acute myocardial involvement after heroin inhalation

    Ritu Karoli

    2012-01-01

    Full Text Available Amongst the illicit drugs cocaine, amphetamines and cannabis have been studied and documented well to cause myocardial infarction by different mechanisms but there is very sparse data available on myocardial involvement after heroin abuse. We report a young man who developed acute myocardial injury after heroin inhalation and alcohol binge drinking. Heroin induced cardio toxic effect and vasospasm compounded by alcohol were suspected to be the cause of this.

  6. Myocardial steatosis and necrosis in atria and ventricles of rats given pyruvate dehydrogenase kinase inhibitors.

    Jones, Huw Bowen; Reens, Jaimini; Johnson, Elizabeth; Brocklehurst, Simon; Slater, Ian

    2014-12-01

    Pharmaceutical therapies for non-insulin-dependent diabetes mellitus (NIDDM) include plasma glucose lowering by enhancing glucose utilization. The mitochondrial pyruvate dehydrogenase (PDH) complex is important in controlling the balance between glucose and fatty acid substrate oxidation. Administration of pyruvate dehydrogenase kinase inhibitors (PDHKIs) to rats effectively lowers plasma glucose but results in myocardial steatosis that in some instances is associated primarily with atrial and to a lesser degree with ventricular pathology. Induction of myocardial steatosis is not dose-dependent, varies from minimal to moderate severity, and is either of multifocal or diffuse distribution. Ventricular histopathology was restricted to few myocardial degenerative fibers, while that in the atrium/atria was of either acute or chronic appearance with the former showing myocardial degeneration/necrosis, acute myocarditis, edema, endothelial activation (rounding up), endocarditis, and thrombosis associated with moderate myocardial steatosis and the latter with myocardial loss, replacement fibrosis, and no apparent or minimal association with steatosis. The evidence from these evaluations indicate that excessive intramyocardial accumulation of lipid may be either primarily adverse or represents an indicator of other adversely affected cellular processes.

  7. Echocardiographic assessment of myocardial strain.

    Gorcsan, John; Tanaka, Hidekazu

    2011-09-27

    Echocardiographic strain imaging, also known as deformation imaging, has been developed as a means to objectively quantify regional myocardial function. First introduced as post-processing of tissue Doppler imaging velocity converted to strain and strain rate, strain imaging has more recently also been derived from digital speckle tracking analysis. Strain imaging has been used to gain greater understanding into the pathophysiology of cardiac ischemia and infarction, primary diseases of the myocardium, and the effects of valvular disease on myocardial function, and to advance our understanding of diastolic function. Strain imaging has also been used to quantify abnormalities in the timing of mechanical activation for heart failure patients undergoing cardiac resynchronization pacing therapy. Further advances, such as 3-dimensional speckle tracking strain imaging, have emerged to provide even greater insight. Strain imaging has become established as a robust research tool and has great potential to play many roles in routine clinical practice to advance the care of the cardiovascular patient. This perspective reviews the physiology of myocardial strain, the technical features of strain imaging using tissue Doppler imaging and speckle tracking, their strengths and weaknesses, and the state-of-the-art present and potential future clinical applications.

  8. Cardiac MRI for myocardial ischemia.

    Daly, Caroline

    2013-01-01

    Proper assessment of the physiologic impact of coronary artery stenosis on the LV myocardium can affect patient prognosis and treatment decisions. Cardiac magnetic resonance imaging (CMR) assesses myocardial perfusion by imaging the myocardium during a first-pass transit of an intravenous gadolinium bolus, with spatial and temporal resolution substantially higher than nuclear myocardial perfusion imaging. Coupled with late gadolinium enhancement (LGE) imaging for infarction during the same imaging session, CMR with vasodilating stress perfusion imaging can qualitatively and quantitatively assess the myocardial extent of hypoperfusion from coronary stenosis independent of infarcted myocardium. This approach has been validated experimentally, and multiple clinical trials have established its diagnostic robustness when compared to stress single-photon emission computed tomography. In specialized centers, dobutamine stress CMR has been shown to have incremental diagnostic value above stress echocardiography due to its high imaging quality and ability to image the heart with no restriction of imaging window. This paper reviews the technical aspects, diagnostic utility, prognostic values, challenges to clinical adaptation, and future developments of stress CMR imaging.

  9. Mineral Status of Myocardial Sarcocystosis

    GA Kojouri

    2011-06-01

    Full Text Available Background: The role of minerals on parasite persistency and the interaction between minerals and animal responses to the parasite infestation is not clear. For these reasons, the present re­search was aimed to compare copper, zinc and iron status in sheep with parasitic myocarditis and healthy ones in 2009.Methods: Blood and heart tissue samples were collected from 145 slaughtered sheep and histopa­thological findings were confirmed as myocardial sarcocystosis in 27 cases. Serum and tis­sue mineral level were determined by atomic absorption spectroscopy. Data were analyzed by Sig­mastat program, using One Way Analysis of Variance (ANOVA at the level of P<0.05.Results: Myocardial sarcocystosis significantly increase myocardial concentration of Cu, Zn and Fe (P<0.05.Conclusion: These findings may explain the role of copper, zinc and iron in parasite persistency and may discuss the pathogenesis of sarcocystosis, which relates to evocate mentioned micronutri­ent to cardiac muscle.

  10. Myocardial bridging as a cause of acute myocardial infarction: a case report

    Emiroglu Yunus

    2002-09-01

    Full Text Available Abstract Background Systolic compression of a coronary artery by overlying myocardial tissue is termed myocardial bridging. Myocardial bridging usually has a benign prognosis, but some cases resulting in myocardial ischemia, infarction and sudden cardiac death have been reported. We are reporting a case of myocardial bridging which was complicated with acute myocardial infarction associated with inappropriate blood donation. Case presentation A 33 year-old-man was admitted to our emergency with acute anteroseptal myocardial infarction after a blood donation. The electrocardiography showed sinus rhythm and was consistent with an acute anteroseptal myocardial infarction. We decided to perform primary percutanous intervention (PCI. Myocardial bridging was observed in the mid segment of the left anterior descending coronary artery on coronary angiogram. PCI was canceled and medical follow up was decided. Blood transfusion was made because he had a deep anemia. A normal hemaglobin level and clinical reperfusion was achieved after ten hours by blood transfusion. At the one year follow up visit, our patient was healthy and had no cardiac complaints. Conclusions Myocardial bridging may cause acute myocardial infarction in various clinical conditions. Although the condition in this case caused profound anemia related acute myocardial infarction, its treatment and management was unusual.

  11. An initial study on the feasibility of diagnosing myocardial ischemia with CT first-pass myocardial perfusion imaging at rest

    汪奇

    2013-01-01

    Objective To assess the feasibility and accuracy of CT first-pass myocardial perfusion imaging(CT first-pass MPI)at rest for diagnosis of myocardial ischemia.Results of adenosine-induced myocardial perfusion scintigraphy(MPS)

  12. 心型脂肪酸结合蛋白在心梗患者行介入治疗中的意义%The study of heart-type fatty acid binding protein in the PCI therapy for patients with acute myocardial infarction

    张健; 李春盛

    2013-01-01

    目的 观察ST段拾高型心肌梗死患者行经皮冠脉介入治疗(PCI)前后心型脂肪酸结合蛋白(H-FABP)变化及意义.方法 选择北京朝阳医院急诊科确诊ST段抬高型心肌梗死患者178例,根据PCI术后ST段回落程度分为两组,即ST段回落组及ST段无回落组,分别为137人及41人.所有病例均于入院即刻测定H-FABP及心肌肌钙蛋白(cTnI),并在PCI术后1h,6h,12 h和24 h再分别测定H-FABP质量浓度,PCI术后12h及24 h测定cTnI.测定PCI术后2 hST段回落幅度(ΣSTR).结果 ST段回落组及ST段无回落组PCI术前人口统计学资料差异无统计学意义.两组患者术后6 h H-FABP明显高于术前(P<0.05),ST段回落组患者于24 h H-FABP恢复至正常水平,而ST段无回落组患者H-FABP未降至正常水平.结论 ST段抬高型心肌梗死患者血清H-FABP升高与冠脉病变程度有关,PCI术可影响H-FABP变化,ΣSTR≥50%与H-FABP降至正常水平以下有利于判断患者的心肌损伤程度和心肌再灌注.%Objective To observe the change and clinical significance of the heart type fatty acid binding protein (H-FABP) in ST Segment Elevation Myocardial Infarction (STEMI) after percutaneous coronary intervention (PCI).Methods Of 178 STEMI patients were recruited and were separated as ST segment drop group (137) and ST segment non-drop group (41).All the patients received H-FABP and cTnI tests,and re-tested H-FABP on 1 h,6 h,12 h and 24 h after the PCI,and re-tested cTnI on 12 h and 24 h after the PCI.Also,the ST segment drop amplitude (ΣSTR) was measured 2 h after the PCI.Results The demographics of both groups were similar.In both groups,the H-FABP on 6 h after PCI was significantly higher than the value measured prior to PCI.In the ST segment drop group,the H-FABP was reduced to normal value on 24 h after PCI,while it was not in the ST segment non-drop group.Conclusions The H-FABP elevation is associated with the severity of coronary lesions in ST segment elevation

  13. Determinants of myocardial energetics and efficiency in symptomatic hypertrophic cardiomyopathy

    Timmer, Stefan A.J.; Germans, Tjeerd; Goette, Marco J.W.; Ruessel, Iris K.; Dijkmans, Pieter A.; Knaapen, Paul; Rossum, Albert C. van [VU University Medical Center, Department of Cardiology, 5F, Amsterdam (Netherlands); Lubberink, Mark; Lammertsma, Adriaan A. [VU University Medical Center, Department of Nuclear Medicine and PET Research, Amsterdam (Netherlands); Berg, Jurrien M. ten [St. Antonius Hospital, Department of Cardiology, Nieuwegein (Netherlands); Cate, Folkert J. ten [Thoraxcenter Erasmus Medical Center, Department of Cardiology, Rotterdam (Netherlands)

    2010-04-15

    Next to hypertrophy, hypertrophic cardiomyopathy (HCM) is characterized by alterations in myocardial energetics. A small number of studies have shown that myocardial external efficiency (MEE), defined by external work (EW) in relation to myocardial oxidative metabolism (MVO{sub 2}), is reduced. The present study was conducted to identify determinants of MEE in patients with HCM by use of dynamic positron emission tomography (PET) and cardiovascular magnetic resonance imaging (CMR). Twenty patients with HCM (12 men, mean age: 55.2 {+-} 13.9 years) and 11 healthy controls (7 men, mean age: 48.1 {+-} 10 years) were studied with [{sup 11}C]acetate PET to assess MVO{sub 2}. CMR was performed to determine left ventricular (LV) volumes and mass (LVM). Univariate and multivariate analyses were employed to determine independent predictors of myocardial efficiency. Between study groups, MVO{sub 2} (controls: 0.12 {+-} 0.04 ml.min{sup -1}.g{sup -1}, HCM: 0.13 {+-} 0.05 ml.min{sup -1}.g{sup -1}, p = 0.64) and EW (controls: 9,139 {+-} 2,484 mmHg.ml, HCM: 9,368 {+-} 2,907 mmHg.ml, p = 0.83) were comparable, whereas LVM was significantly higher (controls: 99 {+-} 21 g, HCM: 200 {+-} 76 g, p < 0.001) and MEE was decreased in HCM patients (controls: 35 {+-} 8%, HCM: 21 {+-} 10%, p < 0.001). MEE was related to stroke volume (SV), LV outflow tract gradient, NH{sub 2}-terminal pro-brain natriuretic peptide (NT-proBNP) and serum free fatty acid levels (all p < 0.05). Multivariate analysis revealed that SV (ss = 0.74, p < 0.001) and LVM (ss = -0.43, p = 0.013) were independently related to MEE. HCM is characterized by unaltered MVO{sub 2}, impaired EW generation per gram of myocardial tissue and subsequent deteriorated myocardial efficiency. Mechanical external efficiency could independently be predicted by SV and LVM. (orig.)

  14. Thrombolysis significantly reduces transient myocardial ischaemia following first acute myocardial infarction

    Mickley, H; Pless, P; Nielsen, J R

    1992-01-01

    In order to investigate whether thrombolysis affects residual myocardial ischaemia, we prospectively performed a predischarge maximal exercise test and early out-of-hospital ambulatory ST segment monitoring in 123 consecutive men surviving a first acute myocardial infarction (AMI). Seventy...... less than 0.02). Thrombolysis resulted in a non-significant reduction in exercise-induced ST segment depression: prevalence 43% vs 62% in controls. However, during ambulatory monitoring the duration of transient myocardial ischaemia was significantly reduced in thrombolysed patients: 322 min vs 1144...... myocardial ischaemia. This may explain the improvement in myocardial function during physical activities, which was also observed in this study....

  15. Biventricular Mechanical Circulatory Support Does Not Prevent Delayed Myocardial Ventricular Rupture following Myocardial Infarction

    Yazhini Ravi

    2013-01-01

    Full Text Available Cardiogenic shock and myocardial rupture can complicate an acute myocardial infarction (AMI. A case is reported in which a 58-year-old male with an acute inferior myocardial infarction required placement of biventricular assist device for hemodynamic support eight days after the onset of his AMI; eleven days after his AMI, the patient developed abrupt onset of hemodynamic instability with massive bleeding from his chest tube due to delayed free wall myocardial rupture that was discovered when he was taking emergently to the operating room. Myocardial rupture in patients with a ventricular assist device should be considered in the differential diagnosis in the event of acute hemodynamic compromise. A high level of suspicion for such a complication should prompt aggressive and emergent actions including surgery. We present a case of delayed free wall myocardial rupture following an acute inferior wall myocardial infarction in a patient with biventricular mechanical circulatory support.

  16. Situational Affordance - Appreciating human Interpretations in New Product Development

    Mathiasen, John Bang; Koch, Christian

    New Product Development (NPD) takes place within a web of connected actors who do not master fully the objects of the process, but rather they interpret the affordance - the en-abling and constraining framing by objects such as sketches, drawings, specifications, mock-ups and prototypes. The arti......New Product Development (NPD) takes place within a web of connected actors who do not master fully the objects of the process, but rather they interpret the affordance - the en-abling and constraining framing by objects such as sketches, drawings, specifications, mock-ups and prototypes...... two are more in the sociological direction. Alpha employs the artefact as a drawing and/or a mock-up in order to understand the customer’s situation, Golf applies a draft version of the customer’s CAD-drawing to translate the requirement to the toolmaker, Juliett utilises drawings and specifications...

  17. Motivational Affordance and Risk-Taking Across Decision Domains.

    Zou, Xi; Scholer, Abigail A

    2016-03-01

    We propose a motivational affordance account to explain both stability and variability in risk-taking propensity in major decision domains. We draw on regulatory focus theory to differentiate two types of motivation (prevention, promotion) that play a key role in predicting risk-taking. Study 1 demonstrated that prevention motivation is negatively associated with risk-taking across six key decision domains, including health/safety, ethics, recreation, gambling, investment, and social. In contrast, promotion motivation is positively associated with risk-taking in the social and investment domains. Study 2 replicated the same pattern and provided direct evidence that promotion motivation is a strong predictor of risk-taking only in domains where there is true potential for gains. Study 3 manipulated promotion (vs. prevention) motivation experimentally to demonstrate that motivational affordance is a critical mechanism for understanding risk-taking behaviors.

  18. Affordances and synchronization in collective creative construction tasks

    Tylén, Kristian; Fusaroli, Riccardo

    to the affordances of the task at hand. We also show that during collective, but not individual tasks, within group synchronization grows over time. Finally, we discuss how these measures of synchronization relate to the participants’ engagement in the tasks at hand and to the end products (LEGO models......: the affordances of the task at hand and the gradual consolidation of collaborative practices. Six groups of participants were instructed to construct LEGO models of six abstract notions (“responsibility”, “knowledge”, “justice” etc.), both individually and in groups. We combine video analysis and heart rate...... measurements and employ recurrence analysis techniques to quantify the mutual adaptability of heart rates among the participants in the different tasks. We show that during individual tasks individual heart rates synchronize both within and between groups (but not with controls) plausibly due...

  19. Increased myocardial lactate oxidation in lambs with aortopulmonary shunts at rest and during exercise

    Beaufort-Krol, GCM; Takens, J; Molenkamp, MC; Smid, GB; Meuzelaar, KJ; Zijlstra, WG; Kuipers, JRG

    1998-01-01

    Free fatty acids are the major fuels for the myocardium, but during a higher load carbohydrates are preferred. Previously, we demonstrated that myocardial net lactate uptake was higher in lambs with aortopulmonary shunts than in control lambs. To determine whether this was caused by an increased lac

  20. FRUGAL INNOVATIONS: THE FUTURE OF AFFORDABLE HEALTH CARE

    GEETHA MANI, KALAIVANI ANNADURAI RAJA DANASEKARAN

    2014-06-01

    Full Text Available Frugal innovations are cost-conscious innovations developed to meet the needs in resource-poor settings, withoutcompromising quality. While there have been various innovations in the field of health care in the past decades, there is avast difference in the distribution and utilization of these innovations between developed and developing countries. Frugalinnovations can play a potential role in bridging the gap between countries and ensure affordable health care for all.

  1. Promoting Prevention Through the Affordable Care Act: Workplace Wellness

    Anderko, Laura; Roffenbender, Jason S.; Goetzel, Ron Z.; Millard, Francois; Wildenhaus, Kevin; DeSantis, Charles; Novelli, William

    2012-01-01

    Public health in the United States can be improved by building workplace “cultures of health” that support healthy lifestyles. The Affordable Care Act (ACA), which includes the Prevention and Public Health Fund, will support a new focus on prevention and wellness, offering opportunities to strengthen the public’s health through workplace wellness initiatives. This article describes the opportunity the ACA provides to improve worker wellness.

  2. Myocardial dysfunction and cardiovascular disease in type 2 diabetes.

    Ofstad, Anne Pernille

    2016-07-01

    Type 2 diabetes mellitus (T2DM) is strongly associated with increased risk of myocardial dysfunction and cardiovascular disease (CVD), two separate conditions which often co-exist and influence each other's course. The prevalence of myocardial dysfunction may be as high as 75% in T2DM populations but is often overlooked due to the initial asymptomatic nature of the disease, complicating co-morbidities such as coronary artery disease (CAD) and obesity, and the lack of consensus on diagnostic criteria. More sensitive echocardiographic applications are furthermore needed to improve detection of early subclinical changes in myocardial function which do not affect conventional echocardiographic parameters. The pathophysiology of the diabetic myocardial dysfunction is not fully elucidated, but involves hyperglycemia and high levels of free fatty acids. It evolves over several years and increases the risk of developing overt HF, and is suggested to at least in part account for the worse outcome seen in T2DM individuals after cardiac events. CAD and stroke are the most frequent CV manifestations among T2DM patients and relate to a large degree to the accelerated atherosclerosis driven by inflammation. Diagnosing CAD is challenging due to the lower sensitivity inherent in the diagnostic tests and there is thus a need for new biomarkers to improve prediction and detection of CAD. It seems that a multi-factorial approach (i.e. targeting several CV risk factors simultaneously) is superior to a strict glucose lowering strategy in reducing risk for macrovascular events, and recent research may even support an effect also on HF outcomes.

  3. Nifedipine for angina and acute myocardial ischemia

    P.G. Hugenholtz (Paul); J.W. de Jong (Jan Willem); P.D. Verdouw (Pieter); P.W.J.C. Serruys (Patrick)

    1983-01-01

    textabstractThis paper reviews the mechanisms believed to be responsible for myocardial ischaemia and the mode of action of calcium antagonist drugs. The clinical management of patients with myocardial ischaemia is discussed in the context of current knowledge about patho-physiology and drug action.

  4. Do episodes of anger trigger myocardial infarction?

    Möller, J; Hallqvist, J; Diderichsen, Finn

    1999-01-01

    Our objectives were to study anger as a trigger of acute myocardial infarction (MI) and to explore potential effect modification by usual behavioral patterns related to hostility.......Our objectives were to study anger as a trigger of acute myocardial infarction (MI) and to explore potential effect modification by usual behavioral patterns related to hostility....

  5. Myocardial infarction : early diagnosis and cardioprotective strategies

    Oerlemans, M.I.F.J.

    2012-01-01

    In this thesis, we have investigated novel diagnostic and cardioprotective strategies to limit myocardial cell death and improve cardiac function after myocardial infarction. We demonstrated a new way to speed up the diagnosis of acute MI by using very small pieces of RNA (microRNAs). Using these mi

  6. Collaborative Affordances of Hybrid Patient Record Technologies in Medical Work

    Houben, Steven; Frost, Mads; Bardram, Jakob E

    2015-01-01

    The medical record is a central artifact used to organize, communicate and coordinate information related to patient care. Despite recent deployments of electronic health records (EHR), paper medical records are still widely used because of the affordances of paper. Although a number of approache......PR in a medical simulation. Based on these empirical studies, this paper introduces and discusses the concept of collaborative affordances, which describes a set of properties of the medical record that foster collaborative collocated work.......The medical record is a central artifact used to organize, communicate and coordinate information related to patient care. Despite recent deployments of electronic health records (EHR), paper medical records are still widely used because of the affordances of paper. Although a number of approaches...... explored the integration of paper and digital technology, there are still a wide range of open issues in the design of technologies that integrate digital and paper-based medical records. This paper studies the use of one such novel technology, called the Hybrid Patient Record (HyPR), that is designed...

  7. Affordance-based individuation of junctions in Open Street Map

    Simon Scheider

    2012-06-01

    Full Text Available We propose an algorithm that can be used to identify automatically the subset of street segments of a road network map that corresponds to a junction. The main idea is to use turn-compliant locomotion affordances, i.e., restricted patterns of supported movement, in order to specify junctions independently of their data representation, and in order to motivate tractable individuation and classification strategies. We argue that common approaches based solely on geometry or topology of the street segment graph are useful but insufficient proxies. They miss certain turn restrictions essential to junctions. From a computational viewpoint, the main challenge of affordance-based individuation of junctions lies in its complex recursive definition. In this paper, we show how Open Street Map data can be interpreted into locomotion affordances, and how the recursive junction definition can be translated into a deterministic algorithm. We evaluate this algorithm by applying it to small map excerpts in order to delineate the contained junctions.

  8. [Percutaneous myocardial laser revascularization (PMR)].

    Lauer, B; Stahl, F; Bratanow, S; Schuler, G

    2000-09-01

    In patients with severe angina pectoris due to coronary artery disease, who are not candidates for either percutaneous coronary angioplasty or coronary artery bypass surgery, transmyocardial laser revascularization (TMR) often leads to improvement of clinical symptoms and increased exercise capacity. One drawback of TMR is the need for surgical thoracotomy in order to gain access to the epicardial surface of the heart. Therefore, a catheter-based system has been developed, which allows creation of laser channels into the myocardium from the left ventricular cavity. Between January 1997 and November 1999, this "percutaneous myocardial laser revascularization" (PMR) has been performed in 101 patients at the Herzzentrum Leipzig. In 63 patients, only 1 region of the heart (anterior, lateral, inferior or septal) was treated with PMR, in 38 patients 2 or 3 regions were treated in 1 session. There were 12.3 +/- 4.5 (range 4 to 22) channels/region created into the myocardium. After 3 months, the majority of patients reported significant improvement of clinical symptoms (CCS class at baseline: 3.3 +/- 0.4, after 6 months: 1.6 +/- 0.8) (p PMR, the CCS class after 2 years was 1.3 +/- 0.7, exercise capacity was 500 +/- 193 s. However, thallium scintigraphy failed to show increased perfusion in the PMR treated regions. The pathophysiologic mechanisms of myocardial laser revascularization is not yet understood. Most of the laser channels are found occluded after various time intervals after intervention. Other possible mechanisms include myocardial denervation or angioneogenesis after laser revascularization, however, unequivocal evidence for these theories is not yet available. In conclusion, PMR seems to be a safe and feasible new therapeutic option for patients with refractory angina pectoris due to end-stage coronary artery disease. The first results indicate improvement of clinical symptoms and increased exercise capacity, whereas evidence of increased perfusion after laser

  9. Myocardial infarction and nocturnal hypoxaemia

    Penčić Biljana

    2007-01-01

    Full Text Available Introduction: There is an increased risk of cardiovascular morbidity and mortality in patients with nocturnal intermittent hypoxaemia. Objecive. The aim of this study was to evalute the influence of nocturnal hypoxaemia on ventricular arrhythmias and myocardial ischaemia in patients with myocardial infarction (MI. Method. We studied 77 patients (55.8±7.9 years with MI free of complications, chronic pulmonary diseases, abnormal awake blood gases tension. All patients underwent overnight pulse oximetry and 24-hour electrocardiography. Patients were divided into two groups according to nocturnal hypoxaemia. Total number of ventricular premature complex (VPC; maximal VPC/h; incidence of VPC Lown class>2 and occurrence of ST-segment depression were analyzed for nocturnal (10 PM to 6 AM, daytime (6 AM to 22 PM periods and for the entire 24 hours. Results. Both groups were similar in age, gender, standard risk factors, myocardial infarction size and did not differ in VPC during the analyzed periods. The number of nocturnal maximal VPC/h was insignificantly greater in group 1 (with hypoxaemia compared to group 2 (without hypoxaemia, (p=0.084. Maximal VPC/h did not differ significantly either for daytime or for 24 hours among the groups. Nocturnal VPC Lown>2 were significantly more frequent in group 1 (25% vs 0%, p=0.002. The incidence of VPC Lown>2 was similar during the daytime, and during 24 hrs in both groups. Occurrence of ST-segment depression did not differ between groups 1 and 2. Conclusion. Nocturnal hypoxaemia was associated with complex nocturnal ventricular arrhythmias in patients with MI. .

  10. [Pharmacological properties of phosphorylacetohydrazides in experimental myocardial ischemia].

    Balashov, V P; Al'miasheva, M I; Tarasova, R I; Rusina, I F; Kul'kova, N P; Kurmysheva, T V; Voskresenskaia, O V

    2007-01-01

    It is shown that 2-chloroethoxy-para-N-dimethylphosphorylacetohydrazide and N-acethylhydrazide-para-dimethylaminophenyl-2-chloroethoxyphosphorylacetic acid reliably reduce ischemia-induced depression of inotropic functions of the left ventricle in cats with experimental myocardial infarction model. The effect of both compounds can be explained by the maintenance of viability of the injured myocardium via a delay of the development of acidosis and the support of oxygen recycling in the ischemized zone. Both compounds show pronounced antiradical properties with a non-standard mechanism of action.

  11. Adaptation of Myocardial Substrate Metabolism to a Ketogenic Nutrient Environment*

    Wentz, Anna E.; d'Avignon, D. André; Weber, Mary L.; Cotter, David G.; Doherty, Jason M.; Kerns, Robnet; Nagarajan, Rakesh; Reddy, Naveen; Sambandam, Nandakumar; Crawford, Peter A.

    2010-01-01

    Heart muscle is metabolically versatile, converting energy stored in fatty acids, glucose, lactate, amino acids, and ketone bodies. Here, we use mouse models in ketotic nutritional states (24 h of fasting and a very low carbohydrate ketogenic diet) to demonstrate that heart muscle engages a metabolic response that limits ketone body utilization. Pathway reconstruction from microarray data sets, gene expression analysis, protein immunoblotting, and immunohistochemical analysis of myocardial tissue from nutritionally modified mouse models reveal that ketotic states promote transcriptional suppression of the key ketolytic enzyme, succinyl-CoA:3-oxoacid CoA transferase (SCOT; encoded by Oxct1), as well as peroxisome proliferator-activated receptor α-dependent induction of the key ketogenic enzyme HMGCS2. Consistent with reduction of SCOT, NMR profiling demonstrates that maintenance on a ketogenic diet causes a 25% reduction of myocardial 13C enrichment of glutamate when 13C-labeled ketone bodies are delivered in vivo or ex vivo, indicating reduced procession of ketones through oxidative metabolism. Accordingly, unmetabolized substrate concentrations are higher within the hearts of ketogenic diet-fed mice challenged with ketones compared with those of chow-fed controls. Furthermore, reduced ketone body oxidation correlates with failure of ketone bodies to inhibit fatty acid oxidation. These results indicate that ketotic nutrient environments engage mechanisms that curtail ketolytic capacity, controlling the utilization of ketone bodies in ketotic states. PMID:20529848

  12. Investigating the affordability of key health services in South Africa.

    Cleary, Susan; Birch, Steve; Chimbindi, Natsayi; Silal, Sheetal; McIntyre, Di

    2013-03-01

    This paper considers the affordability of using public sector health services for three tracer conditions (obstetric care, tuberculosis treatment and antiretroviral treatment for HIV-positive people), based on research undertaken in two urban and two rural sites in South Africa. We understand affordability as the 'degree of fit' between the costs of seeking health care and a household's ability-to-pay. Exit interviews were conducted with over 300 patients for each of the three tracer conditions in each of the four sites (i.e. a total sample of over 3600). Total direct costs for the service used at the time of the interview, as well as other health related costs incurred during the preceding month either for self-care or the use of plural providers were assessed, as were a range of indicators of ability-to-pay. The percentage of households incurring direct costs exceeding 10% of household consumption expenditure and those borrowing money or selling assets as a mechanism for coping with the burden of direct costs were calculated. Logistic regressions were also conducted to identify factors that were significantly associated with these indicators of affordability. There were significant differences in affordability between rural and urban sites; costs were higher, ability-to-pay was lower and there was a greater proportion of households selling assets or borrowing money in rural areas. There were also significant differences across tracers, with a higher percentage of households receiving tuberculosis and antiretroviral treatment borrowing money or selling assets than those using obstetric services. As these conditions require expenses to be incurred on an ongoing basis, the sustainability of such coping strategies is questionable. Policy makers need to explore how to reduce direct costs for users of these key health services in the context of the particular characteristics of different treatment types. Affordability needs to be considered in relation to the dynamic

  13. [New frontiers in myocardial preservation].

    Juffe Stein, A

    1995-01-01

    The high hospital mortality due to primary graft failure, together with the ever more frequent use of "Suboptimum" donors because of the scarcity of organs has, in the recent years, caused renewed interest in perfectioning techniques of cardiac preservation. The numerous studies supporting the benefits of a period of controlled warm reperfusion after global ischemia, and the growth of the continuous warm blood cardioplegia, led us to the evolution of our own technique for myocardial protection during transplantation. Dr John Wallwork introduced the concept of donor "resuscitation" in the attempt to improve the hemodynamic state of the donor, by preload and afterload manipulation and pharmacological treatment of the unstable or "marginal" donor. The Juan Canalejo Hospital introduced the concept "Resuscitation during the implantation" using continuous warm blood cardioplegia. Maintenance of normothermia during heart transplantation produces what is referred to as "cell repair" or "resuscitation during the implantation" and avoid the reperfusion damage. From january 1992 to april 1995, 91 orthotopic heart transplantation were performed at our institution. By harvesting we have employed the conventional preservation technique. We performed a controlled continuous anterograde/retrograde warm blood cardioplegic reperfusion of the graft, before and during the implantation in 53 patients. Since january 1994 we performed in 38 cases the same controlled continuous warm blood reperfusion, but only anterograde. Continuous warm blood cardioplegia in heart transplantation is a safety myocardial protection method. Trasplant programs require the optimal use of the available donors.

  14. Contemporaryperspective on endogenous myocardial regeneration

    2015-01-01

    Considering the complex nature of the adult heart,it is no wonder that innate regenerative processes,while maintaining adequate cardiac function, fall shortin myocardial jeopardy. In spite of these enchaining limitations, cardiac rejuvenation occurs as well asrestricted regeneration. In this review, the backgroundas well as potential mechanisms of endogenousmyocardial regeneration are summarized. We presentand analyze the available evidence in three subsequentsteps. First, we examine the experimental researchdata that provide insights into the mechanisms andorigins of the replicating cardiac myocytes, includingcell populations referred to as cardiac progenitor cells(i.e. , c-kit+ cells). Second, we describe the role ofclinical settings such as acute or chronic myocardialischemia, as initiators of pathways of endogenousmyocardial regeneration. Third, the hitherto conductedclinical studies that examined different approachesof initiating endogenous myocardial regeneration infailing human hearts are analyzed. In conclusion, wepresent the evidence in support of the notion thatregaining cardiac function beyond cellular replacementof dysfunctional myocardium via initiation of innateregenerative pathways could create a new perspectiveand a paradigm change in heart failure therapeutics.Reinitiating cardiac morphogenesis by reintroducingdevelopmental pathways in the adult failing heart mightprovide a feasible way of tissue regeneration. Basedon our hypothesis "embryonic recall", we present firstsupporting evidence on regenerative impulses in themyocardium, as induced by developmental processes.

  15. Cardioprotective proteins upregulated in the liver in response to experimental myocardial ischemia.

    Liu, Shu Q; Tefft, Brandon J; Roberts, Derek T; Zhang, Li-Qun; Ren, Yupeng; Li, Yan Chun; Huang, Yong; Zhang, Di; Phillips, Harry R; Wu, Yu H

    2012-12-15

    Myocardial ischemia (MI) activates innate cardioprotective mechanisms, enhancing cardiomyocyte tolerance to ischemia. Here, we report a MI-activated liver-dependent mechanism for myocardial protection. In response to MI in the mouse, hepatocytes exhibited 6- to 19-fold upregulation of genes encoding secretory proteins, including α-1-acid glycoprotein (AGP)2, bone morphogenetic protein-binding endothelial regulator (BMPER), chemokine (C-X-C motif) ligand 13, fibroblast growth factor (FGF)21, neuregulin (NRG)4, proteoglycan 4, and trefoil factor (TFF)3. Five of these proteins, including AGP2, BMPER, FGF21, NRG4, and TFF3, were identified as cardioprotective proteins since administration of each protein significantly reduced the fraction of myocardial infarcts (37 ± 9%, 34 ± 7%, 32 ± 8%, 39 ± 6%, and 31 ± 7%, respectively, vs. 48 ± 7% for PBS at 24 h post-MI). The serum level of the five proteins elevated significantly in association with protein upregulation in hepatocytes post-MI. Suppression of a cardioprotective protein by small interfering (si)RNA-mediated gene silencing resulted in a significant increase in the fraction of myocardial infarcts, and suppression of all five cardioprotective proteins with siRNAs further intensified myocardial infarction. While administration of a single cardioprotective protein mitigated myocardial infarction, administration of all five proteins furthered the beneficial effect, reducing myocardial infarct fractions from PBS control values from 46 ± 6% (5 days), 41 ± 5% (10 days), and 34 ± 4% (30 days) to 35 ± 5%, 28 ± 5%, and 24 ± 4%, respectively. These observations suggest that the liver contributes to cardioprotection in MI by upregulating and releasing protective secretory proteins. These proteins may be used for the development of cardioprotective agents.

  16. 78 FR 73204 - Announcement of Requirements and Registration for “Innovation in Affordable Housing Student...

    2013-12-05

    ... affordable housing design that strengthens the social and physical fabric of low- and moderate- income... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT Announcement of Requirements and Registration for ``Innovation in Affordable...

  17. Use of thallium 201 myocardial imaging to exclude myocardial infarction after dissection in congenital coarctation of the aorta

    Halon, D.A.; Weiss, A.T.; Tzivoni, D.; Atlan, H.; Gotsman, M.S.

    1981-10-01

    The use of a mobile gamma camera with thallium 201 myocardial imaging is described to exclude myocardial infarction in a patient admitted to the coronary care unit in shock and with clinical, enzyme, and ECG changes consistent with infarction. The patient suffered from acute aortic dissection associated with congenital coarctation of the aorta. The myocardial scan excluded transmural myocardial injury.

  18. A Bootstrap Approach to an Affordable Exploration Program

    Oeftering, Richard C.

    2011-01-01

    This paper examines the potential to build an affordable sustainable exploration program by adopting an approach that requires investing in technologies that can be used to build a space infrastructure from very modest initial capabilities. Human exploration has had a history of flight programs that have high development and operational costs. Since Apollo, human exploration has had very constrained budgets and they are expected be constrained in the future. Due to their high operations costs it becomes necessary to consider retiring established space facilities in order to move on to the next exploration challenge. This practice may save cost in the near term but it does so by sacrificing part of the program s future architecture. Human exploration also has a history of sacrificing fully functional flight hardware to achieve mission objectives. An affordable exploration program cannot be built when it involves billions of dollars of discarded space flight hardware, instead, the program must emphasize preserving its high value space assets and building a suitable permanent infrastructure. Further this infrastructure must reduce operational and logistics cost. The paper examines the importance of achieving a high level of logistics independence by minimizing resource consumption, minimizing the dependency on external logistics, and maximizing the utility of resources available. The approach involves the development and deployment of a core suite of technologies that have minimum initial needs yet are able expand upon initial capability in an incremental bootstrap fashion. The bootstrap approach incrementally creates an infrastructure that grows and becomes self sustaining and eventually begins producing the energy, products and consumable propellants that support human exploration. The bootstrap technologies involve new methods of delivering and manipulating energy and materials. These technologies will exploit the space environment, minimize dependencies, and

  19. Rethinking Space Design Standards Toward Quality Affordable Housing In Malaysia

    Ishak Nor Haniza

    2016-01-01

    Full Text Available Provision of affordable housing is important to low- and middle-income population. A fit form of house will not only fulfil a basic human need for shelter, but it also contributes to physical and psychological well-being of the occupants. Excellent quality and affordable housing is an indication of a high quality of life. While writings exist on various aspects of the quality of affordable housing in Malaysia, discussion regarding space and design standards has scarcely been given any serious academic attention. Standards concerning residential development usually cover different aspects or stages of the development process. They can include planning standards, design standards, space standards and technical construction standards. The main concern of this paper is on space and design standards specifically. Space standard can be defined as a set of framework which dictates fixed internal space minimums. Meanwhile, design standard indicates design guidelines to ensure the functionality, comfortability and habitability of the house. This paper is concerned exclusively with indoor spaces of a house excluding external circulation spaces and service facilities (in case of strata housing. Its interest is in internal space as an aspect of housing quality. It can be concluded that one of the way forward will be to find the balance between providing adequate minimum spaces for resident satisfactions and having economic values for housing developers. This paper may be used as a valuable reference for authorities and policy makers to better address the best housing space design standards that would benefit not only the occupants, but also the local government and developers alike.

  20. Nitrogen-13-labeled ammonia for myocardial imaging

    Walsh, W.F.; Fill, H.R.; Harper, P.V.

    1977-01-01

    Cyclotron-produced nitrogen-13 (half-life 10 min), as labeled ammonia (/sup 13/NH/sub 4//sup +/), has been evaluated as a myocardial perfusion imaging agent. The regional myocardial uptake of /sup 13/NH/sub 4//sup +/ has been shown to be proportional to regional tissue perfusion in animal studies. Intravenously administered /sup 13/NH/sub 4//sup +/ is rapidly cleared from the circulation, being extracted by the liver (15 percent), lungs, myocardium (2 percent--4 percent), brain, kidney, and bladder. Myocardial ammonia is metabolized mainly to glutamine via the glutamine synthetase pathway. Pulmonary uptake is substantial, but usually transient, except in smokers where clearance may be delayed. The positron annihilation irradiation (511 keV) of /sup 13/N may be imaged with a scintillation camera, using either a specially designed tungsten collimator or a pinhole collimator. After early technical problems with collimation and the production method of /sup 13/NH/sub 4//sup +/ were overcome, reproducible high quality myocardial images were consistently obtained. The normal myocardial image was established to be of a homogeneous ''doughnut'' configuration. Imaging studies performed in patients with varying manifestations of ischemic and valvular heart disease showed a high incidence of localized perfusion defects, especially in patients with acute myocardial infarction. Sequential studies at short intervals in patients with acute infarction showed correlation between alterations in regional perfusion and the clinical course of the patient. It is concluded that myocardial imaging with /sup 13/NH/sub 4//sup +/ and a scintillation camera provides a valid and noninvasive means of assessing regional myocardial perfusion. This method is especially suitable for sequential studies of acute cardiac patients at short intervals. Coincidence imaging of the 511 keV annihilation irradiation provides a tomographic and potentially quantitative assessment of the

  1. Situational Affordance - Appreciating human Interpretations in New Product Development

    Mathiasen, John Bang; Koch, Christian

    2009-01-01

    New Product Development (NPD) takes place within a web of connected actors who do not master fully the objects of the process, but rather they interpret the affordance - the enabling and constraining framing by objects such as sketches, drawings, specifications, mock-ups and prototypes. The article...... in the sociological direction. Alpha employs the artefact as a drawing and/or a mock-up in order to understand the customer's situation, Golf applies a draft version of the customer's CAD-drawing to translate the requirement to the toolmaker, Juliett utilises drawings and specifications to negotiate technical and non...

  2. Understanding on-line community: the affordances of virtual space

    Karen Ruhleder

    2002-01-01

    Full Text Available Increasing numbers of on-line venues for learning are emerging as virtual communities become more accessible and commonplace. This paper looks at one particular virtual community, an on-line degree programme at the University of Illinois, Urbana-Champaign, which offers an M.S. in Library and Information Science (called LEEP. It draws on a framework presented by Mynatt, et al. (1998, which provides a lens for talking about on-line community as a set of affordances. This framework is applied to illustrate the interactions, artefacts, and expectations that shape this community.

  3. The Reader's Devices: The affordances of ebook readers

    Heather MacFadyen

    2011-04-01

    Full Text Available Print books and ebook devices now co-exist in a reading eco-system. The ways in which readers understand and describe their experience of reading on ebook devices is shaped by long-established cultural expectations about the abstract as well as the physical affordances of the print book. Ebook devices cannot help but challenge those expectations. A review of readers’ reactions to the emergence of ebook devices offers a glimpse into the complex cultural position of both the idea and the experience of reading.

  4. Learning Objects and Grasp Affordances through Autonomous Exploration

    Kraft, Dirk; Detry, Renaud; Pugeault, Nicolas;

    2009-01-01

    We describe a system for autonomous learning of visual object representations and their grasp affordances on a robot-vision system. It segments objects by grasping and moving 3D scene features, and creates probabilistic visual representations for object detection, recognition and pose estimation...... image sequences as well as (3) a number of built-in behavioral modules on the one hand, and autonomous exploration on the other hand, the system is able to generate object and grasping knowledge through interaction with its environment....

  5. The Affordable Care Act versus Medicare for All.

    Seidman, Laurence

    2015-08-01

    Many problems facing the Affordable Care Act would disappear if the nation were instead implementing Medicare for All - the extension of Medicare to every age group. Every American would be automatically covered for life. Premiums would be replaced with a set of Medicare taxes. There would be no patient cost sharing. Individuals would have free choice of doctors. Medicare's single-payer bargaining power would slow price increases and reduce medical cost as a percentage of gross domestic product (GDP). Taxes as a percentage of GDP would rise from below average to average for economically advanced nations. Medicare for All would be phased in by age.

  6. 慢性肾功能衰竭血尿酸水平与急性 ST 段抬高心肌梗死患者预后关系研究%Serum uric acid level in chronic renal failure and its relationship with prognosis of ST-segment elevation myocardial in-farction

    董丽娜

    2014-01-01

    Objective To study the relationship between serum uric acid level in chronic renal failure (CRF) and the prognosis of ST-segment elevation myocardial infarction(STEMI) .Methods The patients with CRF compli-cating hyperuricemia were selected as the observation group ,the patients with CRF and without comlicating hyperuri-cemia as the negative control group and the patients with normal renal function and hyperuricemia as the positive con-trol group .The cases of STEMI occurrence were observed .The cardiac function related indexes were detected and the negative emotions were evaluated .The related factors of STEMI occurrence were performed the Logistic regression a-nalysis .Results Hyperuricemia existed in different stages of CRF ,its expression level was significantly higher than that in the normal renal function group ;the occurrence of STEMI had the positive relationship with hyperuricemia ,a-nemia ,malnutrition ,hypertension ,ectopic calcification and depression ;LVEDD and LVEF in the observation group were significantly lower than those in the control group ,while the cases of myocardial infarction occurrence ,ST seg-ment elevation degrees and the scores of HAMD ,HAMA and VAS were significantly higher than those in the control group .Conclusion Hyperuricemia is a risk factor of myocardial infarction induced by CRF ,and can cause the damage of cardiac function to different degrees .%目的:研究慢性肾衰竭血尿酸水平与急性ST段抬高心肌梗死患者预后的关系。方法选择慢性肾衰竭合并高尿酸血症患者作为观察组、慢性肾衰竭未合并高尿酸血症患者作为阴性对照组、肾功能正常的高尿酸血症患者作为阳性对照组,观察发生心肌梗死的例数、检测心功能相关指标、评估负面情绪,并对心肌梗死发生的相关因素进行logistic回归分析。结果慢性肾衰竭不同分期均存在高尿酸血症,其表达水平明显高于肾功能正常组;心肌梗死的发生

  7. Determination of the Role of Oxygen in Suspected Acute Myocardial Infarction by Biomarkers

    2016-01-25

    Acute Myocardial Infarction (AMI); Acute Coronary Syndrome (ACS); ST Elevation (STEMI) Myocardial Infarction; Ischemic Reperfusion Injury; Non-ST Elevation (NSTEMI) Myocardial Infarction; Angina, Unstable

  8. Effects of Changes of Serum Uric Acid Levels on Prognosis in Elder Patients with Acute Myocardial Infarction%老年急性心肌梗死患者血尿酸水平变化对预后的影响

    马宇虹

    2015-01-01

    目的:探讨老年急性心肌梗死患者血尿酸水平变化对患者预后的影响。方法对2012年12月至2013年11月内蒙古医科大学附属医院收治的110例老年急性心肌梗死患者行血尿酸测定,男性以尿酸水平>420μmol/L,女性以尿酸水平>357μmol/L定义为高尿酸血症,根据患者是否患有高尿酸血症分为高尿酸血症组( A组,24例)和正常血尿酸组( B组,86例)。比较分析两组间实验室及超声检查、冠状动脉病变及预后。结果①A 组三酰甘油水平及左心房内径显著高于 B 组[(1.74±1.04) mmol/L比(1.08±0.54) mmol/L,(42±5) mm 比(39±6) mm,P <0.05或 P <0.01],而A组左心室射血分数显著低于B组[(46±14)%比(52±10)%,P<0.05]。②A组患者一级终点及二级终点事件的发生率均显著高于B组[24.0%(6例)比9.2%(8例),64.0%(16例)比35.6%(31例),P<0.05]。结论抑制尿酸水平的升高对于改善老年急性心肌梗死患者的预后可能具有重要意义。%Objective To investigate the changes of serum uric acid level on prognosis of elderly patients with acute myocardial infarction .Methods A total of 110 elderly patients with acute myocardial infarction admitted in the Affiliated Hospital of Inner Mongolia Medical University from Dec .2012 to Nov. 2013 were given detection of uric acid levels.Men with uric acid level of >420 μmol/L,and women with uric acid level of >357 μmol/L were defined as hyperuricemia.According to the criteria of hyperuricemia, patients were divided into hyperuricemia group(group A) and normal uric acid group(group B).Results of laboratory and ultrasonography examination, conditions of coronary artery disease and prognosis of the two groupswerecompared.Results ①TriglyceridelevelandleftatrialdiameterofgroupAweresignificantly higher than those of group B [(1.74 ±1.04) mmol/L vs (1.08 ±0.54) mmol/L, (42 ±5) mm vs (39

  9. A vesicular sequestration to oxidative deamination shift in myocardial sympathetic nerves in Parkinson's disease.

    Goldstein, David S; Sullivan, Patricia; Holmes, Courtney; Miller, Gary W; Sharabi, Yehonatan; Kopin, Irwin J

    2014-10-01

    In Parkinson's disease (PD), profound putamen dopamine (DA) depletion reflects denervation and a shift from vesicular sequestration to oxidative deamination of cytoplasmic DA in residual terminals. PD also involves cardiac sympathetic denervation. Whether PD entails myocardial norepinephrine (NE) depletion and a sequestration-deamination shift have been unknown. We measured apical myocardial tissue concentrations of NE, DA, and their neuronal metabolites 3,4-dihydroxyphenylglycol (DHPG), and 3,4-dihydroxyphenylacetic acid (DOPAC) from 23 PD patients and 23 controls and ascertained the extent of myocardial NE depletion in PD. We devised, validated in VMAT2-Lo mice, and applied 5 neurochemical indices of the sequestration-deamination shift-concentration ratios of DOPAC:DA, DA:NE, DHPG:NE, DOPAC:NE, and DHPG:DOPAC-and used a kinetic model to estimate the extent of the vesicular storage defect. The PD group had decreased myocardial NE content (p Parkinson's disease (PD) patients have profound (98%) myocardial norepinephrine depletion, because of both cardiac sympathetic denervation and a shift from vesicular sequestration to oxidative deamination of cytoplasmic catecholamines in the residual nerves. This shift may be part of a final common pathogenetic pathway in the loss of catecholaminergic neurons that characterizes PD.

  10. Impact of Insulin Resistance on Silent and Ongoing Myocardial Damage in Normal Subjects: The Takahata Study

    Taro Narumi

    2012-01-01

    Full Text Available Background. Insulin resistance (IR is part of the metabolic syndrome (Mets that develops after lifestyle changes and obesity. Although the association between Mets and myocardial injury is well known, the effect of IR on myocardial damage remains unclear. Methods and Results. We studied 2200 normal subjects who participated in a community-based health check in the town of Takahata in northern Japan. The presence of IR was assessed by homeostasis model assessment ratio, and the serum level of heart-type fatty acid binding protein (H-FABP was measured as a maker of silent and ongoing myocardial damage. H-FABP levels were significantly higher in subjects with IR and Mets than in those without metabolic disorder regardless of gender. Multivariate logistic analysis showed that the presence of IR was independently associated with latent myocardial damage (odds ratio: 1.574, 95% confidence interval 1.1–2.3 similar to the presence of Mets. Conclusions. In a screening of healthy subjects, IR and Mets were similarly related to higher H-FABP levels, suggesting that there may be an asymptomatic population in the early stages of metabolic disorder that is exposed to myocardial damage and might be susceptible to silent heart failure.

  11. 24 CFR 954.306 - Rental housing: qualification as affordable housing and income targeting.

    2010-04-01

    ... affordable housing and income targeting. 954.306 Section 954.306 Housing and Urban Development Regulations... Affordability § 954.306 Rental housing: qualification as affordable housing and income targeting. (a) Rent...: (1) Bears rents not greater than the lesser of— (i) The section 8 fair market rent for...

  12. 77 FR 42658 - Patient Protection and Affordable Care Act; Data Collection To Support Standards Related to...

    2012-07-20

    ... HUMAN SERVICES 45 CFR Part 156 RIN 0938-AR36 Patient Protection and Affordable Care Act; Data Collection.... SUMMARY: This final rule establishes data collection standards necessary to implement aspects of section 1302 of the Patient Protection and Affordable Care Act (Affordable Care Act), which directs...

  13. 76 FR 59702 - Notice of Intent To Award Affordable Care Act (ACA) Funding

    2011-09-27

    ... HUMAN SERVICES Centers for Disease Control and Prevention Notice of Intent To Award Affordable Care Act... Services (HHS). ACTION: Notice. Overview Information Notice of Intent to Award Affordable Care Act (ACA...: This notice provides public announcement of CDC's intent to award Affordable Care Act...

  14. 75 FR 70160 - Affordable Care Act; Federal External Review Process; Request for Information

    2010-11-17

    ... Administration 29 CFR Part 2590 Affordable Care Act; Federal External Review Process; Request for Information... Act, as amended by the Affordable Care Act, and its implementing regulations. DATES: Submit written or... and external review processes under the Affordable Care Act; those comments are being collected...

  15. 76 FR 20352 - Notice of Intent To Award Affordable Care Act (ACA) Funding

    2011-04-12

    ... HUMAN SERVICES Centers for Disease Control and Prevention Notice of Intent To Award Affordable Care Act (ACA) Funding Notice of Intent to award Affordable Care Act (ACA) funding to two Emerging Infections... participating EIP sites. Funding is appropriated under the Affordable Care Act (PL 111-148), Title IV,...

  16. 76 FR 60788 - Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans...

    2011-09-30

    ... HUMAN SERVICES 45 CFR Parts 153, 155 and 156 Patient Protection and Affordable Care Act; Establishment... and Affordable Care Act of 2010 as amended by the Health Care and Education Reconciliation Act of 2010, referred to collectively as the Affordable Care Act. The other proposed rule would implement standards...

  17. 76 FR 76573 - Medical Loss Ratio Requirements Under the Patient Protection and Affordable Care Act

    2011-12-07

    ... Requirements Under the Patient Protection and Affordable Care Act; Final Rule #0;#0;Federal Register / Vol. 76... Affordable Care Act AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Final rule with... period. I. Background The Patient Protection and Affordable Care Act (Pub. L. 111-148) was enacted...

  18. 78 FR 79619 - Patient Protection and Affordable Care Act; Program Integrity: Exchange, Premium Stabilization...

    2013-12-31

    ...-9957-CN; 9964-CN] RIN 0938-AR82; RIN 0938-AR74 Patient Protection and Affordable Care Act; Program... Affordable Care Act; Program Integrity: Exchange, Premium Stabilization Programs, and Market Standards... and Affordable Care Act; Program Integrity: Exchange, Premium Stabilization Programs, and...

  19. 77 FR 18309 - Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans...

    2012-03-27

    ... Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans; Exchange Standards..., 156, and 157 RIN 0938-AQ67 Patient Protection and Affordable Care Act; Establishment of Exchanges and... collectively as the Affordable Care Act. The Exchanges will provide competitive marketplaces for...

  20. 76 FR 41865 - Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans

    2011-07-15

    ... Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans; Proposed Rule #0... Exchanges (``Exchanges''), consistent with title I of the Patient Protection and Affordable Care Act of 2010...-152), referred to collectively as the Affordable Care Act. The Exchanges will provide...

  1. 76 FR 41929 - Patient Protection and Affordable Care Act; Standards Related to Reinsurance, Risk Corridors and...

    2011-07-15

    ... Affordable Care Act; Standards Related to Reinsurance, Risk Corridors and Risk Adjustment; Proposed Rule #0... OF HEALTH AND HUMAN SERVICES 45 CFR Part 153 RIN 0938-AR07 Patient Protection and Affordable Care Act... corridors, and risk adjustment consistent with title I of the Patient Protection and Affordable Care Act...

  2. 77 FR 31513 - Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans...

    2012-05-29

    ... HUMAN SERVICES 45 CFR Parts 155, 156, and 157 RIN 0938-AQ67 Patient Protection and Affordable Care Act... Federal Register on March 27, 2012, entitled ``Patient Protection and Affordable Care Act; Establishment... rule regarding the codification of section 1413(c) of the Affordable Care Act. To align the...

  3. 75 FR 37187 - Patient Protection and Affordable Care Act: Preexisting Condition Exclusions, Lifetime and Annual...

    2010-06-28

    ... Protection and Affordable Care Act; Requirements for Group Health Plans and Health Insurance Issuers Under the Patient Protection and Affordable Care Act Relating to Preexisting Condition Exclusions, Lifetime... CFR Parts 144, 146, and 147 RIN 0991-AB69 Patient Protection and Affordable Care Act:...

  4. A Prototype using Territories and an Affordance Tree for Social Simulation Gameplay

    Geishauser, Tilman; Cheong, Yun-Gyung; Nelson, Mark

    2014-01-01

    so- cial simulation using smart objects. We extend the concept of smart objects to include a model of human behavior with regard to territoriality. To manage complexity in worlds with many such objects we employ a tree structure, which we call an Affordance Tree. The Affordance Tree allows...... the spatial containment of the affordances in the environment to be hierarchically organized....

  5. Myocardial Ischemia Caused by Subepicardial Hematoma

    Grieshaber, Philippe; Nef, Holger; Böning, Andreas; Niemann, Bernd

    2017-01-01

    Background Bleeding from bypass anastomosis leakage occurs early after coronary artery bypass grafting. Later, once the anastomosis is covered by intima, spontaneous bleeding is unlikely. Case Description A 63-year-old male patient developed a pseudoaneurysm-like, subepicardial late-term bleeding resulting in a hematoma that compromised coronary artery flow by increasing extracoronary pressure. This resulted in severe angina pectoris (Canadian Cardiovascular Society IV) and myocardial ischemia within the affected area. After surgical removal of the hematoma and repair of the anastomosis, the patient's symptoms disappeared and no signs of myocardial ischemia were present. Conclusion Surgical removal is an efficient therapy for subepicardial hematoma inducing myocardial ischemia.

  6. Nanog expression in heart tissues induced by acute myocardial infarction.

    Luo, Huanhuan; Li, Qiong; Pramanik, Jogen; Luo, Jiankai; Guo, Zhikun

    2014-10-01

    Nanog is a potential stem cell marker and is considered a regeneration factor during tissue repair. In the present study, we investigated expression patterns of nanog in the rat heart after acute myocardial infarction by semi-quantitative RT-PCR, immunohistochemistry and Western blot analyses. Our results show that nanog at both mRNA and protein levels is positively expressed in myocardial cells, fibroblasts and small round cells in different myocardial zones at different stages after myocardial infarction, showing a spatio-temporal and dynamic change. After myocardial infarction, the nanog expression in fibroblasts and small round cells in the infarcted zone (IZ) is much stronger than that in the margin zone (MZ) and remote infarcted zone (RIZ). From day 7 after myocardial infarction, the fibroblasts and small cells strongly expressed nanog protein in the IZ, and a few myocardial cells in the MZ and the RIZ and the numbers of nanog-positive fibroblasts and small cells reached the highest peak at 21 days after myocardial infarction, but in this period the number of nanog-positive myocardial cells decreased gradually. At 28 days after myocardial infarction, the numbers of all nanog-positive cells decreased into a low level. Therefore, our data suggest that all myocardial cells, fibroblasts and small round cells are involved in myocardial reconstruction after cardiac infarction. The nanog-positive myocardial cells may respond to early myocardial repair, and the nanog-positive fibroblasts and small round cells are the main source for myocardial reconstruction after cardiac infarction.

  7. SPECT Myocardial Blood Flow Quantitation Concludes Equivocal Myocardial Perfusion SPECT Studies to Increase Diagnostic Benefits.

    Chen, Lung-Ching; Lin, Chih-Yuan; Chen, Ing-Jou; Ku, Chi-Tai; Chen, Yen-Kung; Hsu, Bailing

    2016-01-01

    Recently, myocardial blood flow quantitation with dynamic SPECT/CT has been reported to enhance the detection of coronary artery disease in human. This advance has created important clinical applications to coronary artery disease diagnosis and management for areas where myocardial perfusion PET tracers are not available. We present 2 clinical cases that undergone a combined test of 1-day rest/dipyridamole-stress dynamic SPECT and ECG-gated myocardial perfusion SPECT scans using an integrated imaging protocol and demonstrate that flow parameters are capable to conclude equivocal myocardial perfusion SPECT studies, therefore increasing diagnostic benefits to add value in making clinical decisions.

  8. Obesity Preserves Myocardial Function During Blockade of the Glycolytic Pathway

    Campos, Dijon Henrique Salomé de, E-mail: dijoncampos@gmail.com [Departamento de Clínica Médica - Faculdade de Medicina de Botucatu da Universidade Estadual Paulista (UNESP), Botucatu, SP (Brazil); Leopoldo, André Soares; Lima-Leopoldo, Ana Paula [Departamento de Esportes - Centro de Educação Física e Desportos da Universidade Federal do Espírito Santo (UFES), Vitória, ES (Brazil); Nascimento, André Ferreira do [Instituto de Ciências da Saúde da Universidade Federal do Mato Grosso (UFMT), Sinop, MT (Brazil); Oliveira-Junior, Silvio Assis de [Escola de Fisioterapia da Universidade Federal do Mato Grosso do Sul (UFMS), Campo Grande, MS (Brazil); Silva, Danielle Cristina Tomaz da [Departamento de Clínica Médica - Faculdade de Medicina de Botucatu da Universidade Estadual Paulista (UNESP), Botucatu, SP (Brazil); Sugizaki, Mario Mateus [Instituto de Ciências da Saúde da Universidade Federal do Mato Grosso (UFMT), Sinop, MT (Brazil); Padovani, Carlos Roberto [Departamento de Bioestatística, Instituto de Ciências Biológicas da Universidade Estadual Paulista (UNESP), Botucatu, SP (Brazil); Cicogna, Antonio Carlos, E-mail: dijoncampos@gmail.com [Departamento de Clínica Médica - Faculdade de Medicina de Botucatu da Universidade Estadual Paulista (UNESP), Botucatu, SP (Brazil)

    2014-10-15

    Obesity is defined by excessive accumulation of body fat relative to lean tissue. Studies during the last few years indicate that cardiac function in obese animals may be preserved, increased or diminished. Study the energy balance of the myocardium with the hypothesis that the increase in fatty acid oxidation and reduced glucose leads to cardiac dysfunction in obesity. 30-day-old male Wistar rats were fed standard and hypercaloric diet for 30 weeks. Cardiac function and morphology were assessed. In this paper was viewed the general characteristics and comorbities associated to obesity. The structure cardiac was determined by weights of the heart and left ventricle (LV). Myocardial function was evaluated by studying isolated papillary muscles from the LV, under the baseline condition and after inotropic and lusitropic maneuvers: myocardial stiffness; postrest contraction; increase in extracellular Ca2+ concentration; change in heart rate and inhibitor of glycolytic pathway. Compared with control group, the obese rats had increased body fat and co-morbities associated with obesity. Functional assessment after blocking iodoacetate shows no difference in the linear regression of DT, however, the RT showed a statistically significant difference in behavior between the control and the obese group, most notable being the slope in group C. The energy imbalance on obesity did not cause cardiac dysfunction. On the contrary, the prioritization of fatty acids utilization provides protection to cardiac muscle during the inhibition of glycolysis, suggesting that this pathway is fewer used by obese cardiac muscle.

  9. Obesity Preserves Myocardial Function During Blockade of the Glycolytic Pathway

    Dijon Henrique Salomé de Campos

    2014-10-01

    Full Text Available Background: Obesity is defined by excessive accumulation of body fat relative to lean tissue. Studies during the last few years indicate that cardiac function in obese animals may be preserved, increased or diminished. Objective: Study the energy balance of the myocardium with the hypothesis that the increase in fatty acid oxidation and reduced glucose leads to cardiac dysfunction in obesity. Methods: 30-day-old male Wistar rats were fed standard and hypercaloric diet for 30 weeks. Cardiac function and morphology were assessed. In this paper was viewed the general characteristics and comorbities associated to obesity. The structure cardiac was determined by weights of the heart and left ventricle (LV. Myocardial function was evaluated by studying isolated papillary muscles from the LV, under the baseline condition and after inotropic and lusitropic maneuvers: myocardial stiffness; postrest contraction; increase in extracellular Ca2+ concentration; change in heart rate and inhibitor of glycolytic pathway. Results: Compared with control group, the obese rats had increased body fat and co-morbities associated with obesity. Functional assessment after blocking iodoacetate shows no difference in the linear regression of DT, however, the RT showed a statistically significant difference in behavior between the control and the obese group, most notable being the slope in group C. Conclusion: The energy imbalance on obesity did not cause cardiac dysfunction. On the contrary, the prioritization of fatty acids utilization provides protection to cardiac muscle during the inhibition of glycolysis, suggesting that this pathway is fewer used by obese cardiac muscle.

  10. Clinical significance of {sup 123}I-BMIPP myocardial SPECT

    Yamazaki, Junichi [Toho Univ., Tokyo (Japan). School of Medicine

    1998-07-01

    {sup 123}I-BMIPP is a radioiodinated branched chain fatty acid analog, showing high accumulation as well as prolonged retention in the myocardium. Therefore, it is used as a metabolic imaging agent suitable for myocardial SPECT. After {sup 123}I-BMIPP is taken in the myocardium, it remains there mainly as a storage type fatty acid of triglyceride, and it shows different behavior by the stage of cardiac disease. Usually, we evaluate metabolic findings by early imaging (20 minutes) after intravenous injection of {sup 123}I-BMIPP, however, sometimes washout or fill in are seen in the case of myocardial infarction or hypertrophic cardiomyopathy by delayed imaging (after 4 hours). The mismatch of {sup 201}TlCl and {sup 123}I-BMIPP are useful for the diagnosis of stunned myocardium or evaluation of prognosis. However, behavior of {sup 123}I-BMIPP in myocardium is known still not completely. Therefore clinical significance of this examination is thought to be clarified by the stock of cases of various heart diseases. (author)

  11. Myocardial infarction in the young

    Cengel A

    2009-01-01

    Full Text Available An increasing number of patients under 40 years of age are being hospitalized with the diagnosis of acute myocardial infarction. This is partly due to the increased prevalance of risk factors for atherosclerosis in the younger age group; especially increased incidence of impaired fasting glucose, high triglyceride, low high-density lipoprotein levels and increased waist to hip ratio. However, non-atherosclerotic coronary artery disease or hypercoagulability should also be investigated or at least suspected in the younger patients. The pathophysiology of different clinical conditions and disease states which cause acute coronary syndromes in the young patients are reviewed, and the diagnostic modalities and therapatic options for these conditions are briefly discussed by searching for "premature atherosclerosis", "hypercoagulable states", "risk factors for atherosclerosis in youth", "novel risk factors for atherosclerosis", "non-atherosclerotic coronary artery diseases" in PubMed.

  12. Architecture & Design of Affordable and Highly Available Enterprise Cloud Service

    Rabi Prasad Padhy

    2013-01-01

    Full Text Available Cloud computing is a way to increase capacity or add capabilities on the fly without investing in additional infrastructure, licensing additional software or training new personnel. Enterprises must embrace this bleeding edge real-time business model in order to compete in the current marketplace. Deployment of enterprise applications in public cloud can reduce investment on IT infrastructure both in terms of hardware and software, whenever new services are to be provisioned. Furthermore, cloud services are quite attractive to business because of its dynamic scalability, privacy, performance and ability to handle heterogeneous environments. Instead of spending a lot of time in figuring out server setup and working on routers, it is judicious to subscribe cloud based 24/7 support and affordable services. It’s an extremely important consideration to subscribe to at least two cloud vendors for smooth running of applications and ensure application availability by switching from one provider to another with minimal management effort. In this article we have proposed an architecture and design of a cost affordable online enterprise cloud application that subscribes to two public cloud vendors with respect to cost and availability parameters. We also present the reasons for the current trend of enterprises moving towards 24/7 online business cloud services.

  13. Spatial compatibility and affordance compatibility in patients with chronic schizophrenia.

    Kume, Yu; Sato, Fumiyasu; Hiraoka, Yuya; Suzuki, Shingo; Niyama, Yoshitsugu

    2016-12-01

    A deterioration in information-processing performance is commonly recognized in patients with chronic schizophrenia. Although the enhancement of cognitive skills in patients with schizophrenia is important, the types of external stimuli that influence performance have not received much attention. The aim of present study was to clarify the effects of spatial and affordance compatibility in patients with schizophrenia, compared with those in healthy people. The subjects (25 patients with schizophrenia and 25 healthy controls) participated in two experiment examining the effects of the spatial location of stimuli and the action-relevance of objects. The results showed that the effect of spatial compatibility was similar in both the patients and the controls, whereas the influence of action-relevant objects was not highlighted in either patients with chronic schizophrenia or healthy controls. These findings provide important evidence of a normal spatial compatibility effect in patients with chronic schizophrenia. However, further research examining the affordance compatibility effect is needed, taking into consideration the symptomatology and the severity of the social functioning level in patients with schizophrenia.

  14. Interaction between affordance and handedness recognition: a chronometric study

    A.P. Lameira

    2015-04-01

    Full Text Available The visualization of tools and manipulable objects activates motor-related areas in the cortex, facilitating possible actions toward them. This pattern of activity may underlie the phenomenon of object affordance. Some cortical motor neurons are also covertly activated during the recognition of body parts such as hands. One hypothesis is that different subpopulations of motor neurons in the frontal cortex are activated in each motor program; for example, canonical neurons in the premotor cortex are responsible for the affordance of visual objects, while mirror neurons support motor imagery triggered during handedness recognition. However, the question remains whether these subpopulations work independently. This hypothesis can be tested with a manual reaction time (MRT task with a priming paradigm to evaluate whether the view of a manipulable object interferes with the motor imagery of the subject's hand. The MRT provides a measure of the course of information processing in the brain and allows indirect evaluation of cognitive processes. Our results suggest that canonical and mirror neurons work together to create a motor plan involving hand movements to facilitate successful object manipulation.

  15. Anticipating Human Activities Using Object Affordances for Reactive Robotic Response.

    Koppula, Hema S; Saxena, Ashutosh

    2016-01-01

    An important aspect of human perception is anticipation, which we use extensively in our day-to-day activities when interacting with other humans as well as with our surroundings. Anticipating which activities will a human do next (and how) can enable an assistive robot to plan ahead for reactive responses. Furthermore, anticipation can even improve the detection accuracy of past activities. The challenge, however, is two-fold: We need to capture the rich context for modeling the activities and object affordances, and we need to anticipate the distribution over a large space of future human activities. In this work, we represent each possible future using an anticipatory temporal conditional random field (ATCRF) that models the rich spatial-temporal relations through object affordances. We then consider each ATCRF as a particle and represent the distribution over the potential futures using a set of particles. In extensive evaluation on CAD-120 human activity RGB-D dataset, we first show that anticipation improves the state-of-the-art detection results. We then show that for new subjects (not seen in the training set), we obtain an activity anticipation accuracy (defined as whether one of top three predictions actually happened) of 84.1, 74.4 and 62.2 percent for an anticipation time of 1, 3 and 10 seconds respectively. Finally, we also show a robot using our algorithm for performing a few reactive responses.

  16. A Model of Housing Quality Determinants (HQD for Affordable Housing

    Afaq Hyder Chohan

    2015-01-01

    Full Text Available This research identifies the design quality determinants and parameters for affordable housing in a developing metropolis, Karachi, Pakistan. The absence of quality housing in Karachi has resulted in a variety of factors including policy failure, violation of bylaws, housing scarcity and more low quality housing. The combination of these factors has resulted in poor housing design and construction and has lowered the overall quality of housing. Homeowners (end-users experience unplanned maintenance and repairs. This study provides a design quality model for use as a survey tool among professionals and endusers. This study resulted in a table of 24 quality determinants marked as Housing Quality Determinants (HQD grouped into eight sections. This research concludes that the existing design quality of affordable housing in Karachi could be enhanced by resolving problems related to design, construction, services, site development, neighbourhood and sustainability. The HQD model provides a platform for developing quality indicators of housing design and an opportunity for local and international design and construction professionals to rethink design in the context of housing quality. This article provides the development of the HQD framework (model.

  17. Sonic mediatization of the book: affordances of the audiobook

    Iben Have

    2013-03-01

    Full Text Available This article addresses cultural changes resulting from the growing number of audiobook users and changes in audiobook use emerging from digital technological developments of the past decade. The sonification of the written text is inscribed in the general transformation and mediatization of the printed book but offers radically different affordances than do visually perceived e-books. New portable digital audio media change the act of reading, moving it towards fields of practice in which reading has not been common before: the gym, the bicycle ride, gardening, resting in the dark, etc. From being a medium typically associated with children, the visually handicapped, or the dyslexic, the audiobook has developed into a popular phenomenon, which, we argue, has as much in common with other kinds of mediated mobile listening practices, like music and radio listening, as it has with the reading of printed books. Taking an inductive approach from the micro-level of the individual’s use, the term affordances will be used as a methodological tool within the concept of mediatization.

  18. Affordance-controlled bifurcations of action patterns in martial arts.

    Hristovski, Robert; Davids, Keith; Araújo, Duarte

    2006-10-01

    Effects of participant-target distance and perceived handstriking efficiency on emergent behavior in the martial art of boxing were investigated, revealing affordance-controlled nonlinear dynamical effects (i.e. bifurcations) within the participant--target system. Results established the existence of critical values of scaled distances for emergence of first time excitations and annihilations of a diverse range of boxing actions i.e. on the appearance and dissolution of jabs, hooks and uppercuts. Reasons for the action diversity were twofold: (a) topological discontinuous changes (bifurcations) in the number of possible handstrikes, i.e. motor solutions to the hitting task; (b) fine modification of probabilities of emergence of striking patterns. Exploitation of a 'strikeability' affordance available in scaled distance-to-target information by boxers led to a diversity of emergent actions through a cascade of bifurcations in the task perceptual-motor work space. Data suggested that perceived efficiency (E) of an action changed as a function of scaled distance (D) and was correlated with the probability of occurrence of action patterns (P), exhibiting the following dependence P = P(E(D)). The implication is that probability of occurrence (P) depends on efficiency (E), which in turn depends on scaled distance (D) to the target. Accordingly, scaled distance-dependent perceived efficiency seems a viable candidate for a contextual (control) parameter to describe the nonlinear dynamics of striking actions in boxing.

  19. 心脏脂肪酸结合蛋白对冠状动脉搭桥术后心肌损伤的诊断价值%The diagnosis value of heart fatty acid binding protein for myocardial injury in patients after coronary artery bypass graft

    张兰; 宋丹; 苏晞; 陈国洪; 王琳; 陈运清

    2011-01-01

    目的:探讨心脏脂肪酸结合蛋白(H-FABP)对冠状动脉(冠脉)搭桥术(CABG)患者术后心肌损伤的诊断价值.方法:分别在术前、术中解除主动脉十字夹钳即再灌注即刻、30 min、60 min、90 min、2 h、3 h、4 h、5 h、6 h、12 h、24 h采取动脉血检测H-FABP、肌酸激酶同工酶(CK-MB)、肌钙蛋蛋白I(cTnI).共连续检测了50例.按临床表现分为心肌损伤组和对照组.结果:①对照组(40例)的H-FABP、CK-MB、cTnI在手术前后均没有明显变化.②在心肌损伤组中(10例),在手术前血清H-FABP值为(3.56±1.2)μg/L,在术后(0.85±0.2)h血清H-FABP开始升高并达到峰值(72.4±18.1)μg/L,比CK-MB和cTnI均明显提前(P<0.0001);血清CK-MB值于(4.9±0.6)h开始升高,于(5.9±0.2)h到达峰值(64.4±17.6)IU/L;cTnI值于6 h开始升高,于(13.8±5.7)h达峰值(11.6±4.6)μg/L;再灌注即刻的H-FABP值和H-FABP的峰值呈显著正相关(r=0.88,P<0.0001);H-FABP的峰值分别与CK-MB峰值、cTnI亦呈显著正相关(r=0.91,P<0.0001和r=0.87,P<0.0001).结论:CABG术后监测H-FABP能早期发现心肌损害,并能预示心肌损害的程度,H-FABP是极具前途的血清心脏标记物之一.%Objective:To investigate the diagnosis value of heart fatty acid binding protein for myocardial injury in patients after coronary artery bypass graft (CABG).Method:Serum level of creatine kinase-MB (CK-MB), troponin-Ⅰ (cTnI), and human heart fatty acid binding protein (H-FABP) were detected in continued patients being undergone CABG at before operation,and the time interval reperfusion at 0 min, 30 min, 60 min, 90 min, 2 hr, 3 hr, 4 hr, 5 hr, 6 hr, 12 hr, 24 hr, respectively.Patients were divided into two groups (myocardial injury group and control group) according to the clinic characteristic information.Result:In the control group, the serum levels of H-FABP, CK-MB and cTnI did not change before and after CABG.In the myocardial injury group, the serum levels of H-FABP, CK-MB and c

  20. Bone marrow cells and myocardial regeneration.

    Wang, Fu-Sheng; Trester, Cathy

    2004-05-01

    Hematopoietic stem cell (HSC) plasticity and its clinical application have been studied profoundly in the past few years. Recent investigations indicate that HSC and other bone marrow stem cells can develop into other tissues. Because of the high morbidity and mortality of myocardial infarction and other heart disorders, myocardial regeneration is a good example of the clinical application of HSC plasticity in regenerative medicine. Preclinical studies in animals suggest that the use of this kind of treatment can reconstruct heart blood vessels, muscle, and function. Some clinical study results have been reported in the past 2 years. In 2003, reports of myocardial regeneration treatment increased significantly. Other studies include observations on the cell surface markers of transplanted cells and treatment efficacy. Some investigations, such as HSC testing, have focused on clinical applications using HSC plasticity and bone marrow transplantation to treat different types of disorders. In this review, we focus on the clinical application of bone marrow cells for myocardial regeneration.

  1. Repetitive Myocardial Infarctions Secondary to Delirium Tremens

    David Schwartzberg

    2014-01-01

    Full Text Available Delirium tremens develops in a minority of patients undergoing acute alcohol withdrawal; however, that minority is vulnerable to significant morbidity and mortality. Historically, benzodiazepines are given intravenously to control withdrawal symptoms, although occasionally a more substantial medication is needed to prevent the devastating effects of delirium tremens, that is, propofol. We report a trauma patient who required propofol sedation for delirium tremens that was refractory to benzodiazepine treatment. Extubed prematurely, he suffered a non-ST segment myocardial infarction followed by an ST segment myocardial infarction requiring multiple interventions by cardiology. We hypothesize that his myocardial ischemia was secondary to an increased myocardial oxygen demand that occurred during his stress-induced catecholamine surge during the time he was undertreated for delirium tremens. This advocates for the use of propofol for refractory benzodiazepine treatment of delirium tremens and adds to the literature on the instability patients experience during withdrawal.

  2. Diagnosing Myocardial Contusion after Blunt Chest Trauma

    Zahra Alborzi

    2016-10-01

    Full Text Available A myocardial contusion refers to a bruise of the cardiac muscle, the severity of which can vary depending on the severity of the injury and when the injury occurs. It is a major cause of rapid death which happens after blunt chest trauma and should be suspected at triage in the emergency department. We demonstrated that suspected myocardial contusion patients who have normal electrocardiograms (ECGs and biomarker tests can be safely discharged. However, if the test results are abnormal, the next steps should be echocardiography and more advanced measures. Diagnosing myocardial contusion is very difficult because of its nonspecific symptoms. If a myocardial contusion happens, cardiogenic shock or arrhythmia must be anticipated, and the patient must be carefully monitored.

  3. [Stem cell perspectives in myocardial infarctions].

    Aceves, José Luis; Archundia, Abel; Díaz, Guillermo; Páez, Araceli; Masso, Felipe; Alvarado, Martha; López, Manuel; Aceves, Rocío; Ixcamparij, Carlos; Puente, Adriana; Vilchis, Rafael; Montaño, Luis Felipe

    2005-01-01

    Myocardial infarction is the leading cause of congestive heart failure and death in industrializated countries. The cellular cardiomyoplasty has emerged as an alternative treatment in the regeneration of infarted myocardial tissue. In animals' models, different cellular lines such as cardiomyocites, skeletal myoblasts, embryonic stem cells and adult mesenchymal stem cells have been used, resulting in an improvement in ventricular function and decrease in amount of infarcted tissue. The first three cells lines have disvantages as they are allogenics and are difficult to obtain. The adult mesenchymal stem cells are autologous and can be obtained throught the aspiration of bone marrow or from peripherical circulation, after stimulating with cytokines (G-CSF). The implantation in humans with recent and old myocardial infarction have shown improvements similar to those shown in animal models. These findings encourage the continued investigation in the mechanism of cellular differentiation and implantation methods in infarcted myocardial tissue.

  4. Exosomes and cardiac repair after myocardial infarction.

    Sahoo, Susmita; Losordo, Douglas W

    2014-01-17

    Myocardial infarction is a leading cause of death among all cardiovascular diseases. The analysis of molecular mechanisms by which the ischemic myocardium initiates repair and remodeling indicates that secreted soluble factors are key players in communication to local and distant tissues, such as bone marrow. Recently, actively secreted membrane vesicles, including exosomes, are being recognized as new candidates with important roles in intercellular and tissue-level communication. In this review, we critically examine the emerging role of exosomes in local and distant microcommunication mechanisms after myocardial infarction. A comprehensive understanding of the role of exosomes in cardiac repair after myocardial infarction could bridge a major gap in knowledge of the repair mechanism after myocardial injury.

  5. Social Media, Privacy, and Self-Disclosure: The Turbulence Caused by Social Media’s Affordances

    Sabine Trepte

    2015-04-01

    Full Text Available The struggle we currently perceive in terms of social media privacy may be the result of the incompatible natures of “warm” and “cold” affordances. Whereas social media’s warm affordances reflect long-standing privacy routines and expectations, cold affordances seem to challenge and sometimes violate them. Sharing under the realm of warm affordances means sharing according to the routines and habits we know. Sharing under the realm of cold affordances means understanding social media’s terms and conditions and how they reflect on our relationships and experiences - similar to assimilating to a new culture that seems opaque and constantly in flux.

  6. Medicaid program; eligibility changes under the Affordable Care Act of 2010. Final rule, Interim final rule.

    2012-03-23

    This final rule implements several provisions of the Patient Protection and Affordable Care Act of 2010 and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act). The Affordable Care Act expands access to health insurance coverage through improvements to the Medicaid and Children's Health Insurance (CHIP) programs, the establishment of Affordable Insurance Exchanges ("Exchanges"), and the assurance of coordination between Medicaid, CHIP, and Exchanges. This final rule codifies policy and procedural changes to the Medicaid and CHIP programs related to eligibility, enrollment, renewals, public availability of program information and coordination across insurance affordability programs.

  7. Aortoenteric Fistula Assocaited with Acute Myocardial Infarcation

    Fingerote, Robert J.; Alan BR Thomson

    1990-01-01

    A 64-year-old male with a prior abdominal aortic graft for lower limb ischemia presented with melena and myocardial infarction. Despite aggressive investigation, an aortoenteric fistula was not diagnosed until after massive gastrointestinal hemorrhage. The patient's myocardial infarction may have heen precipitated by hypotension induced by hemorrhage through the aortoenteric fistula. Patients with prior abdominal aortic graft surgery presenting with gastrointestinal bleeding, abdominal pain o...

  8. Do Affordable Housing Projects Harm Suburban Communities? Crime, Property Values, and Taxes in Mount Laurel, NJ.

    Albright, Len; Derickson, Elizabeth S; Massey, Douglas S

    2013-06-01

    This paper offers a mixed-method analysis of the municipal-level consequences of an affordable housing development built in suburban New Jersey. Opponents of affordable housing development often suggest that creating affordable housing will harm surrounding communities. Feared consequences include increases in crime, declining property values, and rising taxes. To evaluate these claims, the paper uses the case of Mt. Laurel, NJ - the site of a landmark affordable housing legal case and subsequent affordable housing development. Employing a multiple time series group control design, we compare crime rates, property values, and property taxes in Mt. Laurel to outcomes in similar nearby municipalities that do not contain comparable affordable housing developments. We find that the opening of the affordable housing development was not associated with trends in crime, property values, or taxes, and discuss management practices and design features that may have mitigated potential negative externalities.

  9. Protective effect and mechanism of lithium chloride pretreatment on myocardial ischemia-reperfusion injury in rats

    Fang-Jiang Li; Tao Hsu; Hui-Xian Li; Jin-Zheng Shi; Mei-Ling Du; Xiao-Yuan Wang; Wen-Ting Zhang

    2014-01-01

    Objective:To investigate the protective effect and mechanism of lithium chloride pretreatment on myocardial ischemia-reperfusion injury(I-RI) in rats.Methods:A total of60SD rats were randomly divided into control group, model group, lithium chloride intervention group and L-arginine methyl ester+ lithium chloride intervention group with15 in each.TheI-RI model was established in model group, the lithium chloride intervention group andL-arginine methyl ester+ lithium chloride intervention group by method of seaming along left anterior descending coronary artery myocardial, control group was only opened the chest without seaming,ST-elevation within2 min was regarded as modeling success.Model group did not adopted any intervention, lithium chloride intervention group was treated with lithium chloride injection 15 mg/kg by jugular venipuncture preoperatively,L-arginine methyl ester+ lithium chloride intervention group was treated with intraperitoneal injection of30 mg•kg-1•d-1L-arginine methyl ester7 d before the test, and intravenous catheter of15 mg/kg lithium chloride preoperatively. The hydroxybutyric acid dehydrogenase(HBDH), creatine kinase isoenzyme(CK-MB), superoxide dismutase(SOD), malondialdehyde(MDA) level and nitric oxide synthase(NOS) activites were tested.Each large area of myocardial ischemia tissue was extracted for determination of the MDA content,SOD activity in tissue and serum, and morphological changes of myocardial tissue.Results:SOD activity was highest in lithium chloride intervention group, followed by L-arginine methyl ester+ lithium chloride intervention group, control group and model group (P0.05);HBDH andCK-MB of plasma were highest in model group, followed byL-arginine methyl ester+ lithium chloride intervention group, lithium chloride intervention group and control group(P<0.05).A significantly lighter myocardial damage was observed microscopically in lithium chloride intervention group than that inL-arginine methyl ester+ lithium

  10. Computational modeling of acute myocardial infarction.

    Sáez, P; Kuhl, E

    2016-01-01

    Myocardial infarction, commonly known as heart attack, is caused by reduced blood supply and damages the heart muscle because of a lack of oxygen. Myocardial infarction initiates a cascade of biochemical and mechanical events. In the early stages, cardiomyocytes death, wall thinning, collagen degradation, and ventricular dilation are the immediate consequences of myocardial infarction. In the later stages, collagenous scar formation in the infarcted zone and hypertrophy of the non-infarcted zone are auto-regulatory mechanisms to partly correct for these events. Here we propose a computational model for the short-term adaptation after myocardial infarction using the continuum theory of multiplicative growth. Our model captures the effects of cell death initiating wall thinning, and collagen degradation initiating ventricular dilation. Our simulations agree well with clinical observations in early myocardial infarction. They represent a first step toward simulating the progression of myocardial infarction with the ultimate goal to predict the propensity toward heart failure as a function of infarct intensity, location, and size.

  11. NASA Affordable Vehicle Avionics (AVA): Common Modular Avionics System for Nano-Launchers Offering Affordable Access to Space

    Cockrell, James

    2015-01-01

    Small satellites are becoming ever more capable of performing valuable missions for both government and commercial customers. However, currently these satellites can only be launched affordably as secondary payloads. This makes it difficult for the small satellite mission to launch when needed, to the desired orbit, and with acceptable risk. NASA Ames Research Center has developed and tested a prototype low-cost avionics package for space launch vehicles that provides complete GNC functionality in a package smaller than a tissue box with a mass less than 0.84 kg. AVA takes advantage of commercially available, low-cost, mass-produced, miniaturized sensors, filtering their more noisy inertial data with realtime GPS data. The goal of the Advanced Vehicle Avionics project is to produce and flight-verify a common suite of avionics and software that deliver affordable, capable GNC and telemetry avionics with application to multiple nano-launch vehicles at 1 the cost of current state-of-the-art avionics.

  12. The corrosion protection of several aluminum alloys by chromic acid and sulfuric acid anodizing

    Danford, M. D.

    1994-01-01

    The corrosion protection afforded 7075-T6, 7075-T3, 6061-T6, and 2024-T3 aluminum alloys by chromic acid and sulfuric acid anodizing was examined using electrochemical techniques. From these studies, it is concluded that sulfuric acid anodizing provides superior corrosion protection compared to chromic acid anodizing.

  13. Predictive value of heart fatty acid-binding protein to major adverse cardiovascular events in patients with acute myocardial infarction%心型脂肪酸结合蛋白对急性心肌梗死患者主要不良心脏事件的预测价值

    魏庆民; 周彬; 史永堂; 张友良

    2012-01-01

    Objective To observe the predictive value of peak concentration of plasma heart fatty acid-binding protein (H-FABP) to major adverse cardiovascular events ( MACE ) in patients with acute myocardial infarction ( AMI) . Methods The AMI patients ( n=60) were selected within two hours from admission to disease attack from Jan. 2010 to Jim. 2011. The concentration of plasma H-FABP was detected every two hours in the patients from admission to disease attack for 10 hours. According to the average value of H-FABP peak value, all the patients were divided into group A ( with higher H-FABP than average ) and group B ( with lower H-FABP than average ) . The occurrence status of MACE [severe heart failure, malignant arrhythmia, recurrent myocardial infarction, cardiac death and target lesion revascularization ( TLR ) ] was compared between two groups after disease attack for one month and one year. Results After disease attack for one month and one year, the incidence of severe heart failure was higher in group A than that in group B (P<0.05 ) , and the incidence of other events had no statistical difference between two groups. Conclusion The increase of H-FABP peak value has some predictive value to severe heart failure of MACE in AMI patients.%目的 观察血浆心型脂肪酸结合蛋白(heart-type fatty acid-binding protein,H-FABP)的峰值浓度对急性心肌梗死(AMI)患者主要不良心脏事件(MACE)的预测价值.方法 入选2010年1月至2011年6月入院距发病时间2h以内的AMI患者60例,于入院即刻至发病10h期间,每2h测定1次血浆H-FABP的浓度.根据H-FABP峰值水平的平均值将患者划分为H-FABP高值组和低值组,比较两组患者发病后1个月、1年的主要不良心脏事件(严重心力衰竭、恶性心律失常、再发心肌梗死、心源性死亡、靶病变血管重建)的发生率.结果 与H-FABP低值组相比,H-FABP高值组发病后1个月、1年,MACE及严重心力衰竭的发生率更

  14. Pico Reentry Probes: Affordable Options for Reentry Measurements and Testing

    Ailor, William H.; Kapoor, Vinod B.; Allen, Gay A., Jr.; Venkatapathy, Ethiraj; Arnold, James O.; Rasky, Daniel J.

    2005-01-01

    It is generally very costly to perform in-space and atmospheric entry experiments. This paper presents a new platform - the Pico Reentry Probe (PREP) - that we believe will make targeted flight-tests and planetary atmospheric probe science missions considerably more affordable. Small, lightweight, self-contained, it is designed as a "launch and forget" system, suitable for experiments that require no ongoing communication with the ground. It contains a data recorder, battery, transmitter, and user-customized instrumentation. Data recorded during reentry or space operations is returned at end-of-mission via transmission to Iridium satellites (in the case of earth-based operations) or a similar orbiting communication system for planetary missions. This paper discusses possible applications of this concept for Earth and Martian atmospheric entry science. Two well-known heritage aerodynamic shapes are considered as candidates for PREP: the shape developed for the Planetary Atmospheric Experiment Test (PAET) and that for the Deep Space II Mars Probe.

  15. Collaborative Affordances of Hybrid Patient Record Technologies in Medical Work

    Houben, Steven; Frost, Mads; Bardram, Jakob E

    2015-01-01

    to digitally augment a paper medical record. We report on two studies: a field study in which we describe the benefits and challenges of using a combination of electronic and paper-based medical records in a large university hospital and a deployment study in which we analyze how 8 clinicians used the Hy......PR in a medical simulation. Based on these empirical studies, this paper introduces and discusses the concept of collaborative affordances, which describes a set of properties of the medical record that foster collaborative collocated work....... explored the integration of paper and digital technology, there are still a wide range of open issues in the design of technologies that integrate digital and paper-based medical records. This paper studies the use of one such novel technology, called the Hybrid Patient Record (HyPR), that is designed...

  16. Suggested Interactivity: Seeking Perceived Affordances for Information Visualization.

    Boy, Jeremy; Eveillard, Louis; Detienne, Françoise; Fekete, Jean-Daniel

    2016-01-01

    In this article, we investigate methods for suggesting the interactivity of online visualizations embedded with text. We first assess the need for such methods by conducting three initial experiments on Amazon's Mechanical Turk. We then present a design space for Suggested Interactivity (i. e., visual cues used as perceived affordances-SI), based on a survey of 382 HTML5 and visualization websites. Finally, we assess the effectiveness of three SI cues we designed for suggesting the interactivity of bar charts embedded with text. Our results show that only one cue (SI3) was successful in inciting participants to interact with the visualizations, and we hypothesize this is because this particular cue provided feedforward.

  17. Design, analysis and testing of small, affordable HAWT rotors

    Pricop, Mihai V.; Niculescu, Mihai L.; Cojocaru, Marius G.; Barsan, Dorin

    2012-09-01

    The paper presents affordable technologies dedicated to design, CAD modelling and manufacturing of the small-medium HAWT rotors. Three numerical tools are developed: blade/rotor design, blade modelling for industry CATIA(CATScript) and blade modelling for small scale developers. Numerical analysis of the rotors is accomplished for both performance and noise level estimation using XFLOW (LES) and an in-house code (URANS). Results are presented for a 5KW rotor at the design point only, since computations are expensive. Developement examples are included as two rotors are designed, manufactured and tested for 1.5 and 5KW. A third one, rated for 20KW is under developement. Basic testing results are also included.

  18. Community-specific evaluation of tool affordances in wild chimpanzees.

    Gruber, Thibaud; Muller, Martin N; Reynolds, Vernon; Wrangham, Richard; Zuberbühler, Klaus

    2011-01-01

    The notion of animal culture, defined as socially transmitted community-specific behaviour patterns, remains controversial, notably because the definition relies on surface behaviours without addressing underlying cognitive processes. In contrast, human cultures are the product of socially acquired ideas that shape how individuals interact with their environment. We conducted field experiments with two culturally distinct chimpanzee communities in Uganda, which revealed significant differences in how individuals considered the affording parts of an experimentally provided tool to extract honey from a standardised cavity. Firstly, individuals of the two communities found different functional parts of the tool salient, suggesting that they experienced a cultural bias in their cognition. Secondly, when the alternative function was made more salient, chimpanzees were unable to learn it, suggesting that prior cultural background can interfere with new learning. Culture appears to shape how chimpanzees see the world, suggesting that a cognitive component underlies the observed behavioural patterns.

  19. Affordances in activity theory and cognitive systems engineering

    Albrechtsen, H.; Andersen, H.H.K.; Bødker, S.;

    2001-01-01

    is supplemented by careful analyses of other human modalities and activities than visual perception. Within HMI two well established perspectives on HMI,Activity Theory (AT) and Cognitive Systems Engineering (CSE), have discussed such analyses and design of action possibilities focusing on providing computer...... in HMI, notably those that have been putforward by Norman and Gaver, affordances are in the foreground, whereas the system or work area is in the background. AT and CSE share the view that the actors' perception of foreground and background shifts dynamically according to the actors'situational context...... in purposeful activity. AT and CSE follow the original notion by Gibson on the actor's dynamic shifting between foreground and background of the environment. Furthermore, their work- and actor-centred approach to analysis and designof information systems opens up to an extension of Gibson's original ideas...

  20. Phased array ultrasonic processing for enhanced and affordable diagnosis

    Dominguez, N.; Rougeron, G.; Leberre, S.; Pautel, R.

    2013-01-01

    Phased array ultrasonic reconstruction techniques are often presented as a prospect for better and enhanced diagnosis. However to date few applications of these techniques can be found in the industry, partly because of questions on sizing but also because they often require heavy acquisitions. A way forward is then to propose techniques requiring less intensive data acquisition to make them broadly affordable in practice. Several approaches ranging from full matrix capture to paintbrush acquisitions are presented in this paper in combination with associated reconstruction processing like the Total Focusing Method (TFM) and the Time Domain Topological Energy (TDTE) techniques. Emphasis is given to their relative relevancies and practical applicability on typical configurations of interest for industries. The paper also presents recent efforts made on the acceleration of processing computation times, in particular through the use of GPU architectures.

  1. Mobilizing slit lamp to the field: A new affordable solution.

    Farooqui, Javed Hussain; Jorgenson, Richard; Gomaa, Ahmed

    2015-11-01

    We are describing a simple and affordable design to pack and carry the slit lamp to the field. Orbis staff working on the Flying Eye Hospital (FEH) developed this design to facilitate mobilization of the slit lamp to the field during various FEH programs. The solution involves using a big toolbox, a central plywood apparatus, and foam. These supplies were cut to measure and used to support the slit lamp after being fitted snuggly in the box. This design allows easy and safe mobilization of the slit lamp to remote places. It was developed with the efficient use of space in mind and it can be easily reproduced in developing countries using same or similar supplies. Mobilizing slit lamp will be of great help for staff and institutes doing regular outreach clinical work.

  2. Health Care Affordability: How to Make It a Reality.

    Rotarius, Timothy; Liberman, Aaron

    2015-01-01

    Health care is a big business. US health care expenditures reached $2.9 trillion in 2013. Patient spending accounted for 28% of the total, which means patients spent approximately $810 billion in 2013 for insurance premiums, deductibles, copays, coinsurance, and noncovered health care services. How are patients expected to pay almost a trillion dollars in health care expenses? There is a need to find a health care financing methodology that will make health care affordable for all patients and families. An alternative method for funding health care is discussed that includes creating a government-funded annuity during the first decade of one's life. When this annuity matures later in life, many individuals will have amassed a large pot of money with which to pay for their (and their family's) health care treatment and products.

  3. Spontaneous coronary dissection associated with myocardial bridge causing acute myocardial infarction

    GE Jun-bo; HUANG Zhe-yong; LIU Xue-bo; QIAN Ju-ying

    2008-01-01

    @@ Spontaneous coronary artery dissection (SCAD) is a rare cause of myocardial ischemia, myocardial infarction and sudden cardiac death.1-10 This disease mainly occurs in young women with oral contraceptive or during the peripartum period,without risk factors for coronary artery disease.

  4. Value of the Doppler index of myocardial performance in the early phase of acute myocardial infarction

    Poulsen, S H; Jensen, S E; Tei, C

    2000-01-01

    Prospective assessment of a nongeometric Doppler-derived index of combined systolic and diastolic myocardial performance was performed in 64 patients with acute myocardial infarction (MI) within 1 hour after their arrival to the hospital and in 39 age-matched healthy subjects. The index is defined...

  5. Clinical Characteristics and Outcomes of Patients with Myocardial Infarction, Myocardial Injury, and Nonelevated Troponins

    Sarkisian, Laura; Saaby, Lotte; Poulsen, Tina S

    2015-01-01

    was diagnosed in cases of a cardiac troponin I increase or decrease pattern with at least 1 value >30 ng/L (99th percentile) together with myocardial ischemia. Myocardial injury was defined as cardiac troponin I values >30 ng/L, but without signs or symptoms indicating overt cardiac ischemia. Patients with peak...

  6. The stability of myocardial area at risk estimated electrocardiographically in patients with ST elevation myocardial infarction

    Carlsen, Esben A; Hassell, Mariëlla E C J; van Hellemond, Irene E G;

    2014-01-01

    In patients with ST-elevation myocardial infarction (STEMI) the amount of myocardial area at risk (MaR) indicates the maximal potential loss of myocardium if the coronary artery remains occluded. During the time course of infarct evolution ischemic MaR is replaced by necrosis, which results in a ...

  7. Endoscopic retrograde cholangiopancreatography causes reduced myocardial blood flow

    Christensen, M; Hendel, H W; Rasmussen, V;

    2002-01-01

    ). PATIENTS AND METHODS: 11 patients scheduled for ERCP were monitored with a Holter tape recorder and underwent myocardial perfusion scintigraphies, to evaluate myocardial perfusion at rest and during ERCP. RESULTS: Ten patients completed the study. Eight patients had no sign of myocardial ischemia...... with either of the two methods, while two patients developed signs of ischemia during ERCP with both the Holter tape recording and on myocardial scintigraphy (P = 0.02). CONCLUSIONS: Patients undergoing ERCP may develop true myocardial ischemia with reduced myocardial blood flow. Although this is a small...

  8. Affordable Development and Qualification Strategy for Nuclear Thermal Propulsion

    Gerrish, Harold P., Jr.; Doughty, Glen E.; Bhattacharyya, Samit K.

    2013-01-01

    A number of recent assessments have confirmed the results of several earlier studies that Nuclear Thermal Propulsion (NTP) is a leading technology for human exploration of Mars. It is generally acknowledged that NTP provides the best prospects for the transportation of humans to Mars in the 2030's. Its high Isp coupled with the high thrusts achievable, allow reasonable trip times, thereby alleviating concerns about space radiation and "claustrophobia" effects. NASA has embarked on the latest phase of the development of NTP systems, and is adopting an affordable approach in response to the pressure of the times. The affordable strategy is built on maximizing the use of the large NTP technology base developed in the 1950's and 60's. The fact that the NTP engines were actually demonstrated to work as planned, is a great risk reduction feature in its development. The strategy utilizes non-nuclear testing to the fullest extent possible, and uses focused nuclear tests for the essential qualification and certification tests. The perceived cost risk of conducting the ground tests is being addressed by considering novel testing approaches. This includes the use of boreholes to contain radioactive effluents, and use of fuel with very high retention capability for fission products. The use of prototype flight tests is being considered as final steps in the development prior to undertaking human flight missions. In addition to the technical issues, plans are being prepared to address the institutional and political issues that need to be considered in this major venture. While the development and deployment of NTP system is not expected to be cheap, the value of the system will be very high, and amortized over the many missions that it enables and enhances, the imputed costs will be very reasonable. Using the approach outlined, NASA and its partners, currently the DOE, and subsequently industry, have a good chance of creating a sustained development program leading to human

  9. Enabling Dedicated, Affordable Space Access Through Aggressive Technology Maturation

    Jones, Jonathan; Kibbey, Tim; Lampton, Pat; Brown, Thomas

    2014-01-01

    A recent explosion in nano-sat, small-sat, and university class payloads has been driven by low cost electronics and sensors, wide component availability, as well as low cost, miniature computational capability and open source code. Increasing numbers of these very small spacecraft are being launched as secondary payloads, dramatically decreasing costs, and allowing greater access to operations and experimentation using actual space flight systems. While manifesting as a secondary payload provides inexpensive rides to orbit, these arrangements also have certain limitations. Small, secondary payloads are typically included with very limited payload accommodations, supported on a non interference basis (to the prime payload), and are delivered to orbital conditions driven by the primary launch customer. Integration of propulsion systems or other hazardous capabilities will further complicate secondary launch arrangements, and accommodation requirements. The National Aeronautics and Space Administration's Marshall Space Flight Center has begun work on the development of small, low cost launch system concepts that could provide dedicated, affordable launch alternatives to small, risk tolerant university type payloads and spacecraft. These efforts include development of small propulsion systems and highly optimized structural efficiency, utilizing modern advanced manufacturing techniques. This paper outlines the plans and accomplishments of these efforts and investigates opportunities for truly revolutionary reductions in launch and operations costs. Both evolution of existing sounding rocket systems to orbital delivery, and the development of clean sheet, optimized small launch systems are addressed. A launch vehicle at the scale and price point which allows developers to take reasonable risks with new propulsion and avionics hardware solutions does not exist today. Establishing this service provides a ride through the proverbial "valley of death" that lies between

  10. Global cancer surgery: delivering safe, affordable, and timely cancer surgery.

    Sullivan, Richard; Alatise, Olusegun Isaac; Anderson, Benjamin O; Audisio, Riccardo; Autier, Philippe; Aggarwal, Ajay; Balch, Charles; Brennan, Murray F; Dare, Anna; D'Cruz, Anil; Eggermont, Alexander M M; Fleming, Kenneth; Gueye, Serigne Magueye; Hagander, Lars; Herrera, Cristian A; Holmer, Hampus; Ilbawi, André M; Jarnheimer, Anton; Ji, Jia-Fu; Kingham, T Peter; Liberman, Jonathan; Leather, Andrew J M; Meara, John G; Mukhopadhyay, Swagoto; Murthy, Shilpa S; Omar, Sherif; Parham, Groesbeck P; Pramesh, C S; Riviello, Robert; Rodin, Danielle; Santini, Luiz; Shrikhande, Shailesh V; Shrime, Mark; Thomas, Robert; Tsunoda, Audrey T; van de Velde, Cornelis; Veronesi, Umberto; Vijaykumar, Dehannathparambil Kottarathil; Watters, David; Wang, Shan; Wu, Yi-Long; Zeiton, Moez; Purushotham, Arnie

    2015-09-01

    Surgery is essential for global cancer care in all resource settings. Of the 15.2 million new cases of cancer in 2015, over 80% of cases will need surgery, some several times. By 2030, we estimate that annually 45 million surgical procedures will be needed worldwide. Yet, less than 25% of patients with cancer worldwide actually get safe, affordable, or timely surgery. This Commission on global cancer surgery, building on Global Surgery 2030, has examined the state of global cancer surgery through an analysis of the burden of surgical disease and breadth of cancer surgery, economics and financing, factors for strengthening surgical systems for cancer with multiple-country studies, the research agenda, and the political factors that frame policy making in this area. We found wide equity and economic gaps in global cancer surgery. Many patients throughout the world do not have access to cancer surgery, and the failure to train more cancer surgeons and strengthen systems could result in as much as US $6.2 trillion in lost cumulative gross domestic product by 2030. Many of the key adjunct treatment modalities for cancer surgery--e.g., pathology and imaging--are also inadequate. Our analysis identified substantial issues, but also highlights solutions and innovations. Issues of access, a paucity of investment in public surgical systems, low investment in research, and training and education gaps are remarkably widespread. Solutions include better regulated public systems, international partnerships, super-centralisation of surgical services, novel surgical clinical trials, and new approaches to improve quality and scale up cancer surgical systems through education and training. Our key messages are directed at many global stakeholders, but the central message is that to deliver safe, affordable, and timely cancer surgery to all, surgery must be at the heart of global and national cancer control planning.

  11. Clinical experience with technetium-99m teboroxime, a neutral, lipophilic myocardial perfusion imaging agent

    Johnson, L.L.; Seldin, D.W. (Columbia Univ., New York, NY (USA))

    1990-10-16

    Technetium-99m (Tc-99m) teboroxime is a new technetium-based myocardial perfusion imaging agent (investigational code = SQ30217 (Cardiotec, Squibb Diagnostics)). A member of a class of neutral, lipophilic, technetium-containing complexes known as boronic acid adducts of technetium dioxime (BATO) complexes, this agent is chemically very different from the cationic tracer thallium-201 (Tl-201) and from the cationic technetium complex Tc-99m sestamibi (Cardiolite, Du Pont Imaging Agents). Tc-99m teboroxime has high myocardial extraction, rapid blood clearance, little lung uptake and rapid myocardial washout. A biexponential pattern of myocardial washout is demonstrated in animals and in man. Effective half-lives of the 2 washout components in man are 5.2 minutes and 3.8 hours and represent approximately 66 and 33% of the myocardial activity, respectively. The first half-life for the myocardium is approximately 11 minutes. As the agent washes out of the heart, hepatic uptake occurs, peaking at about 5 minutes after injection. The liver is the major organ of excretion and receives, along with the large bowel, the largest radiation dose. Rapid imaging protocols using standard cameras have achieved good myocardial counts from 3 planar views acquired over a 4- to 5-minute period or for single photon emission computed tomography (SPECT) images acquired over a 10-minute period. An entire stress/rest procedure can be completed in 1 hour. Analysis of data from 155 patients from 4 centers using planar or SPECT imaging showed a sensitivity and specificity for blinded readings of 82 and 91%, respectively, when compared against overall clinical impression. 13 references.

  12. Myocardial Reloading after Extracorporeal Membrane Oxygenation Alters Substrate Metabolism While Promoting Protein Synthesis

    Kajimoto, Masaki; Priddy, Colleen M.; Ledee, Dolena; Xu, Chun; Isern, Nancy G.; Olson, Aaron; Des Rosiers, Christine; Portman, Michael A.

    2013-08-19

    Extracorporeal membrane oxygenation (ECMO) unloads the heart providing a bridge to recovery in children after myocardial stunning. Mortality after ECMO remains high.Cardiac substrate and amino acid requirements upon weaning are unknown and may impact recovery. We assessed the hypothesis that ventricular reloading modulates both substrate entry into the citric acid cycle (CAC) and myocardial protein synthesis. Fourteen immature piglets (7.8-15.6 kg) were separated into 2 groups based on ventricular loading status: 8 hour-ECMO (UNLOAD) and post-wean from ECMO (RELOAD). We infused [2-13C]-pyruvate as an oxidative substrate and [13C6]-L-leucine, as a tracer of amino acid oxidation and protein synthesis into the coronary artery. RELOAD showed marked elevations in myocardial oxygen consumption above baseline and UNLOAD. Pyruvate uptake was markedly increased though RELOAD decreased pyruvate contribution to oxidative CAC metabolism.RELOAD also increased absolute concentrations of all CAC intermediates, while maintaining or increasing 13C-molar percent enrichment. RELOAD also significantly increased cardiac fractional protein synthesis rates by >70% over UNLOAD. Conclusions: RELOAD produced high energy metabolic requirement and rebound protein synthesis. Relative pyruvate decarboxylation decreased with RELOAD while promoting anaplerotic pyruvate carboxylation and amino acid incorporation into protein rather than to the CAC for oxidation. These perturbations may serve as therapeutic targets to improve contractile function after ECMO.

  13. Metabonomic analysis of Allium macrostemon Bunge as a treatment for acute myocardial ischemia in rats.

    Li, Fang; Xu, Qian; Zheng, Ting; Huang, Fang; Han, Lintao

    2014-01-01

    Myocardial ischemia (MI) refers to a pathological state of the heart caused by reduced cardiac blood perfusion, which leads to a decreased oxygen supply in the heart and an abnormal myocardial energy metabolism. Acute myocardial ischemia (AMI) has posed a significant health risk for humans. Allium macrostemon Bunge (AMB), a popular traditional Chinese medicine, is used for MI treatment. The therapeutic effects of AMB were assessed and the detailed mechanisms of AMB for AMI treatment were investigated. We characterized the metabonomic variations in rats from the sham surgery, AMI, and AMB-pretreated AMI groups through a combination of nuclear magnetic resonance (NMR) spectroscopy and multivariate statistical analysis. Thirty-five metabolites including carbohydrates, a range of amino acids, and organic acids were detected. The (1)H NMR spectra of the rat serum were analyzed using the principal component analysis (PCA) and orthogonal projection to latent structures discriminate analysis (OPLS-DA). Results showed that AMI induced some physiological changes in rats and also led to metabolic disorders related to glycolysis promotion, amino acid metabolism disruption, and other metabolite metabolism perturbation. AMB pretreatment reduced the AMI injury and maintained metabolic balance, possibly by limiting the change in energy metabolism and regulating amino acid metabolism. These findings provide a comprehensive insight on the metabolic response of AMI rats to AMB pretreatment and are important for the use of AMB for AMI therapy.

  14. Evaluation of myocardial viability with cardiac PET before and after CABG and the study of hibernating myocardium

    Adachi, Masahiro; Sakamoto, Shigeru [Kanazawa Medical Univ., Uchinada, Ishikawa (Japan); Seki, Hiroyasu

    1997-09-01

    This study included 28 patients in whom graft patency after coronary artery bypass graft (CABG) was confirmed by coronary angiography. Diagnosis included angina pectoris following myocardial infarction and severe angina pectoris accompanied by stenosis at the left main trunk region or lesion involving multiple branches. As a rule, cardiac PET ({sup 13}NH{sub 3}, {sup 18}FDG) was performed in fasted patients before and 1 to 2 months after surgery. Myocardial blood flow and glucose metabolism in the bypass site were mainly investigated. Furthermore, {sup 201}Tl-SPECT was concurrently performed. The effect of CABG was examined by the two procedures, and redistribution was compared between PET and {sup 201}Tl-SPECT. Preoperative PET with {sup 13}NH{sub 3} revealed reduced blood flow in the ischemic site in all patients. However, preoperative {sup 201}Tl-SPECT showed redistribution in 16 (57.1%) of 28 patients, while there was no redistribution in 12 patients (42.9%). In 10 (83.3%) of 12 patients evaluated as having no myocardial viability on {sup 201}Tl-SPECT, PET showed accumulation of {sup 18}FDG. However, in 21 (75%) of 28 patients, accumulation of {sup 18}FDG was reduced postoperatively, suggesting improvement of aerobic metabolism in cardiac muscle. These patients also showed improvement in regional wall motion. The energy source of cardiac muscle consists mainly of free fatty acid and glucose. Fasting healthy cardiac muscle depends on fatty acid for approximately 60% of its energy source. However, ischemic cardiac muscle depends on the glycolytic system, utilizing glucose. Progression of ischemia causes myocardial necrosis without metabolism. Therefore, ischemic cardiac muscle can be differentiated from infarcted cardiac muscle by cardiac PET. We evaluated myocardial viability before and after CABG for ischemic heart disease, and confirmed that cardiac PET is more useful than standard myocardial scan with {sup 201}Tl for evaluating myocardial viability. (K.H.)

  15. Myocardial lipids and nucleotides of rats fed olive oil or rapeseed oil.

    Beare-Rogers, J L; Gordon, E

    1976-04-01

    After 1 week, the level of myocardial fatty acids was 4 times greater in young rats fed high erucic rapeseed oil than in those fed oliver oil. The proportion of erucic acid was 5.6% in the mitochondrial fraction, 15.1% in the microsomal fraction, and 34.8% in the floating fat fraction. This incorporation of erucic acid into triglycerides of the floating fat was evidence of esterification. The changes in the mitochondrial lipids did not alter the content of adenine nucleotides of the myocardium nor its apparent capacity to oxidize substrates.

  16. Increased myocardial fibrosis and left ventricular dysfunction in Cushing's syndrome.

    Yiu, K.H.; Marsan, N.A.; Delgado, V.; Biermasz, N.R.; Holman, E.R.; Smit, J.W.A.; Feelders, R.A.; Bax, J.J.; Pereira, A.M.

    2012-01-01

    OBJECTIVE: Active Cushing's syndrome (CS) is associated with cardiomyopathy, characterized by myocardial structural, and ultrastructural abnormalities. The extent of myocardial fibrosis in patients with CS has not been previously evaluated. Therefore, the objective of this study was to assess myocar

  17. Association of blood transfusion with increased mortality in myocardial infarction

    Chatterjee, Saurav; Wetterslev, Jørn; Sharma, Abhishek;

    2013-01-01

    The benefit of blood transfusion in patients with myocardial infarction is controversial, and a possibility of harm exists.......The benefit of blood transfusion in patients with myocardial infarction is controversial, and a possibility of harm exists....

  18. Secondary prevention with calcium antagonists after acute myocardial infarction

    Hansen, J F

    1992-01-01

    Experimental studies have demonstrated that the 3 calcium antagonists nifedipine, diltiazem, and verapamil have a comparable effect in the prevention of myocardial damage during ischaemia. Secondary prevention trials after acute myocardial infarction, which aimed at improving survival...

  19. Myocardial perfusion imaging with dual energy CT.

    Jin, Kwang Nam; De Cecco, Carlo N; Caruso, Damiano; Tesche, Christian; Spandorfer, Adam; Varga-Szemes, Akos; Schoepf, U Joseph

    2016-10-01

    Dual-energy CT (DECT) enables simultaneous use of two different tube voltages, thus different x-ray absorption characteristics are acquired in the same anatomic location with two different X-ray spectra. The various DECT techniques allow material decomposition and mapping of the iodine distribution within the myocardium. Static dual-energy myocardial perfusion imaging (sCTMPI) using pharmacological stress agents demonstrate myocardial ischemia by single snapshot images of myocardial iodine distribution. sCTMPI gives incremental values to coronary artery stenosis detected on coronary CT angiography (CCTA) by showing consequent reversible or fixed myocardial perfusion defects. The comprehensive acquisition of CCTA and sCTMPI offers extensive morphological and functional evaluation of coronary artery disease. Recent studies have revealed that dual-energy sCTMPI shows promising diagnostic accuracy for the detection of hemodynamically significant coronary artery disease compared to single-photon emission computed tomography, invasive coronary angiography, and cardiac MRI. The aim of this review is to present currently available DECT techniques for static myocardial perfusion imaging and recent clinical applications and ongoing investigations.

  20. Heart-type fatty acid-binding protein in plasma and urine for the early diagnosis of acute myocardial infarction%血浆和尿液心型脂肪酸结合蛋白与急性心肌梗死的早期诊断

    王宏运; 何海超; 王绍欣; 李转珍; 姚慧霞; 张东江

    2012-01-01

    目的 通过心型脂肪酸结合蛋白(H-FABP)与其他生化标记物的比较,探讨心型脂肪酸结合蛋白(H-FABP)对急性心肌梗死(AMI)患者的早期诊断价值.方法 本研究采用固相夹心酶联免疫法(ELISA)测定64例AMI患者血浆心肌肌钙蛋白(cTnI)、肌酸激酶同工酶(CK-MB)、肌红蛋白(MYO)、H-FABP浓度;同时选取非急性心肌梗死患者53例作为对照组.H-FABP采用两种检测方法:固相夹心酶联免疫法和胶乳比浊法免疫测定(LTIA).结果 cTnT,CK-MB,MYO,H-FABP( by ELISA),H-FABP (by LTIA),心电图(ECG)诊断AMI敏感性分别为39.1%,59.4%,64.1%,68.7%,70.3%和54.7%;特异性为:98.1%,71.7%,81.1%,77.4%,90.6%和92.5%.结论 对AMI患者的诊断,H-FABP(by LTIA)优于cTnT,CK-MB,MYO,H-FABP( by ELISA),ECG.%Objective To investigate the early diagnostic value of heart-type fatty acid-binding protein ( H-FABP) for acute myocardial infarction( AMI),by comparing with other biochemical markers.Methods The concentrations of serum H-FABP,cTnI.CK-MB,MYO of 64 patients with AMI were detected by ELISA.Meanwhile 53 patients without acuter myocardial infarction were also selected as the control group.H-FABP was measured by two immunoassays,the H-FABP enzyme-linked immunosorbent assay( ELISA) and the H-FABP latex turbidimetric immunoassay ( LTIA).Results Sensitivities of cTnI,CK-MB,MYO,H-FABP ( by ELISA).H-FABP ( by LTIA),and electrocardiogram ( ECC) for the diagnosis of AMI were 39.1%,59.4%,64.1%,68.7%,70.3% and 54.7%,respectively.Specificities of cTnT,CK-MB,myoglobin,H-FABP ( by ELISA),H-FABP ( by LTIA),and ECG were 98.1%,71.7%,81.l%,77.4%,90.6% and 92.5%,respectively.Conelusions H-FABP ( by LTIA) is superior to cTnT,CK-MB,MYO,and H-FABP ( by ELISA) tests for the diagnosis of AMI in patients.

  1. 磷酸肌酸钠复合氨甲环酸对非体外循环冠状动脉旁路移植术患者心肌和血液保护作用的研究%The myocardial and blood protectivie effects of creatine phosphate sodium combined with tranexamic acid in off-pump coronary artery bypass grafting

    李长营; 郭爱华; 张宗旺; 张学俊; 张雷; 敖虎山

    2011-01-01

    Objective To investigate whether the supplement of creatine phosphate sodium and tranexamic acid to cardioplegic solutions can improve myocardial protection and blood conservation in off-pump coronary artery bypass graft(OPCABG).Methods 280 patients undergoing OPCABG were randomly assigned to experimental group (CP with TA group, n=70 ) , creatine phosphate sodium group (CP group, n=70), tranexamic acid group (TA group, n=70) and control group (n=70). Before BACG,creatine phosphate sodium ( 100 mg/kg) combined with tranexamic acid (30 mg/kg), creatine phosphate sodium ( 100 mg/kg),tranexamic acid (30 mg/kg), and equal volume of normal saline were given intravenously in each group respectively. Venous blood samples were taken preoperatively, and at 0, 6, 12, 24, 48, 72 h, 7 d postoperatively to analyze creatine kinase isoenzyme (CK-MB), troponin (cTnI) ; Meanwhile, the amount of cumulative chest fluid drainage and inotropic agent and blood transfused were also recorded. Results The plasma concentrations of CK-MB in experimental group at 6, 12, 24, 48, 72 h postoperatively (15±6), (14±5), (16±10), (15±6) and (13±6) U/ml and the plasma concentrations of cTnI(235±1.53), (2.72±1.46), (2.64±1.32),(1.16±0.76) and (0.48±0.24) mg/L were significantly lower than those in group CP, group TA and control group (P<0.05). The amount of postoperative cumulative chest fluid at 6, 12, 24, 48, 72 h were (246±56), (420±82), (680±114), (725±126) and (730±130) ml drainage and blood transfuison in experimental group (5/70) were also significantly lower than those in other groups (P<0.05). Conclusion For patients undergoing OPCABG, creatine phosphate sodium combined with tranexamic acid plays an important role in myocardial protection and blood conservation without increasing the surgical mortality and the incidence of postoperative complications.%目的 研究在非体外循环下行冠状动脉旁路移植术(off-pump coronary artery bypass grafting,OPCABG)中应用

  2. F-35 Sustainment: Need for Affordable Strategy, Greater Attention to Risks, and Improved Cost Estimates

    2014-09-01

    F - 35 SUSTAINMENT Need for Affordable Strategy, Greater Attention to Risks, and Improved Cost Estimates Report...2. REPORT TYPE 3. DATES COVERED 00-00-2014 to 00-00-2014 4. TITLE AND SUBTITLE F - 35 Sustainment: Need for Affordable Strategy, Greater...House of Representatives September 2014 F - 35 SUSTAINMENT Need for Affordable Strategy, Greater Attention to Risks, and Improved Cost Estimates Why

  3. Non-invasive imaging in detecting myocardial viability: Myocardial function versus perfusion

    Iqbal A. Elfigih

    2014-12-01

    Full Text Available Coronary artery disease (CAD is the most prevalent and single most common cause of morbidity and mortality [1] with the resulting left ventricular (LV dysfunction an important complication. The distinction between viable and non-viable myocardium in patients with LV dysfunction is a clinically important issue among possible candidates for myocardial revascularization. Several available non-invasive techniques are used to detect and assess ischemia and myocardial viability. These techniques include echocardiography, radionuclide images, cardiac magnetic resonance imaging and recently myocardial computed tomography perfusion imaging. This review aims to distinguish between the available non-invasive imaging techniques in detecting signs of functional and perfusion viability and identify those which have the most clinical relevance in detecting myocardial viability in patients with CAD and chronic ischemic LV dysfunction. The most current available studies showed that both myocardial perfusion and function based on non-invasive imaging have high sensitivity with however wide range of specificity for detecting myocardial viability. Both perfusion and function imaging modalities provide complementary information about myocardial viability and no optimum single imaging technique exists that can provide very accurate diagnostic and prognostic viability assessment. The weight of the body of evidence suggested that non-invasive imaging can help in guiding therapeutic decision making in patients with LV dysfunction.

  4. Myocardial factor revisited: The importance of myocardial fibrosis in adults with congenital heart disease.

    Broberg, Craig S; Burchill, Luke J

    2015-06-15

    Pioneers in congenital heart surgery observed that exercise capacity did not return to normal levels despite successful surgical repair, leading some to cite a "myocardial factor" playing a role. They conjectured that residual alterations in myocardial function would be significant for patients' long-term outlook. In fulfillment of their early observations, today's adult congenital heart disease (ACHD) population shows well-recognized features of heart failure, even among patients without clear residual anatomic or hemodynamic abnormalities, demonstrating the vital role of the myocardium in their morbidity and mortality. Whereas the 'myocardial factor' was an elusive concept in the early history of congenital heart care, we now have imaging techniques to detect and quantify one such factor--myocardial fibrosis. Understanding the importance of myocardial fibrosis as a final common pathway in a variety of congenital lesions provides a framework for both the study and treatment of clinical heart failure in this context. While typical heart failure pharmacology should reduce or attenuate fibrogenesis, efforts to show meaningful improvements with standard pharmacotherapy in ACHD repeatedly fall short. This paper considers the importance of myocardial fibrosis and function, the current body of evidence for myocardial fibrosis in ACHD, and its implications for research and treatment.

  5. Morphine Does Not Affect Myocardial Salvage in ST-Segment Elevation Myocardial Infarction

    Song, Young Bin; Kim, Eun Kyoung; Jang, Woo Jin; Yang, Jeong Hoon; Hahn, Joo-Yong; Choi, Seung-Hyuk; Choi, Jin-Ho; Lee, Sang Hoon; Choe, Yeon Hyeon; Ahn, Joonghyun; Carriere, Keumhee Chough; Gwon, Hyeon-Cheol

    2017-01-01

    Recent studies have proposed intravenous (IV) morphine is associated with delayed action of antiplatelet agents in acute myocardial infarction. However, it is unknown whether morphine results in increased myocardial damage in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI). We investigated myocardial salvage index (MSI) to determine whether IV morphine affects myocardial injury adversely in STEMI patients undergoing primary PCI. 299 STEMI patients underwent contrast-enhanced magnetic resonance imaging a median of 3 days after PCI. Infarct size was measured on delayed-enhancement imaging, and area at risk was quantified on T2-weighted imaging. MSI was calculated as ‘[area at risk–infarct size] X 100 / area at risk’. IV morphine was administrated in 32.1% of patients. Patients treated with morphine had shorter symptom to balloon time and higher prevalence of Thrombolysis in Myocardial Infarction flow grade 0 or 1. The morphine group showed a trend toward larger MSI and infarct size and significantly greater area at risk than the non-morphine group. After propensity score matching (90 pairs), MSI was similar between the morphine and non-morphine group (46.1% versus 43.5%, P = .11), and infarct size and area at risk showed no difference. In propensity score-matched analysis, IV morphine prior to primary PCI in STEMI patients did not cause adverse impacts on myocardial salvage. PMID:28081269

  6. 78 FR 75581 - Patient Protection and Affordable Care Act; Establishment of the Multi-State Plan Program for the...

    2013-12-12

    ... MANAGEMENT Patient Protection and Affordable Care Act; Establishment of the Multi-State Plan Program for the Affordable Insurance Exchanges; Announcement AGENCY: Office of Personnel Management (OPM). ACTION: Notice of... Affordable Care Act; Establishment of the Multi-State Plan Program for the Affordable Insurance...

  7. Assessment of myocardial viability using multidetector computed tomography in patients with reperfused acute myocardial infarction

    Kim, T. [Department of Radiology, Ajou University School of Medicine, Suwon (Korea, Republic of); Choi, B.J. [Department of Cardiology, Ajou University School of Medicine, Suwon (Korea, Republic of); Kang, D.K., E-mail: kdklsm@ajou.ac.kr [Department of Radiology, Ajou University School of Medicine, Suwon (Korea, Republic of); Sun, J.S. [Department of Radiology, Ajou University School of Medicine, Suwon (Korea, Republic of)

    2012-08-15

    Aim: To assess the prognostic value of 64-section multidetector computed tomography (MDCT) to predict follow-up myocardial dysfunction and functional recovery after reperfusion therapy in patients with acute myocardial infarction (MI) as defined by echocardiography. Materials and methods: After reperfusion therapy for acute MI, 71 patients underwent two-phase contrast-enhanced MDCT and follow-up echocardiography. MDCT findings were compared with echocardiographic findings using kappa statistics. The areas under the receiver operating characteristic curves (AUCs) and the odds ratios (ORs) of early perfusion defects (EPD), delayed enhancement (DE), and residual perfusion defects (RPD) for predicting follow-up myocardial dysfunction and functional recovery were calculated on a segmental basis. Results: The presence of transmural EPD (EPD{sub TM}) or RPD showed good agreement (k = 0.611 and 0.658, respectively) with follow-up myocardial dysfunction, while subendocardial EPD (EPD{sub sub}) or subendocardial DE (DE{sub sub}) showed fair agreement with follow-up myocardial dysfunction (k = 0.235 and 0.234, respectively). The AUC of RPD (0.796) was superior (p < 0.001 and 0.031, respectively) to those of EPD{sub TM} (0.761) and DE{sub TM} (0.771). The presence of EPD{sub TM}, DE{sub TM}, and RPD were significant, independent positive predictors of follow-up myocardial dysfunction (OR = 6.4, 1.9, and 9.8, respectively). EPD{sub TM} was a significant, independent negative predictor of myocardial functional recovery (OR = 0.13). Conclusion: Abnormal myocardial attenuation on two-phase MDCT after reperfusion therapy may provide promising information regarding myocardial viability in patients with acute MI.

  8. Understanding affordances: history and contemporary development of Gibson’s central concept

    Dobromir G. Dotov

    2012-12-01

    Full Text Available Gibson developed the affordance concept to complement his theory of direct perception that stands in sharp contrast with the prevalent inferential theories of perception. A comparison of the two approaches shows that the distinction between them also has an ontological aspect. We trace the history and newer formalizations of the notion of affordance and discuss some competing opinions on its scope. Next, empirical work on the affordance concept is reviewed in brief and the relevance of dynamical systems theory to affordance research is demonstrated. Finally, the striking but often neglected convergence of the ideas of Gibson and those of certain Continental philosophers is discussed.

  9. Innovative Processing Methods for the Affordable Manufacture of Multifunctional High Temperature Coatings Project

    National Aeronautics and Space Administration — Research is proposed to investigate the feasibility of using advanced manufacturing techniques to enable the affordable application of multi-functional high...

  10. Affordance estimation for vision-based object replacement on a humanoid robot

    Mustafa, Wail; Wächter, Mirko; Szedmak, Sandor;

    2016-01-01

    In this paper, we address the problem of finding replacements of missing objects, involved in the execution of manipulation tasks. Our approach is based on estimating functional affordances for the unknown objects in order to propose replacements. We use a vision-based affordance estimation syste...... large-scale datasets. The results indicate that the system is able to successfully predict the affordances of novel objects. We also implement our system on a humanoid robot and demonstrate the affordance estimation in a real scene....

  11. Association of stroke and myocardial infarction in children.

    Nakashima, M; Takashima, S; Hashimoto, K; Shiraishi, M

    1982-02-01

    A 9-year-old boy with cerebrovascular accident (CVA) and old myocardial infarction with mural thrombi is reported. The cause of the myocardial infarction was congenital coronary artery fistula originating from the left coronary artery and emptying into the right atrium. Although a common cause of strokes in adults, myocardial infarction has infrequently been reported as the source of emboli in children.

  12. Detection of myocardial ischemia and infarction by radionuclide studies

    Tamaki, Nagara [Hokkaido Univ., Sapporo (Japan). School of Medicine

    1996-12-31

    Myocardial ischemia and myocardial infarction are the common diseases caused by reduced coronary artery blood flow to the myocardium. Although the radionuclide studies cannot identify stenotic lesions on the coronary arteries, they can demonstrate regional myocardial perfusion at rest and during stress as well which is particularly important for the accurate diagnosis of angina pectoris. (J.P.N.)

  13. Mechanisms and therapeutic modulation of myocardial infarct healing

    Timmers, L.

    2008-01-01

    This thesis aimed to increase the basic mechanistic understanding of myocardial infarct healing and to develop novel approaches to prevent heart failure following myocardial infarction (MI). Different approaches have been tested to reduce myocardial injury in the acute phase of MI, leading to reduce

  14. Myocardial dysfunction in malnourished children

    Faddan Nagla Hassan

    2010-01-01

    Full Text Available Background : Malnourished children suffer several alterations in body composition that could produce cardiac abnormalities. Aim : The aim of the present study was to detect the frequency of myocardial damage in malnourished children as shown by echocardiography and cardiac troponin T (cTnT level. Methods : Forty-five malnourished infants and young children (mean±SD of age was 11.24 ±7.88 months were matched with 25 apparently healthy controls (mean±SD of age was 10.78±6.29 months. Blood sample was taken for complete blood picture, liver and kidney function tests, serum sodium, potassium, calcium levels and cTnT. All the malnourished children were subjected to echocardiographic evaluation. Results : Malnourished children showed a significantly lower left ventricular (LV mass than the control group. The LV systolic functions were significantly impaired in patients with severe malnutrition. The cTnT level was higher than the upper reference limits in 11 (24.44% of the studied malnourished children and all of them had a severe degree of malnutrition. The cTnT level was significantly higher in patients with anemia, sepsis and electrolyte abnormalities and it correlated negatively with LV ejection fraction (EF. Six of the studied children with high cTnT levels (54.5% died within 21 days of treatment while only one case (2.9% with normal level of cTnT died within the same period. Conclusions: LV mass is reduced in malnourished children. Children with severe malnutrition have a significant decrease in LV systolic functions. Elevated cTnT levels in malnourished children has both diagnostic and prognostic significance for cardiomyocyte damage.

  15. Measurement of myocardial perfusion using magnetic resonance

    Fritz-Hansen, T.; Jensen, L.T.; Larsson, H.B.;

    2008-01-01

    Cardiac magnetic resonance imaging (MRI) has evolved rapidly. Recent developments have made non-invasive quantitative myocardial perfusion measurements possible. MRI is particularly attractive due to its high spatial resolution and because it does not involve ionising radiation. This paper review...... myocardial perfusion imaging with MR contrast agents: methods, validation and experiences from clinical studies. Unresolved issues still restrict the use of these techniques to research although clinical applications are within reach Udgivelsesdato: 2008/12/8......Cardiac magnetic resonance imaging (MRI) has evolved rapidly. Recent developments have made non-invasive quantitative myocardial perfusion measurements possible. MRI is particularly attractive due to its high spatial resolution and because it does not involve ionising radiation. This paper reviews...

  16. Hypoplasia of exocrine pancreas with myocardial necrosis

    Xiang Sheng Zhang; Xin Xiu Xu; Yan Zhang; Sbu Hua Wu

    2000-01-01

    AIM To study the clinical and pathological features of hypoplasia of exocrine pancreas with myocardialnecrosis.METHODS One ease of hypoplasia of exocrine pancreas with myocardial necrosis was autopsied. Theclinical signs and pathological changes were analyzed.RESULTS A 15-month-old boy with hypoplasia of exocrine pancreas was reported. The main clinicalfeatures were steatorrhea and marked underdevelopment. He died of acute heart failure afterhospitalization. Autopsy showed that there were aplasia of exocrine portion and fatty metaplasia ofpancreas, the myocardium revealed focal necrosis and sear formation.CONCLUSION Atrophy of exocrine pancreas and myocardial necrosis exist at the same time, suggestingthat there may be some relationship between them. It was likely that the damaged pancreatic tissue releasedsome active materials that may harm the myocardium or decrease pancreatic juice that results in lack ofnutrient and myocardial necrosis.

  17. Quality indicators for acute myocardial infarction

    Schiele, Francois; Gale, Chris P; Bonnefoy, Eric

    2016-01-01

    infarction (AMI), but no such indicators exist in Europe. In this context, the European Society of Cardiology (ESC) Acute Cardiovascular Care Association (ACCA) has reflected on the measurement of quality of care in the context of AMI (ST segment elevation myocardial infarction (STEMI) and non-ST segment...... be estimated solely on the basis of patients' clinical outcomes. Thus, measuring the process of care through quality indicators (QIs) has become a widely used practice in this context. Other professional societies have published QIs for the evaluation of quality of care in the context of acute myocardial...... elevation myocardial infarction (NSTEMI)) and created a set of QIs, with a view to developing programmes to improve quality of care for the management of AMI across Europe. We present here the list of QIs defined by the ACCA, with explanations of the methodology used, scientific justification and reasons...

  18. Regional variations in public opinion on the affordable care act.

    Brodie, Mollyann; Deane, Claudia; Cho, Sarah

    2011-12-01

    One year after passage, the Patient Protection and Affordable Care Act (ACA) remains a divisive topic. Most publicly released polls on the law have focused on the views of Americans as a whole. But with much of the responsibility of implementation lying with the states, this essay explores whether opinion differs geographically. The analysis finds that views on the health reform law do differ by region, and these differences are most likely driven by the political leanings of a given area. While opinion nationally differs by age and race, this pattern does not hold when looking by region. Areas that have a larger share of uninsured and are slated to receive greater federal funding under the ACA also do not differ in their opinions. These data suggest that regional variations in attitudes about the ACA are based less on the demographic structure of a region and more on the political ideologies of residents in a given region. As implementation of the law continues, this analysis shows that national opinion data mask important regional variations in views of the ACA.

  19. Developing affordable multi-touch technologies for use in physics

    Potter, Mark; Ilie, Carolina; Schofield, Damian; Vampola, David

    2012-02-01

    Physics is one of many areas which has the ability to benefit from a number of different teaching styles and sophisticated instructional tools due to it having both theoretical and practical applications which can be explored. The purpose of this research is to develop affordable large scale multi-touch interfaces which can be used within and outside of the classroom as both an instruction technology and a computer supported collaborative learning tool. Not only can this technology be implemented at university levels, but also at the K-12 level of education. Pedagogical research indicates that kinesthetic learning is a fundamental, powerful, and ubiquitous learning style [1]. Through the use of these types of multi-touch tools and teaching methods which incorporate them, the classroom can be enriched to allow for better comprehension and retention of information. This is due in part to a wider range of learning styles, such as kinesthetic learning, which are being catered to within the classroom. [4pt] [1] Wieman, C.E, Perkins, K.K., Adams, W.K., ``Oersted Medal Lecture 2007: Interactive Simulations for teaching physics: What works, what doesn't and why,'' American Journal of Physics. 76 393-99.

  20. Priority Setting, Cost-Effectiveness, and the Affordable Care Act.

    Persad, Govind

    2015-01-01

    The Affordable Care Act (ACA) may be the most important health law statute in American history, yet much of the most prominent legal scholarship examining it has focused on the merits of the court challenges it has faced rather than delving into the details of its priority-setting provisions. In addition to providing an overview of the ACA's provisions concerning priority setting and their developing interpretations, this Article attempts to defend three substantive propositions. First, I argue that the ACA is neither uniformly hostile nor uniformly friendly to efforts to set priorities in ways that promote cost and quality. Second, I argue that the ACA does not take a single, unified approach to priority setting; rather, its guidance varies depending on the aspect of the healthcare system at issue (Patient Centered Outcomes Research Institute, Medicare, essential health benefits) and the factors being excluded from priority setting (age, disability, life expectancy). Third, I argue that cost-effectiveness can be achieved within the ACA's constraints, but that doing so will require adopting new approaches to cost-effectiveness and priority setting. By limiting the use of standard cost-effectiveness analysis, the ACA makes the need for workable rivals to cost-effectiveness analysis a pressing practical concern rather than a mere theoretical worry.

  1. Strategic options towards an affordable high-performance infrared camera

    Oduor, Patrick; Mizuno, Genki; Dutta, Achyut K.; Lewis, Jay; Dhar, Nibir K.

    2016-05-01

    The promise of infrared (IR) imaging attaining low-cost akin to CMOS sensors success has been hampered by the inability to achieve cost advantages that are necessary for crossover from military and industrial applications into the consumer and mass-scale commercial realm despite well documented advantages. Banpil Photonics is developing affordable IR cameras by adopting new strategies to speed-up the decline of the IR camera cost curve. We present a new short-wave IR (SWIR) camera; 640x512 pixel InGaAs uncooled system that is high sensitivity low noise ( 500 frames per second (FPS)) at full resolution, and low power consumption (market adoption by not only demonstrating high-performance IR imaging capability value add demanded by military and industrial application, but also illuminates a path towards justifiable price points essential for consumer facing application industries such as automotive, medical, and security imaging adoption. Among the strategic options presented include new sensor manufacturing technologies that scale favorably towards automation, multi-focal plane array compatible readout electronics, and dense or ultra-small pixel pitch devices.

  2. Grasping the World: Object-Affordance Effect in Schizophrenia

    Jessica Sevos

    2013-01-01

    Full Text Available For schizophrenic patients, the world can appear as deprived of practical meaning, which normally emerges from sensory-motor experiences. However, no research has yet studied the integration between perception and action in this population. In this study, we hypothesize that patients, after having controlled the integrity of their visuospatial integration, would nevertheless present deficit in sensory-motor simulation. In this view, we compare patients to control subjects using two stimulus-response compatibility (SRC tasks. Experiment 1 is performed to ensure that visuo-spatial integration is not impaired (Simon Effect. Experiment 2 replicates a study from Tucker and Ellis (1998 to explore the existence of sensory-motor compatibility between stimulus and response (Object Affordance. In control subjects, the SRC effect appears in both experiments. In schizophrenic patients, it appears only when stimuli and responses share the same spatial localization. This loss of automatic sensory-motor simulation could emerge from a lack of relation between the object and the subject’s environment.

  3. Why do so many Americans oppose the Affordable Care Act?

    Dalen, James E; Waterbrook, Keith; Alpert, Joseph S

    2015-08-01

    The Patient Protection and Affordable Care Act (ACA) was passed by a Democratic Congress and signed into law by a Democratic president in 2010. Republican congressmen, governors, and Republican candidates have consistently opposed the ACA and have vowed to repeal it. Polls have consistently shown that it is supported by care. Yet Medicare, a mandatory insurance for seniors administered by the federal government since 1965, is overwhelmingly approved by the American public. The opposition to a government role in health care is based on the fact that that the vast majority of our citizens do not trust their government. Republicans are much less trusting of the federal government and much less supportive of a government role in health care than Democrats. The overwhelmingly negative TV ads against the ACA by the Republican candidates in the elections of 2012 and 2014 have had a major impact on Americans' views of the ACA. More than 60% of Americans have stated that most of what they know about the ACA came from watching TV. Opposition to a government role in health care and to mandatory health insurance makes it unlikely that the US will be able to insure that all of its citizens have ongoing access to health care in the near future.

  4. The Affordable Care Act: implications for cardiothoracic surgery.

    Ferguson, T Bruce; Babb, Joseph A

    2013-01-01

    The Affordable Care Act legislation that was passed by the US Congress and signed into law by President Obama on March 23, 2010 is having a substantial effect throughout all of health care in the United States. Cardiothoracic surgeons, as hospital-based procedural specialists, bring unique assets and certain important liabilities into this massive restructuring of our health care delivery system. This article highlights how each of the 10 titles in the Obamacare legislation might affect our specialty; its collaborative relationship with our cardiovascular, medical specialty, and primary care colleagues; and our clinical practice roles and responsibilities in accountable care organizations and primary care medical homes. This article also addresses the unique assets in clinical data in medicine and quality improvement demonstrated by our specialty that have been used to help shape the current and future landscape. Finally, key resources are identified to allow the cardiothoracic community to monitor the ongoing progress of Obamacare as implementation begins. Keeping abreast of these rapidly changing developments will be an important role for our specialty societies and for practitioners alike going forward.

  5. The NAO humanoid: a combination of performance and affordability

    Gouaillier, David; Blazevic, Pierre; Kilner, Chris; Monceaux, Jerome; Lafourcade, Pascal; Marnier, Brice; Serre, Julien; Maisonnier, Bruno

    2008-01-01

    This article presents the design of the autonomous humanoid robot called NAO that is built by the French company Aldebaran-Robotics. With its height of 0.57 m and its weight about 4.5 kg, this innovative robot is lightweight and compact. It distinguishes itself from its existing Japanese, American, and other counterparts thanks to its pelvis kinematics design, its proprietary actuation system based on brush DC motors, its electronic, computer and distributed software architectures. This robot has been designed to be affordable without sacrificing quality and performance. It is an open and easy-to-handle platform where the user can change all the embedded system software or just add some applications to make the robot adopt specific behaviours. The robot's head and forearms are modular and can be changed to promote further evolution. The comprehensive and functional design is one of the reasons that helped select NAO to replace the AIBO quadrupeds in the 2008 RoboCup standard league.

  6. Nitroglycerine induced acute myocardial infarction in a patient with myocardial bridging

    Rujic, Dragana; Nielsen, Mette Lundgren; Veien, Karsten Tange

    2014-01-01

    Muscle overlying an intramyocardial segment of a coronary artery is termed a myocardial bridge. The intramyocardial segment, the tunneled artery, is compressed during systole. The condition is generally benign but may occasionally cause myocardial ischemia, infarction, arrhythmia, or sudden cardiac...... death. We present a case regarding a 52-year-old man with exercise-induced angina who was diagnosed with a myocardial bridge overlying the left anterior descending artery. He was initially treated with beta-blockers and later received coronary bypass graft surgery....

  7. INFLAMMATORY REACTIONS IN EXPERIMENTAL MYOCARDIAL DAMAGE

    L. D. Khidirova

    2015-12-01

    Full Text Available Aim. To study the role of hormonal and metabolic changes specific to myocardial infarction in the development of inflammatory reactions in the experimental non-coronarogenic myocardial damage. Material and methods. Wistar male rats weighing 180–220 g (n=80 were used in the study. Metabolic myocardial infarction in intact rats and rats with alloxan diabetes was induced by epinephrine injected subcutaneously as single dose or daily (7 days. Myocardial infarction was verified by ECG analysis, and by histological control. Nitroblue tetrazolium test (NBT-test both spontaneous and zymosan induced NBT-test was used to determine the oxygen-dependent functional activity of neutrophils and their biocidal reserve. Determination of cationic proteins in neutrophils of peripheral blood was performed using lysosomal-cationic test. Results. Increase in oxygen-dependent neutrophil biocidal activity was found as well as reduction in biocidal reserves. Indicators of zymosan induced NBT-test raised according to aggravation of hormonal changes much slower: alloxan increased them by 10% only , epinephrine single dose — by 35%, long-term epinephrine administration simultaneously with alloxan — by 54%. At the same time oxygen-independent neutrophil activity determined by intra-neutrophil cationic proteins level was significantly reduced. Blood levels of pro-inflammatory cytokines raised according to progression of the changes in myocardium: tumor necrosis factor-α (from 5.5±0.03 to 12.6±1.23 pg/ml and interleukin-1β (from 6.0±0.18 to 11.1±0.78 pg/ml. Conclusion. Experimental model of hormonal changes specific to myocardial infarction detected a relationship between inflammatory reactions accompanying myocardial damage and increased catecholamine production.

  8. Antioxidant and Myocardial Preservation Activities of Natural Phytochemicals from Mung Bean (Vigna radiata L.) Seeds.

    Bai, Yan; Chang, Jiawei; Xu, Yan; Cheng, Dan; Liu, Hongxin; Zhao, Yunli; Yu, Zhiguo

    2016-06-08

    Mung bean (Vigna radiata L.) seeds (MBS) contain abundant nutrients with biological activities. This study was aimed to isolate key bioactive components from MBS with antioxidant and myocardial preservation activities. A new flavonoid C-glycoside, isovitexin-6″-O-α-l-glucoside, and 14 known compounds were obtained. Their structures were identified by extensive 1D and 2D NMR and FT-ICR-MS spectroscopic analyses. The antioxidant activities of these compounds were evaluated. Compounds 1-5 and 7-10 displayed 2,2'-azinobis (3-ethylbenzothiazoline-6-sulphonic acid) (ABTS(•+)) scavenging activity, but only 5 and 7 exhibited 2,2-diphenyl-1-picrylhydrazyl (DPPH(•)) scavenging activity. The myocardial preservation effect of 2, 3, and MBS were investigated by measuring the serum levels of LDH, CK, and AST as well as the tissue level of MDA and SOD. The results demonstrated that 2, 3, and MBS had a significant protective effect against ISO-induced myocardial ischemia. MBS can be regarded as a potential new source of antioxidants and myocardial preservation agents.

  9. Effect of aqueous extract of the Desmodium gangeticum DC root in the severity of myocardial infarction.

    Kurian, Gino A; Philip, Sachu; Varghese, Thomas

    2005-03-21

    The aqueous extract of Desmodium gangeticum (L) DC (Fabaceae) (DG) was studied in isoproterenol induced myocardial infarcted (MI) rats for the hypocholesterolemic and antioxidant effect. After inducing MI by isoproterenol (35 mg/kg b wt. i.p.), the aqueous extract of Desmodium gangeticum root at a dose of 3 ml/100 g b wt. was orally administered daily for a period of 30 days in six rats. On induction of MI, the activities of creatinine phosphokinase (CPK), lactate dehydrogenase (LDH), alkaline phosphatase (ALP) and serum glutamate oxaloacetate transaminase (SGOT) increased in myocardial tissue, hepatic tissue and serum. Pretreatment of DG to MI rats prevented the increase of these enzymes. The hypocholesterolemic effect of DG was assessed by the concentration of total cholesterol, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol and through the activities of 3-hydroxy 3-methyl glutaryl co-enzyme (HMG CoA) reductase and lecithin cholesterol acyl transferase (LCAT) in the myocardial tissue. The significant (P < 0.001) decrease in the concentration of thiobarbituric acid reactive substances (TBARS) and improved activities of glutathione reductase and catalase in the myocardial tissues of rats treated with DG suggest free radical scavenging activity of the extract.

  10. Abnormal Glucose Tolerance Is Associated with a Reduced Myocardial Metabolic Flexibility in Patients with Dilated Cardiomyopathy.

    Tricò, Domenico; Baldi, Simona; Frascerra, Silvia; Venturi, Elena; Marraccini, Paolo; Neglia, Danilo; Natali, Andrea

    2016-01-01

    Dilated cardiomyopathy (DCM) is characterized by a metabolic shift from fat to carbohydrates and failure to increase myocardial glucose uptake in response to workload increments. We verified whether this pattern is influenced by an abnormal glucose tolerance (AGT). In 10 patients with DCM, 5 with normal glucose tolerance (DCM-NGT) and 5 with AGT (DCM-AGT), and 5 non-DCM subjects with AGT (N-AGT), we measured coronary blood flow and arteriovenous differences of oxygen and metabolites during Rest, Pacing (at 130 b/min), and Recovery. Myocardial lactate exchange and oleate oxidation were also measured. At Rest, DCM patients showed a reduced nonesterified fatty acids (NEFA) myocardial uptake, while glucose utilization increased only in DCM-AGT. In response to Pacing, glucose uptake promptly rose in N-AGT (from 72 ± 21 to 234 ± 73 nmol/min/g, p equivalents, p metabolism and the reduced myocardial metabolic flexibility in response to an increased workload. This trial is registered with ClinicalTrial.gov NCT02440217.

  11. Visualizing myocardial function using HARP MRI

    Osman, N.F. [Center for Imaging Science, Department of Electrical and Computer Engineering, The Johns Hopkins University, Baltimore, MD 21218 (United States); Prince, J.L. [Center for Imaging Science, Department of Electrical and Computer Engineering, The Johns Hopkins University, Baltimore, MD 21218 (United States). E-mail: prince at jhu.edu

    2000-06-01

    Harmonic phase magnetic resonance imaging (HARP) is a new technique for measuring the motion of the left ventricle of the heart. HARP uses magnetic resonance tagging, Fourier filtering and special processing algorithms to calculate key indices of myocardial motion including Eulerian and Lagrangian strain. This paper presents several new methods for visualizing myocardial motion based on HARP. Quantities that are computed and visualized include motion grids, velocity fields, strain rates, pathlines, tracked Eulerian strain, and contraction angle. The computations are fast and fully automated and have the potential for clinical application. (author)

  12. Visualizing myocardial function using HARP MRI

    Osman, Nael F.; Prince, Jerry L.

    2000-06-01

    Harmonic phase magnetic resonance imaging (HARP) is a new technique for measuring the motion of the left ventricle of the heart. HARP uses magnetic resonance tagging, Fourier filtering and special processing algorithms to calculate key indices of myocardial motion including Eulerian and Lagrangian strain. This paper presents several new methods for visualizing myocardial motion based on HARP. Quantities that are computed and visualized include motion grids, velocity fields, strain rates, pathlines, tracked Eulerian strain, and contraction angle. The computations are fast and fully automated and have the potential for clinical application.

  13. Acute myopericarditis masquerading as acute myocardial infarction

    Wen Tian; Zixin Zhang; Xiaojuan Bai; Dingyin Zeng; Guoxian Qi

    2008-01-01

    Patients with abrupt onset of chest pain, ischemic ECG abnormalities and elevated levels of cardiac markers could be given a diagnosis of acute myocardial infarction. However, some other diseases should be taken into consideration in this clinical setting when coronary arteries are proven to be normal. Here we report a case of acute myopericarditis with clinical presentation of myocardial infarction and normal coronary anatomy. The Herpes Simplex Virus Ⅱ was considered as the organism causing myopericarditis and the patient was recovered by the treatment with valacicloavir. A precise diagnosis is a prerequisite of successful treatment and favorable prognosis.

  14. Gallium-67 myocardial scintigraphy in dilated cardiomyopathy

    Aoki, Toshikazu; Konishi, Tokuji; Koyama, Takao; Morita, Yuriko; Futagami, Yasuo; Hayashi, Takamaro; Hamada, Masayuki; Nakano, Takeshi

    1988-12-01

    Gallium-67 imaging has been employed clinically in the detection of malignant tumor or chronic inflammatory disease. In this study, we evaluated the usefulness of Gallium-67 myocardial imaging as an adjunct to endomyocardial biopsy in the diagnosis of myocarditis. Nine patients who had been diagnosed clinically as dilated cardiomyopathy underwent Gallium-67 myocardial imaging. Left ventricular endomyocardial biopsy was performed on all patients. Two had positive Gallium-67 imaging, but myocarditis was not proven in their tissue specimen. Two others with proven myocarditis had negative Gallium-67 imaging. These results suggest that Gallium-67 imaging is not always a useful tool to detect latent myocarditis in patients with dilated cardiomyopathy.

  15. Absolute quantification of myocardial blood flow.

    Yoshinaga, Keiichiro; Manabe, Osamu; Tamaki, Nagara

    2016-07-21

    With the increasing availability of positron emission tomography (PET) myocardial perfusion imaging, the absolute quantification of myocardial blood flow (MBF) has become popular in clinical settings. Quantitative MBF provides an important additional diagnostic or prognostic information over conventional visual assessment. The success of MBF quantification using PET/computed tomography (CT) has increased the demand for this quantitative diagnostic approach to be more accessible. In this regard, MBF quantification approaches have been developed using several other diagnostic imaging modalities including single-photon emission computed tomography, CT, and cardiac magnetic resonance. This review will address the clinical aspects of PET MBF quantification and the new approaches to MBF quantification.

  16. Altered myocardial substrate metabolism is associated with myocardial dysfunction in early diabetic cardiomyopathy in rats: studies using positron emission tomography

    Brom, van den C.E.; Huisman, M.C.; Vlasblom, R.; Boontje, N.; Duijst, S.; Lubberink, J.M.; Molthoff, C.F.M.; Lammertsma, A.A.; Velden, van der J.; Boer, C.; Ouwens, D.M.; Diamant, M.

    2009-01-01

    0.05). CONCLUSION: Using PET and echocardiography, we found increases in myocardial FA oxidation with a concomitant decrease of insulin-mediated myocardial glucose utilisation in early DCM. In addition, the latter was associated with impaired myocardial function. These in vivo data expand previous i

  17. Evaluation of heart perfusion in patients with acute myocardial infarction using dynamic contrast-enhanced magnetic resonance imaging

    Nielsen, Gitte; Fritz-Hansen, Thomas; Dirks, Christina G;

    2004-01-01

    with acute transmural myocardial infarction were studied using a Turbo-fast low angle shot (FLASH) MRI sequence to monitor the first pass of an extravascular contrast agent (CA), gadolinium diethylene triamine pentaacetic acid (Gd-DTPA). Quantitation of perfusion, expressed as Ki (mL/100 g/minute), in five......PURPOSE: To investigate the diagnostic ability of quantitative magnetic resonance imaging (MRI) heart perfusion in acute heart patients, a fast, multislice dynamic contrast-enhanced MRI sequence was applied to patients with acute myocardial infarction. MATERIALS AND METHODS: Seven patients...

  18. Systemic Atherosclerotic Inflammation Following Acute Myocardial Infarction: Myocardial Infarction Begets Myocardial Infarction

    Joshi, Nikhil V; Toor, Iqbal; Shah, Anoop S V; Carruthers, Kathryn; Vesey, Alex T; Alam, Shirjel R; Sills, Andrew; Hoo, Teng Y; Melville, Adam J; Langlands, Sarah P; Jenkins, William S A; Uren, Neal G; Mills, Nicholas L; Fletcher, Alison M; van Beek, Edwin J R; Rudd, James H F; Fox, Keith A A; Dweck, Marc R; Newby, David E

    2015-01-01

    Background Preclinical data suggest that an acute inflammatory response following myocardial infarction (MI) accelerates systemic atherosclerosis. Using combined positron emission and computed tomography, we investigated whether this phenomenon occurs in humans. Methods and Results Overall, 40 patients with MI and 40 with stable angina underwent thoracic 18F-fluorodeoxyglucose combined positron emission and computed tomography scan. Radiotracer uptake was measured in aortic atheroma and nonvascular tissue (paraspinal muscle). In 1003 patients enrolled in the Global Registry of Acute Coronary Events, we assessed whether infarct size predicted early (≤30 days) and late (>30 days) recurrent coronary events. Compared with patients with stable angina, patients with MI had higher aortic 18F-fluorodeoxyglucose uptake (tissue-to-background ratio 2.15±0.30 versus 1.84±0.18, P50 000] versus 3800 [1000 to 9200] ng/L, P<0.0001) and greater aortic 18F-fluorodeoxyglucose uptake (2.24±0.32 versus 2.02±0.21, P=0.03) than those with non–ST-segment elevation MI. Peak plasma troponin concentrations correlated with aortic 18F-fluorodeoxyglucose uptake (r=0.43, P=0.01) and, on multivariate analysis, independently predicted early (tertile 3 versus tertile 1: relative risk 4.40 [95% CI 1.90 to 10.19], P=0.001), but not late, recurrent MI. Conclusions The presence and extent of MI is associated with increased aortic atherosclerotic inflammation and early recurrent MI. This finding supports the hypothesis that acute MI exacerbates systemic atherosclerotic inflammation and remote plaque destabilization: MI begets MI. Clinical Trial Registration URL: https://www.clinicaltrials.gov. Unique identifier: NCT01749254. PMID:26316523

  19. Dose-dependent effects of atorvastatin on myocardial infarction

    Barbarash O

    2015-06-01

    Full Text Available Olga Barbarash, Olga Gruzdeva, Evgenya Uchasova, Ekaterina Belik, Yulia Dyleva, Victoria KaretnikovaFederal State Budgetary Institution, Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, the Russian Federation Background: Dyslipidemia is a key factor determining the development of both myocardial infarction (MI and its subsequent complications. Dyslipidemia is associated with endothelial dysfunction, activation of inflammation, thrombogenesis, and formation of insulin resistance. Statin therapy is thought to be effective for primary and secondary prevention of complications associated with atherosclerosis.Methods: This study examined 210 patients with Segment elevated MI (ST elevated MI who were treated with atorvastatin from the first 24 hours after MI. Group 1 (n=110 were given atorvastatin 20 mg/day. Group 2 (n=100 were given atorvastatin 40 mg/day. At days 1 and 12 after MI onset, insulin resistance levels determined by the homeostasis model assessment of insulin resistance index, lipid profiles, and serum glucose, insulin, adipokine, and ghrelin levels were measured.Results: Free fatty acid levels showed a sharp increase during the acute phase of MI. Treatment with atorvastatin 20 mg/day, and especially with 40 mg/day, resulted in a decrease in free fatty acid levels. The positive effect of low-dose atorvastatin (20 mg/day is normalization of the adipokine status. Administration of atorvastatin 20 mg/day was accompanied with a statistically significant reduction in glucose levels (by 14% and C-peptide levels (by 38%, and a decrease in the homeostasis model assessment of insulin resistance index on day 12.Conclusion: Determination of atorvastatin dose and its use during the in-hospital period and subsequent periods should take into account changes in biochemical markers of insulin resistance and adipokine status in patients with MI.Keywords: myocardial infarction, statin, insulin resistance, adipokines

  20. Thrombolytic therapy of acute myocardial infarction alters collagen metabolism

    Høst, N B; Hansen, S S; Jensen, L T

    1994-01-01

    infarction and receiving thrombolytic therapy. Regardless of whether acute myocardial infarction was confirmed or not, S-PIIINP increased (94-120%) 4 h after streptokinase therapy (p ....02). With confirmed acute myocardial infarction, S-PIIINP increased from 24 h towards a plateau reached at day 2-3 (p acute myocardial infarction had S-PICP above baseline at 1, 2, and 6 months (p ....05). A less pronounced S-PIIINP increase was noted with tissue-plasminogen activator than with streptokinase. Thrombolytic therapy induces collagen breakdown regardless of whether acute myocardial infarction is confirmed or not. With confirmed acute myocardial infarction collagen metabolism is altered...

  1. Comparison of myocardial perfusion after successful primary percutaneous coronary intervention in patients with ST-elevation myocardial infarction with versus without diabetes mellitus

    Timmer, [No Value; van der Horst, ICC; de Luca, G; Ottervanger, JP; Hoorntje, JCA; de Boer, MJ; Suryapranata, H; Gosselink, M; Zijlstra, F; van't Hof, AWJ; Dambrink, Jan Hendrik Everwijn

    2005-01-01

    Patients with diabetes mellitus (DM) have an adverse prognosis after ST-segment elevation myocardial infarction (STEMI). Whether DM was associated with impaired myocardial reperfusion after successful primary percutaneous coronary intervention for STEMI was investigated. Myocardial reperfusion was a

  2. [Effect of wall thickness of left ventricle on 201Tl myocardial SPECT images: myocardial phantom study].

    Koto, M; Namura, H; Kawase, O; Yamasaki, K; Kono, M

    1996-07-01

    201Tl myocardial SPECT is known for better sensitivity, specificity, and accuracy than planar images in detecting coronary artery disease and diagnosing myocardial viability. SPECT images are also superior to planar images in diagnostic sensitivity and anatomical orientation. However, as limitation of the spatial resolution of the machine, we often encounter poor SPECT plower image quality in patients with decreased wall thickness. To test the accuracy of SPECT images in patients with marked thinning of the left ventricular wall, as occurs in dilated cardiomyopathy, we performed a experimental study using myocardial phantom with 7 mm wall thickness. Tomographic image of the phantom images were rather heterogeneous, though no artificial defect was located. Dilated cardiomyopathy is thought to be characterized by patchy defects in the left ventricle. Careful attention should be given to elucidating myocardial perfusion in patients with a thin left ventricle wall, as there are technical limitations in addition to clinical features.

  3. Affordable Development and Qualification Strategy for Nuclear Thermal Propulsion

    Gerrish, Harold P., Jr.; Doughty, Glen E.; Bhattacharyya, Samit K.

    2013-01-01

    Nuclear Thermal Propulsion (NTP) is a concept which uses a nuclear reactor to heat a propellant to high temperatures without combustion and can achieve significantly greater specific impulse than chemical engines. NTP has been considered many times for human and cargo missions beyond low earth orbit. A lot of development and technical maturation of NTP components took place during the Rover/NERVA program of the 60's and early 70's. Other NTP programs and studies followed attempting to further mature the NTP concept and identify a champion customer willing to devote the funds and support the development schedule to a demonstration mission. Budgetary constraints require the use of an affordable development and qualification strategy that takes into account all the previous work performed on NTP to construct an existing database, and include lessons learned and past guidelines followed. Current guidelines and standards NASA uses for human rating chemical rocket engines is referenced. The long lead items for NTP development involve the fuel elements of the reactor and ground testing the engine system, subsystem, and components. Other considerations which greatly impact the development plans includes the National Space Policy, National Environmental Policy Act, Presidential Directive/National Security Council Memorandum #25 (Scientific or Technological Experiments with Possible Large-Scale Adverse Environmental Effects and Launch of Nuclear Systems into Space), and Safeguards and Security. Ground testing will utilize non-nuclear test capabilities to help down select components and subsystems before testing in a nuclear environment to save time and cost. Existing test facilities with minor modifications will be considered to the maximum extent practical. New facilities will be designed to meet minimum requirements. Engine and test facility requirements are based on the driving mission requirements with added factors of safety for better assurance and reliability

  4. Automated quantitative coronary computed tomography correlates of myocardial ischaemia on gated myocardial perfusion SPECT

    Graaf, Michiel A. de; Boogers, Mark J.; Veltman, Caroline E. [Leiden University Medical Center, Department of Cardiology, Leiden (Netherlands); The Interuniversity Cardiology Institute of The Netherlands, Utrecht (Netherlands); El-Naggar, Heba M.; Bax, Jeroen J.; Delgado, Victoria [Leiden University Medical Center, Department of Cardiology, Leiden (Netherlands); Broersen, Alexander; Kitslaar, Pieter H.; Dijkstra, Jouke [Leiden University Medical Center, Department of Radiology, Division of Image Processing, Leiden (Netherlands); Kroft, Lucia J. [Leiden University Medical Center, Department of Radiology, Leiden (Netherlands); Younis, Imad Al [Leiden University Medical Center, Department of Nuclear Medicine, Leiden (Netherlands); Reiber, Johan H. [Leiden University Medical Center, Department of Radiology, Division of Image Processing, Leiden (Netherlands); Medis medical imaging systems B.V., Leiden (Netherlands); Scholte, Arthur J. [Leiden University Medical Center, Department of Cardiology, Leiden (Netherlands)

    2013-08-15

    Automated software tools have permitted more comprehensive, robust and reproducible quantification of coronary stenosis, plaque burden and plaque location of coronary computed tomography angiography (CTA) data. The association between these quantitative CTA (QCT) parameters and the presence of myocardial ischaemia has not been explored. The aim of the present investigation was to evaluate the association between QCT parameters of coronary artery lesions and the presence of myocardial ischaemia on gated myocardial perfusion single-photon emission CT (SPECT). Included in the study were 40 patients (mean age 58.2 {+-} 10.9 years, 27 men) with known or suspected coronary artery disease (CAD) who had undergone multidetector row CTA and gated myocardial perfusion SPECT within 6 months. From the CTA datasets, vessel-based and lesion-based visual analyses were performed. Consecutively, lesion-based QCT was performed to assess plaque length, plaque burden, percentage lumen area stenosis and remodelling index. Subsequently, the presence of myocardial ischaemia was assessed using the summed difference score (SDS {>=}2) on gated myocardial perfusion SPECT. Myocardial ischaemia was seen in 25 patients (62.5 %) in 37 vascular territories. Quantitatively assessed significant stenosis and quantitatively assessed lesion length were independently associated with myocardial ischaemia (OR 7.72, 95 % CI 2.41-24.7, p < 0.001, and OR 1.07, 95 % CI 1.00-1.45, p = 0.032, respectively) after correcting for clinical variables and visually assessed significant stenosis. The addition of quantitatively assessed significant stenosis ({chi} {sup 2} = 20.7) and lesion length ({chi} {sup 2} = 26.0) to the clinical variables and the visual assessment ({chi} {sup 2} = 5.9) had incremental value in the association with myocardial ischaemia. Coronary lesion length and quantitatively assessed significant stenosis were independently associated with myocardial ischaemia. Both quantitative parameters have

  5. Scientific experimentation afforded by the International Asteroid Mission

    The International Asteroid Mission (IAM) affords scientists the opportunity to perform interesting and important experimentations. This opportunity is not sufficient in its own right to mandate inclusion of science into the mission. Certain scientific experimentations are essential to the success of the mission, and are the driving force behind the inclusion of science. Instrument designs incorporate the need for direct contribution to the success of the mining mission. Examples of these applications include the search for additional candidate asteroids, especially at the Earth-Sun Trojan points, with an infrared telescope facility; a gamma ray burst detector provides the crew with real-time notification of potentially harmful solar-flare activity; and a materials processing laboratory provides information on the porosity, composition, and crystalline structure of samples to optimize the mining operations in addition to yielding great insight into the history and formation of the solar-system. Instrument designs have emphasized the use of off-the-shelf hardware, demonstrated technologies. Their scientific value is derived from the location on an interplanetary platform, not necessarily advancements in technology or detection methods. Instrumentation will be delivered to the IAM project after completion of a thorough certification program. The program will include qualification, acceptance, performance, thermal balance, thermal vacuum, vibration, electromagnetic susceptibility and compatibility, and calibration testing. After delivery to the assembly-site in low-Earth orbit, an additional series of functional and compatibility tests will be required prior to initiation of the mission. The scientific instrumentation proposed for the IAM consists of experiments using a Gamma Ray Burst Detector, a Infrared Observatory, a Materials Processing Facility, Long-Wavelength Radar, Seismic Measurement Devices, Cosmic Ray Detectors, Interplanetary Plasma Measurements, a Solar

  6. The research progress on the diagnosis of myocardial injury of heart-type fatty acid-binding protein%心型脂肪酸结合蛋白在心肌损伤诊断中的研究进展

    李继元; 李洪; 杨天德

    2011-01-01

    背景 心肌标志物的正确应用为临床准确诊断、鉴别心血管疾病和判断治疗效果起到了革命性的作用,目前已经有越来越多的心肌损伤标志物在临床中得到应用,现对心型脂肪酸结合蛋白(heart-type fatty acid-binding protein,H-FABP)的研究相关进展作一综述.目的 了解H-FABP的理化性质和临床检测方法,认识H-FABP在早期心肌梗塞诊断中的独特优势.内容 结合国内外文献对H-FABP的基础和临床研究现状进行了阐述,对目前临床检测的方法进行了介绍,并对发展的趋势做了进一步展望.趋向 随着H-FABP测定方法的不断改进及临床研究的不断深入,H-FABP正逐渐成为诊断心肌损伤的重要生化标志物.%Background The correct application of cardiac markers have played a revolutionary role for clinical accurate diagnosis,identification and treatment of cardiovascular disease. Now more and more cardiac biochemical markers have been applied in clinic researches,and the latest research progress in the field of H-FABP is reviewed in this paper.Objective To understand the physical and chemical properties and clinical detection methods of H-FABP,to recognize the unique advantages in diagnosis of the early AMI.Content To survey the basic and clinical research of H-FABP by reviewing domestic and international literatures, and to introduce the current clinical detection methods.Trend With the development of H-FABP determination methods and clinical research,H-FABP is becoming an important biochemical marker of myocardial injury.

  7. 急性ST段抬高型心肌梗死患者心型脂肪酸结合蛋白水平与GRACE危险评分的相关性研究%Relationship between Heart-type Fatty Acid-binding Protein and GRACE Risk Score in Patients with Acute ST-elevation Myocardial Infarction

    魏庆民; 周彬; 王晓纲; 樊延明; 王爱平; 刘翠华

    2013-01-01

    Objective To study the relationship between heart - type fatty acid - binding protein ( H - FABP ) level and Global Registry of Acute Coronary Events ( GRACE ) risk score in patients with acute ST - elevation myocardial infarction ( STEMI ). Methods From April 2010 to December 2011 , 60 STEM patients admitted to our hospital within 2 hours of symptom onset were enrolled in this study. Twelve hours after admission, blood samples were obtained for H - FABP measurement every two hours. Then, H - FABP peak values were found. The baseline data were recorded and the GRACE risk score were calculated. The Pearson's correlation analysis were used to analyze the relationship between the H - FABP peak value and GRACE risk score. Results The peak value of H - FABP was ( 59. 4 ± 23. 1 ) μg/L, which occmed 4~8 hours after admission. It was positively correlated with GRACE risk score in these patients ( r = 0.701 , P<0. 05 ). Conclusion H -FABP peak value is directly relevant with GRACE risk score in STEMI patients. Measurement of H - FABP level can provide additional risk stratification information in these patients.%目的 探讨急性ST段抬高型心肌梗死(STEMI)患者血浆心型脂肪酸结合蛋白(H-FABP)的峰值水平与全球急性冠状动脉事件注册(GRACE)风险评分的相关性.方法 选择2010年4月-2011年12月我科收治的发病2 h内的STEMI患者60例,于患者发病后2、4、6、8、10、12 h采血,检测H-FABP水平,找出其峰值.记录患者的基线资料,计算GRACE风险评分,对GRACE评分和H-FABP的峰值水平进行Pearson直线相关分析.结果 H-FABP的达峰时间为4~8 h,平均峰值为(59.4±23.1)μg/L;STEMI患者H-FABP峰值水平与GRACE危险评分呈正相关(r=0.701,P<0.05).结论 STEMI的H-FABP峰值水平与GRACE评分相关,检测H-FABP峰值水平可以为STEMI患者的危险分层提供参考.

  8. Influences of percutaneous coronary intervention on myocardial activity in myocardial infarction patients with different viable myocardium

    李丽琪

    2013-01-01

    Objective To evaluate the effect of percutaneous coronary intervention (PCI) on left ventricular function in patients with different types of myocardial infarction and to explore the correlation factors for the left ventricular function.Methods A total of 43 patients diagnosed as acute myocardial infarction were enrolled in this study.The perfusion and delayed enhancement magnetic resonance imaging (DE-MRI) was applied to observe the fol-

  9. Relation of impaired Thrombolysis In Myocardial Infarction myocardial perfusion grades to residual thrombus following the restoration of epicardial patency in ST-elevation myocardial infarction.

    Kirtane, Ajay J; Weisbord, Aaron; Karmpaliotis, Dimitrios; Murphy, Sabina A; Giugliano, Robert P; Cannon, Christopher P; Antman, Elliott M; Ohman, E Magnus; Roe, Matthew T; Braunwald, Eugene; Gibson, C Michael

    2005-01-15

    Clinical and angiographic data were analyzed from 929 patients who had ST-elevation myocardial infarction and open epicardial arteries after fibrinolytic therapy. Residual angiographically evident thrombus was associated with more frequent Thrombolysis In Myocardial Infarction (TIMI) grade 2 flow (33.6% vs 26.8%, p = 0.03), higher corrected TIMI frame counts (34 vs 31 frames, p = 0.0003), and lower TIMI myocardial perfusion grades (43.0% vs 32.0% TIMI myocardial perfusion grades 0/1, p = 0.001) among all patients and among patients who had TIMI grade 3 flow (33.5% vs 26.0% TIMI myocardial perfusion grades 0/1, p = 0.043). In multivariate analyses, angiographically evident thrombus was associated with higher corrected TIMI frame counts and worsened myocardial perfusion independent of clinical and angiographic covariates, including TIMI grade 3 flow.

  10. 78 FR 41074 - 60-Day Notice of Proposed Information Collection: Innovation in Affordable Housing Design Student...

    2013-07-09

    ... quality affordable housing design that strengthens the social and physical fabric of low- and moderate... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT 60-Day Notice of Proposed Information Collection: Innovation in Affordable...

  11. Confined Metastable 2-Line Ferrihydrite for Affordable Point-of-Use Arsenic-Free Drinking Water.

    Kumar, Avula Anil; Som, Anirban; Longo, Paolo; Sudhakar, Chennu; Bhuin, Radha Gobinda; Gupta, Soujit Sen; Anshup; Sankar, Mohan Udhaya; Chaudhary, Amrita; Kumar, Ramesh; Pradeep, Thalappil

    2017-02-01

    Arsenic-free drinking water, independent of electrical power and piped water supply, is possible only through advanced and affordable materials with large uptake capacities. Confined metastable 2-line ferrihydrite, stable at ambient temperature, shows continuous arsenic uptake in the presence of other complex species in natural drinking water and an affordable water-purification device is made using the same.

  12. Affordance as a Key Aspect in the Creation of New learning Spaces

    Dau, Susanne

    2014-01-01

    This research aims to highlight how different places and spaces in undergraduate teacher education afford student learning and the development of certain types of knowledge related. The questions this article addresses are: a) What is the affordance of different learning spaces in an undergraduate...

  13. Towards a Representational Model of Social Affordances from an Institutional Perspective

    Sileno, G.; Boer, A.; van Engers, T.

    2014-01-01

    The paper investigates the connection of the concept of affordance with the concept of institution, fundamental in social sciences and in legal theory, with the purpose of delineating a working definition of social affordance. This hybrid concept enriches the representation tools to be used with age

  14. 77 FR 29235 - Patient Protection and Affordable Care Act; Standards Related to Reinsurance, Risk Corridors, and...

    2012-05-17

    ... HUMAN SERVICES 45 CFR Part 153 RIN 0938-AR07 Patient Protection and Affordable Care Act; Standards... ] entitled, ``Patient Protection and Affordable Care Act; Standards Related to Reinsurance, Risk Corridors... section 553(b) of the Administrative Procedure Act (APA) (5 U.S.C. 553(b)). However, we can waive...

  15. Understanding social engagement in autism: being different in perceiving and sharing affordances

    Hellendoorn, Annika

    2014-01-01

    In the current paper I will argue that the notion of affordances offers an alternative to theory of mind (ToM) approaches in studying social engagement in general and in explaining social engagement in autism spectrum disorder (ASD) specifically. Affordances are the possibilities for action offered

  16. Ecological Affordance and Anxiety in an Oral Asynchronous Computer-Mediated Environment

    McNeil, Levi

    2014-01-01

    Previous research suggests that the affordances (van Lier, 2000) of asynchronous computer-mediated communication (ACMC) environments help reduce foreign language anxiety (FLA). However, FLA is rarely the focus of these studies and research has not adequately addressed the relationship between FLA and the affordances that students use. This study…

  17. 78 FR 20581 - Patient Protection and Affordable Care Act; Exchange Functions: Standards for Navigators and Non...

    2013-04-05

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES 45 CFR Part 155 RIN 0938-AR75 Patient Protection and Affordable Care Act; Exchange.... Introduction The Patient Protection and Affordable Care Act (Pub. L. 111-148) was enacted on March 23,...

  18. The Role of Affordances in the Evolutionary Process Reconsidered A Niche Construction Perspective

    Withagen, Rob; van Wermeskerken, Margot

    2010-01-01

    Gibson asserted that affordances are the primary objects of perception. Although this assertion is especially attractive when considered in the context of evolutionary theory, the role that affordances play in the evolution of animals' perceptual and action systems is still unclear. Trying to combin

  19. 78 FR 13575 - Coverage of Certain Preventive Services Under the Affordable Care Act; Correction

    2013-02-28

    ... Affordable Care Act; Correction AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Correction to... Health Service Act, as added by the Patient Protection and Affordable Care Act, as amended, and incorporated into the Employee Retirement Income Security Act of 1974 and the Internal Revenue Code....

  20. 76 FR 52663 - Notice of Intent To Award Affordable Care Act Funding, DP-09-001

    2011-08-23

    ... 4002 of the Patient Protection and Affordable Care Act (Pub. L. 111-148.). DATES: The effective date..., 2010, the President signed into law the Patient Protection and Affordable Care Act (ACA). ACA is... Care Act Funding, DP-09-001 AGENCY: Centers for Disease Control and Prevention (CDC), Department...

  1. 29 CFR 1977.12 - Exercise of any right afforded by the Act.

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false Exercise of any right afforded by the Act. 1977.12 Section..., DEPARTMENT OF LABOR (CONTINUED) DISCRIMINATION AGAINST EMPLOYEES EXERCISING RIGHTS UNDER THE WILLIAMS-STEIGER OCCUPATIONAL SAFETY AND HEALTH ACT OF 1970 Specific Protections § 1977.12 Exercise of any right afforded by...

  2. 24 CFR 982.632 - Homeownership option: Financing purchase of home; affordability of purchase.

    2010-04-01

    ... purchase of home; affordability of purchase. 982.632 Section 982.632 Housing and Urban Development...: Financing purchase of home; affordability of purchase. (a) The PHA may establish requirements for financing purchase of a home to be assisted under the homeownership option. Such PHA requirements may...

  3. Affordability of Private Schools: Exploration of a Conundrum and towards a Definition of "Low-Cost"

    Tooley, James; Longfield, David

    2016-01-01

    The affordability of private education is a contentious issue. While the extent of "low-cost" private schooling is widely accepted, there is no agreement on what "low-cost" means in this context and how this relates to affordability for poor families. This paper addresses the lacuna in the literature by defining…

  4. Educational Affordances of a Ubiquitous Learning Environment in a Natural Science Course

    Tan, Tan-Hsu; Lin, Min-Sheng; Chu, Yu-Ling; Liu, Tsung-Yu

    2012-01-01

    Educational affordances are worthy of being explored because the affordances of Information and Communication Technologies (ICT) provide the pedagogical effects for promoting cognitive acceleration, increasing the self-management of students, facilitating data collection, and presentation in science learning. This study aims to explore educational…

  5. Affordances shape pass kick behavior in association football : effects of distance and social context

    Pepping, Gert-Jan; Heijmerikx, Johan; de Poel, Harjo J.

    2011-01-01

    A prerequisite for accurate passing in association football is that a player perceives the affordances, that is, the opportunities for action, of a given situation. The present study examined how affordances shape passing in association football by comparing the performance of pass-kicks in two task

  6. In search of an adequate yet affordable tutor in online learning networks

    Sloep, Peter; Van Rosmalen, Peter; Kester, Liesbeth; Brouns, Francis; Koper, Rob

    2006-01-01

    Sloep, P., van Rosmalen, P., Kester, L., Brouns, F. M. R., & Koper, E. J. R. (2006). In search of an adequate yet affordable tutor in online learning networks. In search of an adequate yet affordable tutor in online learning networks. Presentation at the 6th IEEE International Conference on Advanced

  7. Using task dynamics to quantify the affordances of throwing for long distance and accuracy.

    Wilson, Andrew D; Weightman, Andrew; Bingham, Geoffrey P; Zhu, Qin

    2016-07-01

    In 2 experiments, the current study explored how affordances structure throwing for long distance and accuracy. In Experiment 1, 10 expert throwers (from baseball, softball, and cricket) threw regulation tennis balls to hit a vertically oriented 4 ft × 4 ft target placed at each of 9 locations (3 distances × 3 heights). We measured their release parameters (angle, speed, and height) and showed that they scaled their throws in response to changes in the target's location. We then simulated the projectile motion of the ball and identified a continuous subspace of release parameters that produce hits to each target location. Each subspace describes the affordance of our target to be hit by a tennis ball moving in a projectile motion to the relevant location. The simulated affordance spaces showed how the release parameter combinations required for hits changed with changes in the target location. The experts tracked these changes in their performance and were successful in hitting the targets. We next tested unusual (horizontal) targets that generated correspondingly different affordance subspaces to determine whether the experts would track the affordance to generate successful hits. Do the experts perceive the affordance? They do. In Experiment 2, 5 cricketers threw to hit either vertically or horizontally oriented targets and successfully hit both, exhibiting release parameters located within the requisite affordance subspaces. We advocate a task dynamical approach to the study of affordances as properties of objects and events in the context of tasks as the future of research in this area. (PsycINFO Database Record

  8. 77 FR 36272 - SunShot Prize: America's Most Affordable Rooftop

    2012-06-18

    ... Prize: America's Most Affordable Rooftop AGENCY: Office of Energy Efficiency and Renewable Energy...) announces in this notice the release of the SunShot Prize: America's Most Affordable Rooftop Solar for public comment. Interested persons are encouraged to learn about the SunShot Prize: America's...

  9. Affordance of Braille Music as a Mediational Means: Significance and Limitations

    Park, Hyu-Yong; Kim, Mi-Jung

    2014-01-01

    Affordance refers to the properties or designs of a thing that offer the function of the thing. This paper discusses the affordance of Braille music in terms of three notions: mediational means, mastery and appropriation, and focuses on answering the following three questions: (i) How do musicians with visual impairments (MVI) perceive Braille…

  10. PET and MRI for the evaluation of regional myocardial perfusion and wall thickening after myocardial infarction

    Slart, Riemer H.J.A.; Golestani, Reza; Glaudemans, Andor W.J.M. [University Medical Center Groningen, University of Groningen, Department of Nuclear Medicine and Molecular Imaging, Hanzeplein 1, P.O. Box 30001, Groningen (Netherlands); Glauche, Julius; Jansen, Jan W. [University Medical Center Groningen, University of Groningen, Department of Nuclear Medicine and Molecular Imaging, Hanzeplein 1, P.O. Box 30001, Groningen (Netherlands); University Medical Center Groningen, University of Groningen, Department of Cardiology, Groningen (Netherlands); Zeebregts, Clark J. [University Medical Center Groningen, University of Groningen, Department of Surgery, Division of Vascular Surgery, Groningen (Netherlands); Dierckx, Rudi A.J.O. [University Medical Center Groningen, University of Groningen, Department of Nuclear Medicine and Molecular Imaging, Hanzeplein 1, P.O. Box 30001, Groningen (Netherlands); Ghent University Hospital, Department of Nuclear Medicine, Ghent (Belgium); Oudkerk, Matthijs; Willems, Tineke P. [University Medical Center Groningen, University of Groningen, Department of Radiology, Groningen (Netherlands); Boersma, Hendrikus H. [University Medical Center Groningen, University of Groningen, Department of Nuclear Medicine and Molecular Imaging, Hanzeplein 1, P.O. Box 30001, Groningen (Netherlands); University Medical Center Groningen, University of Groningen, Clinical and Hospital Pharmacy, Groningen (Netherlands); Tio, Rene A. [University Medical Center Groningen, University of Groningen, Department of Cardiology, Groningen (Netherlands)

    2012-06-15

    Deterioration of left ventricular (LV) function after myocardial infarction (MI) is a major cause of heart failure. Myocardial perfusion performance may play an important role in deterioration or improvement in LV function after MI. The aim of this study was to evaluate the myocardial perfusion reserve (MPR) and stress perfusion in deteriorating and non-deteriorating LV segments in patients after MI by PET and MRI, respectively. Regional wall thickening of 352 segments in 22 patients was assessed at 4 and 24 months after MI by cardiac MRI. PET was performed to evaluate MPR and adenosine stress {sup 13}N-ammonia perfusion 24 months after MI. Segments were divided into four groups according to deterioration or improvement in wall thickening. Normal functional segments at 4 months after MI that remained stable had a significantly higher mean MPR and mean stress perfusion PET value than deteriorated segments (p < 0.001). Furthermore, dysfunctional segments that improved had a significantly higher mean stress perfusion PET value than dysfunctional segments that remained dysfunctional (p < 0.001). This study demonstrated the additional value of myocardial perfusion assessment in relation to the functional integrity of the injured myocardium. Segmental functional LV improvement after MI was associated with better regional myocardial perfusion characteristics. Furthermore, the amount of wall thickening reduction was associated with regional myocardial perfusion abnormalities in patients after MI. (orig.)

  11. Early assessment and treatment of myocardial infarction

    Hoog, V.C. de

    2015-01-01

    Although the detection and treatment of acute myocardial infarction (MI) has dramatically improved the last decades, ischemic heart disease is still a leading cause of death worldwide. Whereas mortality has declined in industrialized countries, it continues to rise in other parts of the world. There

  12. Oral Antithrombotic Use Among Myocardial Infarction Patients

    van der Elst, Menno E; Cisneros-Gonzalez, Nelly; de Blaey, Cornelis J; Buurma, Henk; de Boer, Anthonius

    2003-01-01

    OBJECTIVE: To examine the use of oral antithrombotics (i.e., antiplatelet agents, oral anticoagulants) after myocardial infarction (MI) in the Netherlands from 1988 to 1998. METHODS: Retrospective follow-up of 3800 patients with MI, using data from the PHARMO Record Linkage System. RESULTS: From 198

  13. Cellular and genetic approaches to myocardial regeneration

    Tuyn, John van

    2008-01-01

    Injection of (stem) cells into the damaged heart has a positive effect on cardiac function. In this thesis two strategies for improving myocardial regeneration over classical cell therapy were investigated. The first is to induce cardiomyogenic differentiation by genetically engineering cells to ex

  14. [Management of myocardial damage in muscular dystrophy].

    Tamura, Takuhisa

    2011-11-01

    Heart failure (HF) is a fatal complication in many muscular dystrophy cases and has become the most common cause of death in Duchenne muscular dystrophy (DMD) since 2001. HF deaths in DMD occur in young patients and increase, along with respiratory failure, in older patients. Managing HF, therefore, is the most important component of DMD treatment. Management of HF is necessary in DMD patients of all ages because myocardial damage progresses regardless of age and disability. Electrocardiography, echocardiography, myocardial single-photon emission computed tomography (SPECT), and natriuretic peptides are used for the diagnosis of myocardial damage and chronic HF. Tissue Doppler echocardiography is in particularly useful for early detection of minute myocardial damage and dysfunction in DMD. The first-line drugs for chronic HF are angiotensin-converting enzyme inhibitors, and the prognosis of DMD patients has been improved using these drugs and beta-blockers. Diuretics are added in the presence of pulmonary congestion. Digoxin is most effective at a blood level of 0.5-0.8 ng/mL because of its pharmacokinetics in DMD. Surgical treatment may be necessary in cases of intractable HF. Cardiac resynchronization therapy (biventricular pacing), a treatment with an artificial pacemaker, is indicated for cases that meet specific criteria, including HF with ventricular dyssynchrony. Applications of partial left ventriculectomy (Batista procedure) and left ventricular assist devices in muscular dystrophy are likely in the near future.

  15. Aeromedical transport after acute myocardial infarction

    Seidelin, Jakob B; Bruun, Niels Eske; Nielsen, Henrik

    2009-01-01

    BACKGROUND: No guidelines exist for the planning of aeromedical repatriation after acute myocardial infarction (AMI). In 2004, we employed a risk evaluation-based decision-making system for repatriation of patients after AMI. The objective was to evaluate the safety of transports during 2005...

  16. Nonrigid registration of myocardial perfusion MRI

    Ólafsdóttir, Hildur

    2005-01-01

    This paper describes a fully automatic registration of 10 multi-slice myocardial perfusion magnetic resonance image sequences. The registration of these sequences is crucial for the clinical interpretation, which currently is subjected to manual labour. The approach used in this study is a nonrig...

  17. TOWARD THE QUESTION OF ISCHEMIC MYOCARDIAL DYSFUNCTION

    V. V. Kalyuzhin

    2014-01-01

    Full Text Available The authors of the review have analyzed papers published on the problem of ischemic myocardial dysfunction. They begin with a definition of the term “ischemia” (derived from two Greek words: ischō, meaning to hold back, and haima, meaning blood - a condition at which the arterial blood flow is insufficient to provide enough oxygen to prevent intracellular respiration from shifting from the aerobic to the anaerobic form. The poor rate of ATP generation from this process causes a decrease in cellular ATP, a concomitant rise in ADP, and ultimately, to depression inotropic (systolic and lusitropic (diastolic function of the affected segments of the myocardium. But with such simplicity of basic concepts, the consequences of ischemia so diverse. Influence of an ischemia on myocardial function so unequally at different patients, which is almost impossible to find two identical cases (as in the case of fingerprints. It depends on the infinite variety of lesions of coronary arteries, reperfusion (time and completeness of restoration of blood flow and reactions of a myocardium which, apparently, has considerable flexibility in its response. Ischemic myocardial dysfunction includes a number of discrete states, such as acute left ventricular failure in angina, acute myocardial infarction, ischemic cardiomyopathy, stunning, hibernation, pre- and postconditioning. There are widely differing underlying pathophysiologic states. The possibility exists that several of these states can coexist.

  18. Surgical myocardial revascularization without extracorporeal circulation

    Salomón Soriano Ordinola Rojas

    2003-05-01

    Full Text Available OBJECTIVE: To assess the immediate postoperative period of patients undergoing myocardial revascularization without extracorporeal circulation with different types of grafts. METHODS: One hundred and twelve patients, 89 (79.5% of whom were males, were revascularized without extracorporeal circulation. Their ages ranged from 39 to 85 years. The criteria for indicating myocardial revascularization without extracorporeal circulation were as follows: revascularized coronary artery caliber > 1.5 mm, lack of intramyocardial trajectory on coronary angiography, noncalcified coronary arteries, and tolerance of the heart to the different rotation maneuvers. RESULTS: Myocardial revascularization without extracorporeal circulation was performed in 112 patients. Three were converted to extracorporeal circulation, which required a longer hospital stay but did not impact mortality. During the procedure, the following events were observed: atrial fibrillation in 10 patients, ventricular fibrillation in 4, total transient atrioventricular block in 2, ventricular extrasystoles in 58, use of a device to retrieve red blood cells in 53, blood transfusion in 8, and arterial hypotension in 89 patients. Coronary angiography was performed in 20 patients on the seventh postoperative day when the grafts were patent. CONCLUSION: Myocardial revascularization without extracorporeal circulation is a reproducible technique that is an alternative for treating ischemic heart disease.

  19. Myocardial ATP catabolism and its pharmacological prevention

    T. Huizer (Tom)

    1991-01-01

    textabstractThis thesis deals with high-energy phosphate metabolism during myocardial ischemia. describes the effects of some pharmacological interventions on the energy metabolism of ischemic myocardium. The chapters of this thesis are based on 11 published papers, added as appendices.

  20. Mesenchymal Stem Cells : Promising for Myocardial Regeneration?

    Przybyt, Ewa; Harmsen, Martin C.

    2013-01-01

    The pandemic of cardiovascular disease is continuously expanding as the result of changing life styles and diets throughout the Old and New World. Immediate intervention therapy saves the lives of many patients after acute myocardial infarction (MI). However, for many this comes at the price of adve

  1. An Analysis of Professional Perceptions of Criteria Contributing to Sustainable Housing Affordability

    Emma Mulliner

    2014-12-01

    Full Text Available Housing affordability is a multi-dimensional issue, yet it is typically defined and assessed quite narrowly in terms of financial criteria. The housing affordability problem encompasses more than financial costs of housing and extends to larger issues of social wellbeing and sustainability. Accordingly, a broader range of factors ought to be considered when defining and assessing affordability, particularly if more sustainable outcomes are desired from housing. A comprehensive system of criteria representing sustainable housing affordability, developed by the authors, is validated and analysed in this paper. The quantitative data analysis of surveys conducted with housing and planning professionals across the UK is used to determine stakeholder’s perceptions on the criteria contributing to sustainable housing affordability and to rank these criteria according to their importance. The paper establishes that professional opinions on this issue differ insignificantly across different regions of the UK, while it varies to some extent depending on the sector of housing industry.

  2. Affordances of ICT in science learning: implications for an integrated pedagogy

    Webb, Mary E.

    2005-06-01

    This paper presents an analysis of how affordances of ICT-rich environments identified from a recent review of the research literature can support students in learning science in schools within a proposed framework for pedagogical practice in science education. Furthermore other pedagogical and curriculum innovations in science education (promoting cognitive change, formative assessment and lifelong learning) are examined to see how they may be supported and enhanced by affordances of ICT-rich environments. The affordances that I have identified support learning through four main effects: promoting cognitive acceleration; enabling a wider range of experience so that students can relate science to their own and other real-world experiences; increasing students' self-management; and facilitating data collection and presentation. ICT-rich environments already provide a range of affordances that have been shown to enable learning of science but integrating these affordances with other pedagogical innovations provides even greater potential for enhancement of students' learning.

  3. Navigating the Affordance Landscape: Feedback Control as a Process Model of Behavior and Cognition.

    Pezzulo, Giovanni; Cisek, Paul

    2016-06-01

    We discuss how cybernetic principles of feedback control, used to explain sensorimotor behavior, can be extended to provide a foundation for understanding cognition. In particular, we describe behavior as parallel processes of competition and selection among potential action opportunities ('affordances') expressed at multiple levels of abstraction. Adaptive selection among currently available affordances is biased not only by predictions of their immediate outcomes and payoffs but also by predictions of what new affordances they will make available. This allows animals to purposively create new affordances that they can later exploit to achieve high-level goals, resulting in intentional action that links across multiple levels of control. Finally, we discuss how such a 'hierarchical affordance competition' process can be mapped to brain structure.

  4. Encapsulating the delivery of affordable housing: An overview of Malaysian practice

    Jamaluddin Nor Baizura

    2016-01-01

    Full Text Available Urban population increases much faster than other geographical areas and this brings huge challenges to Malaysian government especially those responsible for the provision of housing. Moreover, the rise of living cost and pressure towards the current economic situation had inevitably led to huge demands for affordable housing. Thus, affordability and inaccessibility of people in owning a house has become one of the major issues in Malaysia. These issues are not only faced by the low-income group but mostly experienced by urban dwellers including the middle-income group whom are not eligible to apply for low-cost housing delivered by the government, yet cannot afford to buy a house. Hence, the Malaysian government had therefore established the Perumahan Rakyat 1 Malaysia (PR1MA as the catalyst in providing adequate, quality and affordable houses. Furthermore, the Syarikat Perumahan Negara Berhad (SPNB and the state governments also play their big role in providing affordable house at the state level. In trying to ensure smooth delivery of affordable housing, a systematic approach is required. This paper intends to examine the delivery of affordable housing in Malaysia. The objective was to assess the parties involved, and the various stages of the process. The methodology adopted for this study includes in-depth interviews with affordable housing agencies. Investigation showed that the major problem relates to a mismatch in the delivery of affordable housing. Moreover, the political and economic aspects, as well as the organization situation had also influenced the inefficiency of affordable housing delivery system. Additionally, the significant of this paper is expected to formulate an improved strategy and guidance in delivery system, thus ensuring that the method of practice is applicable throughout the country.

  5. Understanding the adoption dynamics of medical innovations: affordances of the da Vinci robot in the Netherlands.

    Abrishami, Payam; Boer, Albert; Horstman, Klasien

    2014-09-01

    This study explored the rather rapid adoption of a new surgical device - the da Vinci robot - in the Netherlands despite the high costs and its controversial clinical benefits. We used the concept 'affordances' as a conceptual-analytic tool to refer to the perceived promises, symbolic meanings, and utility values of an innovation constructed in the wider social context of use. This concept helps us empirically understand robot adoption. Data from 28 in-depth interviews with diverse purposively-sampled stakeholders, and from medical literature, policy documents, Health Technology Assessment reports, congress websites and patients' weblogs/forums between April 2009 and February 2014 were systematically analysed from the perspective of affordances. We distinguished five interrelated affordances of the robot that accounted for shaping and fulfilling its rapid adoption: 'characteristics-related' affordances such as smart nomenclature and novelty, symbolising high-tech clinical excellence; 'research-related' affordances offering medical-technical scientific excellence; 'entrepreneurship-related' affordances for performing better-than-the-competition; 'policy-related' affordances indicating the robot's liberalised provision and its reduced financial risks; and 'communication-related' affordances of the robot in shaping patients' choices and the public's expectations by resonating promising discourses while pushing uncertainties into the background. These affordances make the take-up and use of the da Vinci robot sound perfectly rational and inevitable. This Dutch case study demonstrates the fruitfulness of the affordances approach to empirically capturing the contextual dynamics of technology adoption in health care: exploring in-depth actors' interaction with the technology while considering the interpretative spaces created in situations of use. This approach can best elicit real-life value of innovations, values as defined through the eyes of (potential) users.

  6. Abnormal Glucose Tolerance Is Associated with a Reduced Myocardial Metabolic Flexibility in Patients with Dilated Cardiomyopathy

    Domenico Tricò

    2016-01-01

    Full Text Available Dilated cardiomyopathy (DCM is characterized by a metabolic shift from fat to carbohydrates and failure to increase myocardial glucose uptake in response to workload increments. We verified whether this pattern is influenced by an abnormal glucose tolerance (AGT. In 10 patients with DCM, 5 with normal glucose tolerance (DCM-NGT and 5 with AGT (DCM-AGT, and 5 non-DCM subjects with AGT (N-AGT, we measured coronary blood flow and arteriovenous differences of oxygen and metabolites during Rest, Pacing (at 130 b/min, and Recovery. Myocardial lactate exchange and oleate oxidation were also measured. At Rest, DCM patients showed a reduced nonesterified fatty acids (NEFA myocardial uptake, while glucose utilization increased only in DCM-AGT. In response to Pacing, glucose uptake promptly rose in N-AGT (from 72 ± 21 to 234 ± 73 nmol/min/g, p<0.05, did not change in DCM-AGT, and slowly increased in DCM-NGT. DCM-AGT sustained the extra workload by increasing NEFA oxidation (from 1.3 ± 0.2 to 2.9 ± 0.1 μmol/min/gO2 equivalents, p<0.05, while DCM-NGT showed a delayed increase in glucose uptake. Substrate oxidation rates paralleled the metabolites data. The presence of AGT in patients with DCM exacerbates both the shift from fat to carbohydrates in resting myocardial metabolism and the reduced myocardial metabolic flexibility in response to an increased workload. This trial is registered with ClinicalTrial.gov NCT02440217.

  7. Investigation of (/sup 18/F)2-fluoro-2-deoxyglucose for the measure of myocardial glucose metabolism

    Phelps, M.E.; Hoffman, E.J.; Selin, C.; Huang, S.C.; Robinson, G.; MacDonald, N.; Schelbert, H.; Kuhl, D.E.

    1978-12-01

    Fluorine-18-labeled 2-deoxyglucose (FDG) was studied as a glucose analog for the measure of myocardial glucose metabolism. Myocardial uptake and retention, blood clearance, species dependence (dog, monkey, man), and effect of diet on uptake were investigated. Normal myocardial uptake of FDG was 3 to 4% of injected dose in dog and monkey, and 1 to 4% in man, compared with brain uptakes of 1.5 to 3% in dog, 5 to 6% in monkey, and 4 to 8% in man. The myocardial metabolic rate (MR) for glucose in the nonfasting (glycolytic) state was 2.8 times that in the fasting (ketogenic) state. Human subjects showed higher myocardial uptake after a normal meal than after a meal containing mostly free fatty acids (FFA). Blood clearance was rapid with initial clearance t/sub 1/2/ of 0.2 to 0.3 min, followed by a t/sub 1/2/ of 8.4 +- 1.2 min in dog and 11.6 +- 1.1 min in man. A small third component had half-times of 59 +- 10 min and 88 +- 4 min in dog and man, respectively. With the ECAT positron tomograph, high image-contrast ratios were found between heart and blood (dog 3.5/1, man 14/1), heart and lung (dog 9/1, man 20/1), and heart and liver (dog 15/1, man 10/1). The FDG was taken up rapidly by the myocardium without any significant tissue clearance over a 4-hr period. The FDG exhibited excellent imaging properties. Average counting rates of 12K, 20K, and 40K c/min-mCi injected are obtained in human subjects with high, medium, and low resolutions of the ECAT tomograph. Determination of glucose and FFA MR in vivo with EACT provides a method for investigation and assessment of changing aerobic and anaerobic metabolic rates in ischemic heart disease in man.

  8. 游泳训练联合补充α-硫辛酸对WistarⅡ型糖尿病大鼠心肌线粒体的保护作用%Protective Effects of Swimming Exercise and Joint Supplement α-Lipoic Acid on Myocardial Mitochondria in Wistar Ⅱ Diabetic Rats

    江红轲

    2012-01-01

    将60只wistar大鼠糖尿病造模完成后随机分成4组,即对照组(CON)、α-硫辛酸(LA)组、游泳训练组(SEX)和α-硫辛酸+游泳训练组(SEX+ LA)进行训练,训练结束后,检测大鼠心肌线粒体呼吸功能、氧化磷酸化蛋白表达及氧化应激相关指标,以便对游泳训练及联合补充α-硫辛酸对Ⅱ型糖尿病大鼠心肌线粒体的保护作用的内在影响机制进行探索.结果显示:α-硫辛酸和游泳运动均可以显著性改善糖尿病引起的3态呼吸水平、呼吸控制率及磷氧比值降低(P <0.05);联合作用在提高3态呼吸及降低4态呼吸方面存在增强作用(P<0.05).在对氧化磷酸化蛋白表达的影响方面,α-硫辛酸可有效提高complex Ⅰ、Ⅲ蛋白表达;游泳训练具有和α-硫辛酸相似的作用效果,且能显著性地上调complex Ⅳ表达水平(P<0.05),联合作用在提高complexⅠ、Ⅲ蛋白表达水平上存在加强作用(P <0.05).在降低组织氧化应激水平方面,各种干预方式均可降低ROS含量,提高抗氧化蛋白SOD和GSH-Px水平(P<0.05);联合作用方式在降低ROS,增强SOD水平上有叠加作用(P<0.05).以上结果说明,游泳训练及联合补充α-硫辛酸可能通过对抗氧化酶活性的提高,进一步降低ROS对呼吸链复合物及膜结构的损伤而实现线粒体呼吸功能的增强.%In the current study, after diabetic models, 60 Wistar rats randomly divided into four groups, namely the control group (CON), alpha-lipoic acid (LA) group, swimming training group (SEX) and alpha-lipoic acid + swimming training group (SEX+LA). Rats were detected myocardial mitochondrial respiratory function, oxidative phosphorylation, protein expression and oxidative stress indicators in order to elucidate swim training and joint supplement alpha-lipoic acid of type II diabetic rat heart mitochondriathe protective effect and to explore the internal influence mechanism. The results showed that alpha-lipoic acid

  9. Depressive disorder and gastrointestinal dysfunction after myocardial infarct are associated with abnormal tryptophan-5-hydroxytryptamine metabolism in rats

    Liu, Chunyan; Wang, Yangang

    2017-01-01

    In this study, we investigated the relationship between tryptophan-5-hydroxytryptamine metabolism, depressive disorder, and gastrointestinal dysfunction in rats after myocardial infarction. Our goal was to elucidate the physiopathologic bases of somatic/psychiatric depression symptoms after myocardial infarction. A myocardial infarction model was established by permanent occlusion of the left anterior descending coronary artery. Depression-like behavior was evaluated using the sucrose preference test, open field test, and forced swim test. Gastric retention and intestinal transit were detected using the carbon powder labeling method. Immunohistochemical staining was used to detect indoleamine 2,3-dioxygenase expression in the hippocampus and ileum. High-performance liquid chromatography with fluorescence and ultraviolet detection determined the levels of 5-hydroxytryptamine, its precursor tryptophan, and its metabolite 5-hydroxyindoleacetic acid in the hippocampus, distal ileum, and peripheral blood. All data were analyzed using one-way analyses of variance. Three weeks after arterial occlusion, rats in the model group began to exhibit depression-like symptoms. For example, the rate of sucrose consumption was reduced, the total and central distance traveled in the open field test were reduced, and immobility time was increased, while swimming, struggling and latency to immobility were decreased in the forced swim test. Moreover, the gastric retention rate and gastrointestinal transit rate were increased in the model group. Expression of indoleamine 2,3-dioxygenase was increased in the hippocampus and ileum, whereas 5-hydroxytryptamine metabolism was decreased, resulting in lower 5-hydroxytryptamine and 5-hydroxyindoleacetic acid levels in the hippocampus and higher levels in the ileum. Depressive disorder and gastrointestinal dysfunction after myocardial infarction involve abnormal tryptophan-5-hydroxytryptamine metabolism, which may explain the somatic, cognitive

  10. Microvascular obstruction on delayed enhancement cardiac magnetic resonance imaging after acute myocardial infarction, compared with myocardial {sup 201}Tl and {sup 123}I-BMIPP dual SPECT findings

    Mori, Hiroaki [Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya (Japan); Department of Cardiology, Kainan Hospital, Yatomi (Japan); Isobe, Satoshi, E-mail: sisobe@med.nagoya-u.ac.jp [Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya (Japan); Sakai, Shinichi [Department of Cardiology, Kainan Hospital, Yatomi (Japan); Yamada, Takashi [Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya (Japan); Watanabe, Naoki; Miura, Manabu [Department of Cardiology, Kainan Hospital, Yatomi (Japan); Uchida, Yasuhiro; Kanashiro, Masaaki; Ichimiya, Satoshi [Department of Cardiology, Yokkaichi Municipal Hospital, Yokkaichi (Japan); Okumura, Takahiro; Murohara, Toyoaki [Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya (Japan)

    2015-08-15

    Highlights: • The percentage infarct size (%IS) was significantly greater in the microvascular obstruction (MO) group than in the non-MO group. • The percentage mismatch score (%MMS) on dual scintigraphy significantly correlated with the %IS and the percentage MO. • The %MMS was significantly greater in the non-MO group than in the MO group, and was an independent predictor for MO. - Abstract: Background: The hypo-enhanced regions within the hyper-enhanced infarct areas detected by cardiac magnetic resonance (CMR) imaging reflect microvascular obstruction (MO) after acute myocardial infarction (AMI). The combined myocardial thallium-201 ({sup 201}Tl)/iodine-123-15-(p-iodophenyl)-3-(R,S)-methylpentadecanoic acid ({sup 123}I-BMIPP) dual single-photon emission computed tomography (SPECT) is a useful tool for detecting myocardial reversibility after AMI. We evaluated whether MO could be an early predictor of irreversible myocardial damage in comparison with {sup 201}Tl and {sup 123}I-BMIPP dual SPECT findings in AMI patients. Methods: Sixty-two patients with initial AMI who successfully underwent coronary revascularization were enrolled. MO was defined by CMR imaging. Patients were divided into 2 groups as follows: MO group (n = 32) and non-MO group (n = 30). Scintigraphic defect scores were calculated using a 17-segment model with a 5-point scoring system. The mismatch score (MMS) was calculated as follows: the total sum of (Σ) {sup 123}I-BMIPP defect score minus Σ{sup 201}Tl defect score. The percentage mismatch score (%MMS) was calculated as follows: MMS/(Σ{sup 123}I-BMIPP score) × 100 (%). Results: The percentage infarct size (%IS) was significantly greater in the MO group than in the non-MO group (32.2 ± 13.8% vs. 18.3 ± 12.1%, p < 0.001). The %MMS significantly correlated with the %IS and the percentage MO (r = −0.26, p = 0.03; r = −0.45, p < 0.001, respectively). The %MMS was significantly greater in the non-MO group than in the MO group (45.4

  11. Effects of acidic reperfusion fluid on myocardial endoplasmic reticulum stress and apoptosis after ischemia/reperfusion in rabbits%低pH液复灌对兔缺血再灌注心肌内质网应激与细胞凋亡的影响研究

    杨海燕; 刘新伟; 马亚飞; 王群英; 刘柳

    2011-01-01

    Objective To determine the effect of acidic reperfusion fluid in cardiopulmonary bypass (CPB) on the myocardial endoplasmic reticulum stress (ERS) and apoptosis after ischemia/reperfusion in rabbits. Methods Twenty-four adult New Zealand white rabbits of both sexes weighing 2.5~3.0 kg were randomly divided into 4 groups (6 each). Control group (C); CPB for 3 hours without aortic clamping; pHT. 4 group and pH6. 9 group: hearts were subjected to ischemia for 40min followed by 2 hours of reperfusion, and then perfused with Krebs-Henseleit bicarbonate buffer solution, respectively, at pHT. 4 and pH6o 9 in the first 2min of reperfnsion; ischemic postconditioning group (I-postC) : 40min after aortic clamping, 6 cycles of 10-second reperfusion/10-second occlusion were given in the first 2min of 2-hour reperfusion. Cardiac troponin I (cTnI) concentration was determined with ELISA, apoptosis of myocardial cell was detected by TUNEL, the expressions of glucose-regulated protein 78(GRP78)and calreticulin (CRT) mRNA were detected by RT-PCR,and the expressions of caspase-12 and C/EBP homologous protein (CHOP) were assayed by immunohistochemistry. Results Compared with the C group, the cTnI concentration, apoptotic rate, expressions of GRP78, CRT mRNA, caspase-12 and CHOP of the other groups increased significantly (P<0. 05). Compared with the pHT. 4 group, all the indexes were significantly lower in pH6. 9 group and I-postC group (P<0. 05), but no significant difference was found between the latter two groups (P>0. 05). Conclusion Acidic reperfusion may protect the heart against I/R injury, regulate ERS response, inhibit excessive ERS, and alleviate ERS-mediated apoptosis during I/R.%目的 探讨体外循环(CPB)下再灌注初短暂低pH液复灌对兔缺血再灌注(I/R)心肌内质网应激(ERS)与细胞凋亡的影响.方法 健康成年新西兰大白兔24只,雌雄不拘,体重2.5~3.0kg,随机分为4组(n=6).对照组(C组)不阻断主动脉,单纯转机3h;

  12. Efficient Debromination of Vicinal (, (-Dibromo Carboxylic Acid Derivatives with the Sm/HOAc System

    2002-01-01

    The α, β vicinal dibromo carboxylic acid and its derivatives were debrominated with Sm/HOAc system to afford the corresponding cinnamic acid and its derivatives in good yields under mild conditions.

  13. Evaluation of myocardial abnormalities in patients with collagen diseases by thallium-201 myocardial scintigram

    Yamano, Shigeru (Nara Medical Univ., Kashihara (Japan))

    1992-08-01

    This study was performed to evaluate myocardial lesions in patients with collagen diseases by rest and exercise thallium-201 myocardial scintigraphies. A total of 76 patients without ischemic ECG changes, consisting of 27 cases of systemic lupus erythematosus (SLE), 17 cases of polymyositis or dermatomyositis (PM[center dot]DM), 11 cases of progressive systemic sclerosis (PSS), and 21 cases of Sjoegren's syndrome (SjS), were enrolled in this study. Reversible exercise-induced defects suggesting myocardial ischemia were noted in 12 cases of SLE, 5 cases of PM[center dot]DM, 3 cases of PSS, and 3 cases of SjS. Of the 23 patients who had exercise-induced defects, 9 patients showed normal coronary angiograms by cardiac catheterization. Fixed hypoperfusion areas were observed in 5 cases of SLE, 6 cases of PM[center dot]DM, 4 cases of PSS and 3 cases of SjS. Rest thallium-201 myocardial scintigraphy disclosed hypoperfusion areas, which were not induced by exercise, in 1 case of SLE, 4 cases of PM[center dot]DM, 1 case of PSS and 5 cases of SjS. Endomyocardial biopsy was performed on 20 patients. Myocardial lesions in PM[center dot]DM and PSS were more severe and wide spread than in SLE. Ejection fraction and fractional shortening evaluated by echocardiography had no significant differences between each disease group and the healthy control group. These findings suggest that patients with collagen diseases show the presence of abnormalities of coronary circulation at the level of the intramyocardial vasculature in the stage before impairment of cardiac function, myocardial fibrosis and functional abnormalities of the cell membrane level that were not dependent on myocardial ischemia. (author).

  14. Incremental predictive value of myocardial scintigraphy with {sup 123}I-BMIPP in patients with acute myocardial infarction treated with primary percutaneous coronary intervention

    Nanasato, Mamoru; Hirayama, Haruo [Nagoya Daini Red Cross Hospital, Cardiovascular Center, Nagoya (Japan); Ando, Akitada; Isobe, Satoshi; Nonokawa, Makoto; Murohara, Toyoaki [Nagoya University Graduate School of Medicine, Department of Cardiology, Nagoya (Japan); Kinoshita, Yoshimi; Nanbu, Ichiro [Nagoya Daini Red Cross Hospital, Department of Radiology, Nagoya (Japan); Yokota, Mitsuhiro [Nagoya University Graduate School of Medicine, Cardiovascular Division, Department of Clinical Pathophysiology, Nagoya (Japan)

    2004-11-01

    It is unclear whether {sup 123}I-labelled {beta}-methyl iodophenyl pentadecanoic acid ({sup 123}I-BMIPP) myocardial scintigraphy adds further predictive value for future cardiac events compared with the variables obtained during cardiac catheterisation in patients with acute myocardial infarction (AMI) treated with primary percutaneous coronary intervention (PCI). We therefore investigated whether {sup 123}I-BMIPP imaging in patients with AMI treated by primary PCI was useful in predicting future cardiac events. One hundred and fifty-nine patients with AMI who were treated with primary PCI and underwent left ventriculography (LVG) on admission underwent {sup 201}Tl and {sup 123}I-BMIPP myocardial scintigraphy. Scintigrams were visually classified, and the total defect score (TDS) was calculated. Major adverse cardiac events (MACE) were defined as cardiac death including sudden death, congestive heart failure and recurrence of acute coronary syndrome. Patients were followed up for a mean of 34.5 months (12-63 months). Twenty-six patients had MACE. Kaplan-Meier analysis indicated that patients with the top 50% of {sup 123}I-BMIPP TDSs had a significantly higher rate of MACE (P=0.007). Patients with mismatch between {sup 201}Tl and {sup 123}I-BMIPP images also had significantly more MACE (P=0.02). In the prediction of MACE, the global chi-square value was 5.2 (P=0.001) based on LVEF (<45%) and the number of diseased vessels (two or three). Adding {sup 123}I-BMIPP TDS and the mismatch improved the global chi-square value ({chi}{sup 2}=7.2) Myocardial scintigraphy using {sup 201}Tl and {sup 123}I-BMIPP predicts future cardiac events in patients with AMI treated with primary PCI, and provides additional predictive value compared with the variables obtained with cardiac catheterisation alone. (orig.)

  15. Americans' Experiences with ACA Marketplace Coverage: Affordability and Provider Network Satisfaction: Findings from the Commonwealth Fund Affordable Care Act Tracking Survey, February--April 2016.

    Gunja, Munira Z; Collins, Sara R; Doty, Michelle M; Beutel, Sophie

    2016-07-01

    For people with low and moderate incomes, the Affordable Care Act's tax credits have made premium costs roughly comparable to those paid by people with job-based health insurance. For those with higher incomes, the tax credits phase out, meaning that adults in marketplace plans on average have higher premium costs than those in employer plans. The law's cost-sharing reductions are reducing deductibles. Lower-income adults in marketplace plans were less likely than higher-income adults to report having deductibles of $1,000 or more. Majorities of new marketplace enrollees and those who have changed plans since they initially obtained marketplace coverage are satisfied with the doctors participating in their plans. Overall, the majority of marketplace enrollees expressed confidence in their ability to afford care if they were to become seriously ill. This issue brief explores these and other findings from the Commonwealth Fund Affordable Care Act Tracking Survey, February--April 2016.

  16. Experience with nalbuphine, a new opioid analgesic, in acute myocardial infarction.

    Greenbaum, R A; Kaye, G; Mason, P D

    1987-07-01

    A total of 141 patients admitted to hospital with a diagnosis of suspected myocardial infarction were randomized to treatment with intravenous diamorphine (71) or nalbuphine (70). Myocardial infarction was subsequently confirmed in 109 patients. Both drugs provided good analgesia. Heart rate, blood pressure, respiratory rate, peak flow and minute volume were measured over a three-hour study period. Except for a slight fall in systolic blood pressure in the nalbuphine-treated group, there were no statistically significant differences between the groups. The nalbuphine-treated group had higher levels of aspartate aminotransferase and hydroxybutyric acid dehydrogenase but not creatine phosphokinase. The haemodynamic outcome and mortality at three months of the two groups were similar. It is concluded that nalbuphine provides effective analgesia coupled with few adverse circulatory or respiratory effects.

  17. Protective Effect of Adansonia digitata against Isoproterenol-Induced Myocardial Injury in Rats.

    Ghoneim, Mona A M; Hassan, Amal I; Mahmoud, Manal G; Asker, Mohsen S

    2016-01-01

    The baobab fruit (Adansonia digitata) was analyzed for proximate composition, amino acids, and minerals. The fruit pulp was found to be a good source of carbohydrates, proteins, phenols, and substantial quantities of K, Ca, and Mg. Amino acid analyses revealed high glutamic and aspartic acid, but the sulfur amino acids were the most limited. The present study was designed to investigate the role of Adansonia digitata (Baobab fruit pulp) against isoproterenol induced myocardial oxidative stress in experimental rats by demonstrating the changes in tissue cardiac markers, some antioxidant enzymes, interleukin-1 β (IL-1 β), monocyte chemoattractant protein-1(MCP-1), myeloperoxidase (MPO), Collagen-1, galectin-3, and serum corticosterone. The activities of enzymatic antioxidant glutathione peroxidase (GPX) and non-enzymatic antioxidant reduced glutathione (GSH) in the heart tissue; additionally, histopathological examination of the heart was estimated. Male albino rats were randomly divided into four groups of ten animals each. Group I served as normal control animal. Group II animals received isoproterenol (ISP) (85 mg/kg body weight intraperitonealy (i.p.) to develop myocardial injury. Group III were myocardial oxidative animals treated with Baobab fruit pulp (200 µg/rats/day) for 4 weeks. Group IV received Baobab fruit pulp only. The data suggested an isoproterenol increase in levels of cardiac marker enzymes [creatine kinase MB (CK- MB), lactate dehydrogenase (LDH), and aspartate aminotransferase (AST)], IL-1ß, MCP-1, MPO, Collagen, and galectin-3, with concomitant decrease in the activities GPX and GSH in heart tissue as well as corticosterone in serum. Baobab fruit pulp brings all the parameters to near normal level in ISP-induced myocardial infarction in rats. Histopathological examination of heart tissue of ISP-administered model rat showed infiltration of inflammatory cells and congestion in the blood vessels. However, treatment with Baobab fruit pulp (200

  18. Optimal myocardial protection with fluosol cardioplegia.

    Magovern, G J; Flaherty, J T; Gott, V L; Bulkley, B H; Gardner, T J

    1982-09-01

    An oxygenated perfluorocarbon cardioplegic solution was examined, utilizing a blood-perfused canine model. Twenty-one animals were divided into three equal groups, and each animal received Fluosol cardioplegia at one of three infusion temperatures: 20 degrees C, or 4 degrees C. All hearts underwent 90 minutes of ischemia, during which time 150 ml of the cardioplegic solution was infused every 30 minutes. Myocardial oxygen and carbon dioxide tensions (PmO2 and PmCO2) were monitored continually using mass spectrometry, and myocardial oxygen consumption was calculated with each cardioplegic injection. The mean increase in PmO2 was 7.1 +/- 0.9 mm Hg with 20 degrees C Fluosol infusions, 31.1 +/- 4.7 mm Hg with 10 degrees C Fluosol injections, and 22.2 +/- 4.7 mm Hg with infusions of 4 degrees C Fluosol. Average myocardial oxygen consumptioN, expressed as cubic centimeters of oxygen per 100 gm of left ventricle (wet weight), was 21.2 +/- 0.5 with 20 degrees C Fluosol, 22.8 +/- 1.3 for 10 degrees C Fluosol, and 19.6 +/- 1.0 for 4 degrees C Fluosol. Mean myocardial temperatures with infusions of 20 degrees C, 10 degrees C, and 4 degrees C solutions were 21.4 +/- 0.1 degree C, 16.9 +/- 0.4 degree C, and 15.9 +/- 0.5 degree C, respectively. After 45 minutes of reperfusion, maximum rate of rise of left ventricular pressure, expressed as percentage of preischemic control, was 70.9 +/- 3.9% for 20 degrees C Fluosol, 90.9 +/- 3.2% for 10 degrees C Fluosol, and 90.4 +/- 2.3% for 4 degrees C Fluosol (p less than 0.005, 20 degrees C versus 10 degrees C, 4 degrees C Fluosol). In addition, the 10 degrees C and 4 degrees C Fluosol hearts had essentially normal structure by light and electron microscopy. These data demonstrate tht Fluosol cardioplegia results in near optimal myocardial protection when infused at cold temperatures (4 degrees C to 10 degree C). The increases intramyocardial oxygen and myocardial oxygen consumption with each injection demonstrate that there is enhanced

  19. Both creatine and its product phosphocreatine reduce oxidative stress and afford neuroprotection in an in vitro Parkinson's model.

    Cunha, Mauricio Peña; Martín-de-Saavedra, Maria D; Romero, Alejandro; Egea, Javier; Ludka, Fabiana K; Tasca, Carla I; Farina, Marcelo; Rodrigues, Ana Lúcia S; López, Manuela G

    2014-01-01

    Creatine is the substrate for creatine kinase in the synthesis of phosphocreatine (PCr). This energetic system is endowed of antioxidant and neuroprotective properties and plays a pivotal role in brain energy homeostasis. The purpose of this study was to investigate the neuroprotective effect of creatine and PCr against 6-hydroxydopamine (6-OHDA)-induced mitochondrial dysfunction and cell death in rat striatal slices, used as an in vitro Parkinson's model. The possible involvement of the signaling pathway mediated by phosphatidylinositol-3 kinase (PI3K), protein kinase B (Akt), and glycogen synthase kinase-3β (GSK3β) was also evaluated. Exposure of striatal slices to 6-OHDA caused a significant disruption of the cellular homeostasis measured as 3-(4,5 dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide reduction, lactate dehydrogenase release, and tyrosine hydroxylase levels. 6-OHDA exposure increased the levels of reactive oxygen species and thiobarbituric acid reactive substances production and decreased mitochondrial membrane potential in rat striatal slices. Furthermore, 6-OHDA decreased the phosphorylation of Akt (Serine(473)) and GSK3β (Serine(9)). Coincubation with 6-OHDA and creatine or PCr reduced the effects of 6-OHDA toxicity. The protective effect afforded by creatine or PCr against 6-OHDA-induced toxicity was reversed by the PI3K inhibitor LY294002. In conclusion, creatine and PCr minimize oxidative stress in striatum to afford neuroprotection of dopaminergic neurons.

  20. Both Creatine and Its Product Phosphocreatine Reduce Oxidative Stress and Afford Neuroprotection in an In Vitro Parkinson’s Model

    Martín-de-Saavedra, Maria D.; Romero, Alejandro; Egea, Javier; Ludka, Fabiana K.; Tasca, Carla I.; Farina, Marcelo; Rodrigues, Ana Lúcia S.; López, Manuela G.

    2014-01-01

    Creatine is the substrate for creatine kinase in the synthesis of phosphocreatine (PCr). This energetic system is endowed of antioxidant and neuroprotective properties and plays a pivotal role in brain energy homeostasis. The purpose of this study was to investigate the neuroprotective effect of creatine and PCr against 6-hydroxydopamine (6-OHDA)-induced mitochondrial dysfunction and cell death in rat striatal slices, used as an in vitro Parkinson’s model. The possible involvement of the signaling pathway mediated by phosphatidylinositol-3 kinase (PI3K), protein kinase B (Akt), and glycogen synthase kinase-3β (GSK3β) was also evaluated. Exposure of striatal slices to 6-OHDA caused a significant disruption of the cellular homeostasis measured as 3-(4,5 dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide reduction, lactate dehydrogenase release, and tyrosine hydroxylase levels. 6-OHDA exposure increased the levels of reactive oxygen species and thiobarbituric acid reactive substances production and decreased mitochondrial membrane potential in rat striatal slices. Furthermore, 6-OHDA decreased the phosphorylation of Akt (Serine473) and GSK3β (Serine9). Coincubation with 6-OHDA and creatine or PCr reduced the effects of 6-OHDA toxicity. The protective effect afforded by creatine or PCr against 6-OHDA-induced toxicity was reversed by the PI3K inhibitor LY294002. In conclusion, creatine and PCr minimize oxidative stress in striatum to afford neuroprotection of dopaminergic neurons. PMID:25424428

  1. Affordable uniform isotope labeling with {sup 2}H, {sup 13}C and {sup 15}N in insect cells

    Sitarska, Agnieszka; Skora, Lukasz; Klopp, Julia; Roest, Susan; Fernández, César; Shrestha, Binesh; Gossert, Alvar D., E-mail: alvar.gossert@novartis.com [Novartis Institutes for BioMedical Research (Switzerland)

    2015-06-15

    For a wide range of proteins of high interest, the major obstacle for NMR studies is the lack of an affordable eukaryotic expression system for isotope labeling. Here, a simple and affordable protocol is presented to produce uniform labeled proteins in the most prevalent eukaryotic expression system for structural biology, namely Spodoptera frugiperda insect cells. Incorporation levels of 80 % can be achieved for {sup 15}N and {sup 13}C with yields comparable to expression in full media. For {sup 2}H,{sup 15}N and {sup 2}H,{sup 13}C,{sup 15}N labeling, incorporation is only slightly lower with 75 and 73 %, respectively, and yields are typically twofold reduced. The media were optimized for isotope incorporation, reproducibility, simplicity and cost. High isotope incorporation levels for all labeling patterns are achieved by using labeled algal amino acid extracts and exploiting well-known biochemical pathways. The final formulation consists of just five commercially available components, at costs 12-fold lower than labeling media from vendors. The approach was applied to several cytosolic and secreted target proteins.

  2. Calotropis procera Latex Extract Affords Protection against Inflammation and Oxidative Stress in Freund's Complete Adjuvant-Induced Monoarthritis in Rats

    Sanjeev Roy

    2007-03-01

    Full Text Available In view of the well-established anti-inflammatory properties of latex of Calotropis procera (DL, the present study was carried out to evaluate the protective effect of its methanol extract (MeDL against inflammation and oxidative stress in monoarthritis induced by Freund's complete adjuvant (FCA in rats. Intra-articular injection of FCA produced inflammation of the joint with a peak effect occurring on day 4 where a maximum increase in the levels of myeloperoxidase and inflammatory mediators like PGE2, TNF-α, and nitric oxide was observed. This was associated with oxidative stress with a marked reduction in the levels of glutathione, catalase, superoxide dismutase and glutathione peroxidase and an increase in the lipid peroxidation as indicated by the higher levels of thiobarbituric acid reactive substances (TBARSs. Subsequently on day 28 the histological analysis of the joint also revealed arthritic changes. Daily treatment of rats with MeDL (50 and 500 mg/kg and standard anti-inflammatory drug rofecoxib (20 and 100 mg/kg, produced a significant attenuation in the inflammatory response and ameliorated the arthritic changes in the joint. The protection afforded by MeDL and rofecoxib was more pronounced than that of phenylbutazone and was associated with normalization of the levels of inflammatory mediators and biochemical parameters of oxidative stress. However, the overall protection afforded by rofecoxib was better than that of MeDL.

  3. Dissociating between object affordances and spatial compatibility effects using early response components

    Meytal eWilf

    2013-09-01

    Full Text Available Perception and action are tightly linked: objects may be perceived not only in terms of visual features, but also in terms of possibilities for action. Previous studies showed that when a centrally located object has a salient graspable feature (e.g., a handle, it facilitates motor responses corresponding with the feature's position. However, such so-called affordance effects have been criticized as resulting from spatial compatibility effects, due to the visual asymmetry created by the graspable feature, irrespective of any affordances. In order to dissociate between affordance and spatial compatibility effects, we asked participants to perform a simple reaction-time task to typically graspable and non-graspable objects with similar visual features (e.g., lollipop and stop sign. Responses were measured using either electromyography (EMG on proximal arm muscles during reaching-like movements, or with finger key-presses. In both EMG and button press measurements, participants responded faster when the object was either presented in the same location as the responding hand, or was affordable, resulting in significant and independent spatial compatibility and affordance effects, but no interaction. Furthermore, while the spatial compatibility effect was present from the earliest stages of movement preparation and throughout the different stages of movement execution, the affordance effect was restricted to the early stages of movement execution. Finally, we tested a small group of unilateral arm amputees using EMG, and found residual spatial compatibility but no affordance, suggesting that spatial compatibility effects do not necessarily rely on individuals’ available affordances. Our results show dissociation between affordance and spatial compatibility effects, and suggest that rather than evoking the specific motor action most suitable for interaction with the viewed object, graspable objects prompt the motor system in a general, body

  4. A Burgeoning Crisis? A Nationwide Assessment of the Geography of Water Affordability in the United States.

    Mack, Elizabeth A; Wrase, Sarah

    2017-01-01

    While basic access to clean water is critical, another important issue is the affordability of water access for people around the globe. Prior international work has highlighted that a large proportion of consumers could not afford water if priced at full cost recovery levels. Given growing concern about affordability issues due to rising water rates, and a comparative lack of work on affordability in the developed world, as compared to the developing world, more work is needed in developed countries to understand the extent of this issue in terms of the number of households and persons impacted. To address this need, this paper assesses potential affordability issues for households in the United States using the U.S. EPA's 4.5% affordability criteria for combined water and wastewater services. Analytical results from this paper highlight high-risk and at-risk households for water poverty or unaffordable water services. Many of these households are clustered in pockets of water poverty within counties, which is a concern for individual utility providers servicing a large proportion of customers with a financial inability to pay for water services. Results also highlight that while water rates remain comparatively affordable for many U.S. households, this trend will not continue in the future. If water rates rise at projected amounts over the next five years, conservative projections estimate that the percentage of U.S. households who will find water bills unaffordable could triple from 11.9% to 35.6%. This is a concern due to the cascading economic impacts associated with widespread affordability issues; these issues mean that utility providers could have fewer customers over which to spread the large fixed costs of water service. Unaffordable water bills also impact customers for whom water services are affordable via higher water rates to recover the costs of services that go unpaid by lower income households.

  5. Foregrounding Sociomaterial Practice in Our Understanding of Affordances: The Skilled Intentionality Framework

    van Dijk, Ludger; Rietveld, Erik

    2017-01-01

    Social coordination and affordance perception always take part in concrete situations in real life. Nonetheless, the different fields of ecological psychology studying these phenomena do not seem to make this situated nature an object of study. To integrate both fields and extend the reach of the ecological approach, we introduce the Skilled Intentionality Framework that situates both social coordination and affordance perception within the human form of life and its rich landscape of affordances. We argue that in the human form of life the social and the material are intertwined and best understood as sociomateriality. Taking the form of life as our starting point foregrounds sociomateriality in each perspective we take on engaging with affordances. Using ethnographical examples we show how sociomateriality shows up from three different perspectives we take on affordances in a real-life situation. One perspective shows us a landscape of affordances that the sociomaterial environment offers. Zooming in on this landscape to the perspective of a local observer, we can focus on an individual coordinating with affordances offered by things and other people situated in this landscape. Finally, viewed from within this unfolding activity, we arrive at the person’s lived perspective: a field of relevant affordances solicits activity. The Skilled Intentionality Framework offers a way of integrating social coordination and affordance theory by drawing attention to these complementary perspectives. We end by showing a real-life example from the practice of architecture that suggests how this situated view that foregrounds sociomateriality can extend the scope of ecological psychology to forms of so-called “higher” cognition.

  6. FCJ-178 Network Affordances: The unpredictable parameters of a Hong Kong SPEED SHOW

    Audrey Samson

    2015-06-01

    Full Text Available This paper examines the notion of network affordance within the context of network art. We expand on the notion of affordances, (Gibson, 1977; Gaver, 1996 to include ecological and computational parameters of unpredictability. We illustrate the notion of unpredictability by considering four specific works that were included in a network art exhibition, SPEED SHOW [2.0] Hong Kong (2013. The paper discusses how the artworks are contingent upon the parametric relations (Parisi, 2013 of the network. We introduce network affordance as a dynamic framework that could articulate the experience of tension arising from the (visible symbolic representation of computational processes and its hidden occurrences.

  7. Coverage, access, and affordability under health reform: learning from the Massachusetts model.

    Long, Sharon K; Stockley, Karen; Nordahl, Kate Willrich

    While the impacts of the Affordable Care Act will vary across the states given their different circumstances, Massachusetts' 2006 reform initiative, the template for national reform, provides a preview of the potential gains in insurance coverage, access to and use of care, and health care affordability for the rest of the nation. Under reform, uninsurance in Massachusetts dropped by more than 50%, due, in part, to an increase in employer-sponsored coverage. Gains in health care access and affordability were widespread, including a 28% decline in unmet need for doctor care and a 38% decline in high out-of-pocket costs.

  8. EVALUATION OF LIPOPROTEIN ( a LEVELS IN YOUNG PATIENTS WITH MYOCARDIAL INFARCTION IN NORTH COASTAL ANDHRA REGION

    Rajini

    2015-01-01

    Full Text Available CONTEXT: Coronary artery disease (CAD is one of the leading causes of mortality in the developing countries. Various risk factors i.e,. Conventional, modifiable and novel risk factors along with certain medical conditions may contribute to CAD. In India, due to rapid changes in life style towards sedentary and dietary habits, contribute to myocardial infarction (MI in young individuals. Lp (a – lipoprotein (a is now recognized as an independent risk factor for CAD. It is also a genetic r isk factor. AIM : to evaluate Lp (a levels in young patients, of both sexes, with myocardial infarction. STUDY DESIGN : Fifty young patients with myocardial infarction, of both sexes, with cut off age 45 years. Values are compared with age and sex matched 2 5 controls. METHODOLOGY: Fasting samples are collected for sugar, creatinine, uric acid and particularly lipid profile and Lp (a levels, using a fully automated analyzer and a turbid metric biochemistry analyzer. Statistical analysis is carried out by using student’s t - test. RESULTS : The Lp (a levels in patient cases were significantly higher, in comparison to controls (p valu e <0.001. The uric acid levels are increased at a mild rate in proportion to raised Lp (a levels. The LDL cholesterol and triglycerides show a linear rise, being significant, with raised Lp (a levels, w here as HDL - c showed an inverse relation. CONCLUSION S: The study demonstrated that in young patients with myocardial infarction, there is a male predominance with more raised Lp (a values, being lesser in females - may be due to estrogens’ effect in them, Lp (a level had been an important and independent r isk factor for CAD.

  9. Effect of Wenxin Granule on Ventricular Remodeling and Myocardial Apoptosis in Rats with Myocardial Infarction

    Aiming Wu

    2013-01-01

    Full Text Available Aim. To determine the effect of a Chinese herbal compound named Wenxin Granule on ventricular remodeling and myocardial apoptosis in rats with myocardial infarction (MI. Methods. Male Sprague-Dawley (SD rats were randomly divided into four groups: the control group, the model group, the metoprolol group, and the Wenxin Granule group (WXKL group with sample size (n of 7 rats in each group. An MI model was established in all rats by occlusion of the left anterior descending coronary artery (the control group was without occlusion. Wenxin Granule (1.35 g/kg/day, metoprolol (12 mg/kg/day, and distilled water (5 mL/kg/day for the control and model groups were administered orally for 4 weeks. Ultrasonic echocardiography was used to examine cardiac structural and functional parameters. Myocardial histopathological changes were observed using haematoxylin and eosin (H&E dyeing. Myocardial apoptosis was detected by terminal deoxynucleotidyl transferase mediated dUTP nick end labeling (TUNEL staining. Serum angiotensin II (Ang II concentration was measured using the enzyme-linked immunosorbent assay (ELISA. Results. It was found that Wenxin Granule could partially reverse ventricular remodeling, improve heart function, alleviate the histopathological damage, inhibit myocardial apoptosis, and reduce Ang II concentration in rats with MI. Conclusions. The results of the current study suggest that Wenxin Granule may be a potential alternative and complementary medicine for the treatment of MI.

  10. Effect of hydroxy safflower yellow A on myocardial apoptosis after acute myocardial infarction in rats.

    Zhou, M X; Fu, J H; Zhang, Q; Wang, J Q

    2015-04-10

    This study aimed to investigate the effect of hydroxy safflower yellow A (HSYA) on myocardial apoptosis after acute myocardial infarction (AMI) in rats. We randomly divided 170 male Wistar rats into 6 groups (N = 23): normal control, sham, control, SY (90 mg/kg), HSYA high-dose (HSYA-H, 40 mg/kg), and HSYA low-dose groups (HSYA-L, 20 mg/kg). Myocardial ischemic injury was induced by ligating the anterior descending coronary artery, and the degree of myocardial ischemia was evaluated using electrocardiography and nitroblue tetrazolium staining. Bax and Bcl-2 expressions in the ischemic myocardium were determined using immunohistochemical analysis. Peroxisome proliferator-activated receptor-γ (PPAR-γ) expression in the myocardium of rats with AMI was determined using reverse transcription-polymerase chain reaction. Compared to rats in the control group, those in the HYSA-H, HSYA-L, and SY groups showed a decrease in the elevated ST segments and an increase in the infarct size. The rats in the drug-treated groups showed a significantly lower percentage of Bax-positive cells and a significantly higher percentage of Bcl-2-positive cells than those in the control group (P myocardial ischemia in rats, possibly by increasing the level of Bcl-2/Bax, and PPAR-γ may be not a necessary link in this process.

  11. Use of resting myocardial scintigraphy during chest pain to exclude diagnosis of acute myocardial infarction

    Barbirato, Gustavo Borges; Azevedo, Jader Cunha de; Felix, Renata Christian Martins; Correa, Patricia Lavatori; Volschan, Andre; Viegas, Monica; Pimenta, Lucia; Dohmann, Hans Fernando Rocha; Mesquita, Evandro Tinoco; Mesquita, Claudio Tinoco [Centro de Estudos do Hospital Pro-Cardiaco (Procep), Rio de Janeiro, RJ (Brazil)

    2009-04-15

    Background: Images of myocardial perfusion taken during an episode of chest pain have been used for patients in the emergency department. Objective: To evaluate the operating characteristics of {sup 99m}Tc-Tetrofosmin scintigraphy during an episode of chest pain to exclude the diagnosis of cute myocardial infarction. Methods: One hundred and eight patients admitted with chest pain, or up to four hours after the end of symptoms and non diagnostic electrocardiogram, underwent resting scintigraphy and measurement of troponin I concentrations. Patients with a history of myocardial infarction (MI) were not excluded (24 patients). Troponin I concentrations were determined at admission and 6 hours later. Nuclear physicians performed a blind analysis of the images, and myocardial infarction was confirmed whenever troponin I level increase was three times that of the control. Results: Resting perfusion image was abnormal in all 6 patients with MI. Only 1 patient had a normal image and increased troponin levels. Fifty-five patients had positive images without MI, and 46 patients had normal images and troponin levels. The prevalence of the disease was 6.5%. The sensitivity and specificity of the resting images during an episode of chest pain to diagnose MI was 85.7% and 45.5%, respectively. The negative predictive value was 97.7%. Conclusion: Patients undergoing chest pain protocol with SPECT showed an excellent negative predictive value to exclude diagnosis of myocardial infarction. These results suggest that resting perfusion image is an important tool at the chest pain unit. (author)

  12. Myocardial salvage after intracoronary thrombolysis with streptokinase in acute myocardial infarction

    Markis, J.E.; Malagold, M.; Parker, J.A.; Silverman, K.J.; Barry, W.H.; Als, A.V.; Paulin, S.; Grossman, W.; Braunwald, E.

    1981-10-01

    Nine patients with acute myocardial infarction had cardiac catheterization and intracoronary infusions of streptokinase 2.3 to 4.3 hours (mean, 3.5) after the onset of symptoms. Occluded coronary arteries were opened within approximately 20 minutes in all patients, but reocclusion occurred in one patient. The immediate effect of thrombolysis on myocardial salvage was assessed with the intracoronary injection of thallium-201. Improved regional perfusion, indicating myocardial salvage after recanalization, was observed in seven of the nine patients. One patient, who had also sustained a nontransmural infarction one week before, had no change after thrombolysis. In the ninth patient, recanalization of a coronary artery was followed by reocclusion and worsening of the myocardial-perfusion defect. Intracoronary thallium-201 studies two weeks and three months after streptokinase infusion in two patients were unchanged in comparison with scintiscans performed 1.5 hours after thrombolysis. These short-term observations suggest that recanalization of obstructed coronary arteries after intracoronary thrombolysis can salvage jeopardized myocardium, However, evaluation of the long-term effects of this procedure on survival and myocardial function will require controlled clinical trials.

  13. Salvianolic acid B protects against myocardial damage caused by nanocarrier TiO2; and synergistic anti-breast carcinoma effect with curcumin via codelivery system of folic acid-targeted and polyethylene glycol-modified TiO2 nanoparticles.

    Ding, Lingling; Li, Jiawei; Huang, Rui; Liu, Zhidong; Li, Chunhua; Yao, Shaozi; Wang, Jinyan; Qi, Dongli; Li, Nan; Pi, Jiaxin

    Targeted delivery by the folate ligand is an effective way to enhance an anti-breast carcinoma effect, due to its high affinity for the folate receptor, which is overexpressed in many tumor cells. In this study, we firstly synthesized a folic acid (FA)-targeted and polyethylene glycol (PEG)-modified TiO2 nanocarrier. Then, an FA-PEG-TiO2 nanoparticle (NP) codelivery system loaded with curcumin and salvianolic acid B were prepared by emulsion evaporation-solidification at low temperature. The obtained folate-targeted NPs (FA-NPs) showed more cytotoxicity on MCF7 cells and MDA-MB-231 cells than a nontargeted NP group. Apart from a synergistic anti-breast cancer effect with curcumin, salvianolic acid B protects the cardiovascular system from oxidative injury by the TiO2 nanocarrier. With coumarin 6 as a fluorescent probe to observe cellular uptake of NPs, the results of in vitro cellular uptake demonstrated FA-NPs exhibited higher cellular uptake and accumulation in MCF7 cells and MDA-MB-231 cells than nontargeted NPs. Then, in vivo biodistribution of NPs was further qualitatively and quantitatively confirmed by in vivo imaging. More importantly, the animal study further suggested that FA-NPs had significantly stronger antitumor effects via receptor-mediated targeted delivery. Consequently, FA-PEG-TiO2 NPs loaded with curcumin and salvianolic acid B could be a promising drug-delivery system to treat breast cancer.

  14. In situ detection of myocardial infarction in pig by measurements of aspartate aminotransferase (ASAT) activity in the interstitial fluid.

    Kennergren, C; Nyström, B; Nyström, U; Berglin, E; Larsson, G; Mantovani, V; Lönnroth, P; Hamberger, A

    1997-01-01

    Microdialysis probes permeable to large molecules (m.w. cut-off > 200 kD) were introduced into the myocardium of anaesthetized pigs in order to evaluate their potential for early detection of myocardial ischaemia and enzyme markers for infarction. The left anterior descending coronary artery was occluded for 30 min and the myocardium was reperfused for 3 h. The concentrations of aspartate aminotransferase (ASAT), lactate, glucose and selected free amino acids were measured. The levels in the interstitium of ischaemic and non-ischaemic myocardium were compared with those in plasma from the coronary sinus as well as from a peripheral vein. Twelve probes were inserted in six pigs and withdrawn after 8-72 hours of sampling. No complications occurred. Simultaneous 100% increase of ASAT and lactate was found in myocardial dialysates after 30 min of ischaemia. ASAT activity remained at that level until the end of reperfusion. The plasma peak ASAT level was not attained until after 3 h. Glutamate was the only amino acid which increased significantly in the myocardial interstitium during ischaemia, peaking after 30 min of reperfusion. Dialysates from the unaffected myocardium showed no effects on lactate, ASAT or glutamate. The use of myocardial microdialysis for pre- and postoperative recordings in man is discussed.

  15. 心型脂肪酸结合蛋白在急性心肌梗死早期诊断价值的研究%Clinical value of heart-type fatty acid binding protein in the diagnosis of acute myocardial infarction

    周晓茜; 蔡英; 于萍; 朱琛颖; 刘学波

    2013-01-01

    Objective To investigate the value of heart - type fatty acid binding protein (H -FABP) in the early diagnosis of acute myocardial infarction ( AMI). Methods 68 patients admitted to hospital with acute chest pain were selected in this study, and were divided into unstable angina pectoris (UAP) group and acute myocardial infarction (AMI)group according to the clinical diagnosis including ECG and the results of coronary arteriography. Serum H - FABP concentrations were tested by using ELISA method at 3 h ( H - FABP3) and 6 h ( H - FABP6) after the chest pain. The sensitivity, specificity, positive predictive value, negative predictive value were compared with hsTnT and CK -MB. Results Serum H - FABP3 and H - FABP6 concentrations were significantly higher in group AMI than in group UAP ( P < 0. 05 ). The sensitivity, specificity, positive predictive value, negative predictive value of H - FABP3 in the diagnosis of AMI were 87.0% , 81.8% , 90. 9% , 75.0% , while in H - FABP6 were 95.7% 、90. 9% 、95. 7% 、90.9% . The data of H - FABP6 were significantly higher than those of HABP3 except positive predictive value(P <0. 05) ; Further, the sensitivity and negative predictive value of H - FABP were significantly higher than those of hsTnT and CK - MB (P < 0. 05). Conclusion The serum H - FABP concentrations of patients were significantly increased at the early stage of AMI. The sensitivity and specificity of H - FABP in the early diagnosis of AMI were significantly higher than those of hsTnT and CK - MB.%目的 探讨心型脂肪酸结合蛋白(H-FABP)在急性心肌梗死(AMI)早期的诊断价值.方法 选择急诊胸痛可疑心肌梗死入院患者68例,根据患者的临床症状、心电图及冠状动脉造影结果将患者分为不稳定型心绞痛组(UAP组,共22例)和AMI组(共46例).分别在患者胸痛发生后3h和6h抽取静脉血5 mL,ELISA法定量测定血清H-FABP浓度.分别计算H-FABP在AMI诊断中的敏感度、特异度、阳性预测值及

  16. 心脏型脂肪酸结合蛋白在早期诊断老年人急性心肌梗死中的应用价值%The value of heart-type fatty acid binding protein in the early diagnosis of acute myocardial infarction in elderly patients

    唐江; 方臻飞; 何毅; 郭书红

    2013-01-01

    Objective To investigate the diagnostic value of heart-type fatty acid binding protein (H-FABP) versus cardiac trofonin I (cTnI) and creatinekinase-MB (CK-MB) in early diagnosis of acute myocardial infarction (AMI) in elderly patients.Methods 67 patients with acute chest pain were selceted sequentially and divided into AMI group (n=30) and non-AMI group (n=37).Plasma H-FABP level was rapidly detected by using colloidal gold reagent plate and solid phase immunochromatographic assay for qualitative determination within and after 6 hours of AMI onset.Plasma levels of cTnI and CK-MB were determined within and after 6 hours of onset.The diagnositic value of H-FABP,cTnI and CK-MB in AMI was compared within and after 6 hours of onset.Results The sensitivity of H-FABP was better than that of cTnI and CK-MB within 6 hours of onset (93.3% vs.46.6%,23.3%,both P<0.05).The negative predictive value of H-FABP was better than that of cTnI and CK-MB within 6 hours of onset (94.7% vs.69.8%,61.1%,both P< 0.05) While,positive predictive value and specificity were basically the same between H-FABP,versus cTnI and CK-MB.H-FABP and cTnI levels had significant differences between AMI and non AMI group after 6 hours of onset (all P<0.05).Plasma levels of cTnl and CK-MB were higher after 6 hours than within6 hours [cTnI (4.10±1.79) mg/L vs.(1.45±1.31) mg/L,CK MB(180.52± 158.70) U/L vs.(20.02± 7.97) U/L,both P<0.05].Conclusions As compared with cTnI and CK-MB,within 6 hours after AMI onset,H-FABP as a new myocardial necrosis marker has higher sensitivity,specificity,positive and negative predictive values in the diagnosis of AMI.While,after 6 hours of AMI onset,H-FABP has the same diagnostic value as cTnI and CK-MB.%目的 探讨心脏型脂肪酸结合蛋白(H-FABP)、肌钙蛋白(cTnI)、肌酸激酶同工酶(CKMB)在老年人的急性心肌梗死(AMI)中早期诊断价值. 方法 序贯选择2012年9月至2013年1月67例急性胸痛

  17. Myocardial ischemia in hypertrophic cardiomyopathy; Isquemia miocardica na cardiomiopatia hipertrofica

    Lima Filho, Moyses de Oliveira; Figueiredo, Geraldo L.; Simoes, Marcus V.; Pyntia, Antonio O.; Marin Neto, Jose Antonio [Sao Paulo Univ., Ribeirao Preto, SP (Brazil). Faculdade de Medicina. Div. de Cardiologia

    2000-08-01

    Myocardial ischemia in hypertrophic cardiomyopathy is multifactorial and explains the occurrence of angina, in about 50% of patients. The pathophysiology of myocardial ischemia may be explained by the increase of the ventricular mass and relative paucity of the coronary microcirculation; the elevated ventricular filling pressures and myocardial stiffness causing a compression of the coronary microvessels; the impaired coronary vasodilator flow reserve caused by anatomic and functional abnormalities; and the systolic compression of epicardial vessel (myocardial bridges). Myocardial ischemia must be investigated by perfusion scintigraphic methods since its presence influences the prognosis and has relevant clinical implications for management of patients. Patients with hypertrophic cardiomyopathy and documented myocardial ischemia usually need to undergo invasive coronary angiography to exclude the presence of concomitant atherosclerotic coronary disease. (author)

  18. Amphetamine Abuse Related Acute Myocardial Infarction

    Archana Sinha

    2016-01-01

    Full Text Available Amphetamine abuse is a global problem. The cardiotoxic manifestations like acute myocardial infarction (AMI, heart failure, or arrhythmia related to misuse of amphetamine and its synthetic derivatives have been documented but are rather rare. Amphetamine-related AMI is even rarer. We report two cases of men who came to emergency department (ED with chest pain, palpitation, or seizure and were subsequently found to have myocardial infarction associated with the use of amphetamines. It is crucial that, with increase in amphetamine abuse, clinicians are aware of this potentially dire complication. Patients with low to intermediate risk for coronary artery disease with atypical presentation may benefit from obtaining detailed substance abuse history and urine drug screen if deemed necessary.

  19. Toll-Like Receptors and Myocardial Inflammation

    Yan Feng

    2011-01-01

    Full Text Available Toll-like receptors (TLRs are a member of the innate immune system. TLRs detect invading pathogens through the pathogen-associated molecular patterns (PAMPs recognition and play an essential role in the host defense. TLRs can also sense a large number of endogenous molecules with the damage-associated molecular patterns (DAMPs that are produced under various injurious conditions. Animal studies of the last decade have demonstrated that TLR signaling contributes to the pathogenesis of the critical cardiac conditions, where myocardial inflammation plays a prominent role, such as ischemic myocardial injury, myocarditis, and septic cardiomyopathy. This paper reviews the animal data on (1 TLRs, TLR ligands, and the signal transduction system and (2 the important role of TLR signaling in these critical cardiac conditions.

  20. Myocardial contractile function and intradialytic hypotension.

    Owen, Paul J; Priestman, William S; Sigrist, Mhairi K; Lambie, Stewart H; John, Stephen G; Chesterton, Lindsay J; McIntyre, Christopher W

    2009-07-01

    Dialysis-induced hypotension remains a significant problem in hemodialysis (HD) patients. Numerous factors result in dysregulation of blood pressure control and impaired myocardial reserve in response to HD-induced cardiovascular stress. Episodic intradialytic hypotension may be involved in the pathogenesis of evolving myocardial injury. We performed an initial pilot investigation of cardiovascular functional response to pharmacological cardiovascular stress in hypotension-resistant (HR) and hypotension-prone (HP) HD patients. We studied 10 matched chronic HD patients (5 HP, 5 HR). Dobutamine-atropine stress (DAS) was performed on a nondialysis short interval day, with noninvasive pulse-wave analysis using the Finometer to continuously measure hemodynamic variables. Baroreflex sensitivity was assessed at rest and during DAS. Baseline hemodynamic variables were not significantly different. The groups had differing hemodynamic responses to DAS. The Mean arterial pressure was unchanged in the HR group but decreased in HP patients (-13.6 +/- 3.5 mmHg; P<0.001). This was associated with failure to significantly increase cardiac output in the HP group (cf. increase in cardiac output in the HR group of +33.4 +/- 6%; P<0.05), and a reduced response in total peripheral resistance (HP -10.3 +/- 6.8%, HR -22.7 +/- 2.9%, P=NS). Baroreflex sensitivity was not significantly different between groups at baseline or within groups with increasing levels of DAS; however, the mean baroreflex sensitivity was higher in HR cf. HP subjects throughout pharmacological stress (P<0.05). Hypotension-prone patients appear to have an impaired cardiovascular response to DAS. The most significant abnormality is an impaired myocardial contractile reserve. Early identification of these patients would allow utilization of therapeutic strategies to improve intradialytic tolerability, potentially abrogating aggravation of myocardial injury.

  1. Severe myocardial injury and extracorporeal membrane oxygenation following perinatal asphyxia

    P. Benson Ham

    2015-05-01

    Full Text Available Perinatal asphyxia is a common cause of morbidity and mortality in the newborn and is associated with myocardial injury in a significant proportion of cases. Biomarkers, echocardiography, and rhythm disturbances are sensitive indicators of myocardial ischemia and may predict mortality. We present a case of severe myocardial dysfunction immediately after delivery managed with extracorporeal membrane oxygenation (ECMO and discuss the role of cardiac biomarkers, echocardiography, electrocardiography, and ECMO in the asphyxiated newborn.

  2. Postoperative myocardial performance during glucose-induced hypophosphatemia

    Rasmussen, A; Buus, S; Hessov, I

    1985-01-01

    Long-lasting hypophosphatemia was previously found to diminish myocardial performance. The present study aimed to elucidate if postoperative glucose-induced hypophosphatemia is of importance for myocardial performance. Sixteen patients undergoing elective colonic or rectal surgery were given 100 g....... As the preload (central venous pressure) and the afterload (arterial pressure) similarly were unchanged by the glucose infusion, glucose-induced hypophosphatemia following elective surgery was judged to lack importance for the myocardial performance....

  3. The value of exercise tests after acute myocardial infarction

    Nielsen, F E; Nielsen, S L; Knudsen, F

    1992-01-01

    The aim of the present study was to relate the clinical course in patients after a first acute myocardial infarction with the response to exercise-tests performed one month after discharge. 90 consecutive patients who suffered an acute myocardial infarction for the first time were followed-up after...... (W) were predictive with respect to mortality, heart failure, and angina pectoris requiring drug treatment. Exercise tests following acute myocardial infarction could not predict the chances of returning to work....

  4. Myocardial infarction association with the Riley-Day syndrome.

    Reshef, R; Aderka, D; Suprun, H; Manelis, G; Manelis, J

    1977-10-01

    The "sudden death" of a 23-year-old Ashkenazy Jew, suffering from "familial dysautonomia" was probably caused by an arrhythmia accompanying a myocardial infarction. Such a report is unique. Diffuse coronary atherosclerosis and direct myocardial "catecholamine cardiomyopathy" seem responsible for the myocardial damage. However, diversion of the endocardial blood flow toward dpicardium and a "coronary steal" phenomenon, both the result of a sudden catecholamine discharge, could aggravate the ischemic injury.

  5. Influence of central inhibition of sympathetic nervous activity on myocardial metabolism in chronic heart failure: acute effects of the imidazoline I1-receptor agonist moxonidine.

    Mobini, Reza; Fu, Michael; Jansson, Per-Anders; Bergh, Claes-Håkan; Scharin Täng, Margareta; Waagstein, Finn; Andersson, Bert

    2006-03-01

    Although beta-adrenergic blockade is beneficial in heart failure, inhibition of central sympathetic outflow using moxonidine has been associated with increased mortality. In the present study, we studied the acute effects of the imidazoline-receptor agonist moxonidine on haemodynamics, NA (noradrenaline) kinetics and myocardial metabolism. Fifteen patients with CHF (chronic heart failure) were randomized to a single dose of 0.6 mg of sustained-release moxonidine or matching placebo. Haemodynamics, NA kinetics and myocardial metabolism were studied over a 2.5 h time period. There was a significant reduction in pulmonary and systemic arterial pressures, together with a decrease in cardiac index in the moxonidine group. Furthermore, there was a simultaneous reduction in systemic and cardiac net spillover of NA in the moxonidine group. Analysis of myocardial consumption of substrates in the moxonidine group showed a significant increase in non-esterified fatty acid consumption and a possible trend towards an increase in myocardial oxygen consumption compared with the placebo group (P=0.16). We conclude that a single dose of moxonidine (0.6 mg) in patients already treated with a beta-blocker reduced cardiac and overall sympathetic activity. The finding of increased lipid consumption without decreased myocardial oxygen consumption indicates a lack of positive effects on myocardial metabolism under these conditions. We suggest this might be a reason for the failure of moxonidine to prevent deaths in long-term studies in CHF.

  6. Myocardial infarction: management of the subacute period.

    Mercado, Michael G; Smith, Dustin K; McConnon, Michael L

    2013-11-01

    Optimal management of myocardial infarction in the subacute period focuses on improving the discharge planning process, implementing therapies early to prevent recurrent myocardial infarction, and avoiding hospital readmission. Evidence-based guidelines for the care of patients with acute coronary syndrome are not followed up to 25% of the time. Antiplatelet therapy, renin-angiotensin-aldosterone system inhibitors, beta blockers, and statins constitute the foundation of medical therapy. Early noninvasive stress testing is an important risk assessment tool, especially in patients who do not undergo revascularization. Discharge preparation should include a review of medications, referral for exercise-based cardiac rehabilitation, activity recommendations, education about lifestyle modification and recognition of cardiac symptoms, and a clear follow-up plan. Because nonadherence to medications is common in patients after a myocardial infarction and is associated with increased mortality risk, modifiable factors associated with medication self-discontinuation should be addressed before discharge. Structured discharge processes should be used to enhance communication and facilitate the transition from the hospital to the family physician's care.

  7. Prognostic significance of transient myocardial ischaemia after first acute myocardial infarction: five year follow up study

    Mickley, H; Nielsen, J R; Berning, J

    1995-01-01

    an association between transient ST segment depression and an adverse long term outcome was found (Kaplan-Meier analysis; P = 0.004). The presence of exercise induced angina identified a similar proportion of patients with a poor prognosis (Kaplan-Meier analysis; P ...OBJECTIVE: To assess the five year prognostic significance of transient myocardial ischaemia on ambulatory monitoring after a first acute myocardial infarction, and to compare the diagnostic and long term prognostic value of ambulatory ST segment monitoring, maximal exercise testing...... discharge (left ventricular ejection fraction), maximal bicycle ergometric testing one day before discharge (ST segment depression, angina, blood pressure, heart rate), and ambulatory ST segment monitoring (transient myocardial ischaemia) started at hospital discharge a mean of 11 (SD 5) days after...

  8. Closing the Communal Gap: The Importance of Communal Affordances in Science Career Motivation.

    Brown, Elizabeth R; Thoman, Dustin B; Smith, Jessi L; Diekman, Amanda B

    2015-12-01

    To remain competitive in the global economy, the United States (and other countries) is trying to broaden participation in science, technology, engineering, and mathematics (STEM) by graduating an additional 1 million people in STEM fields by 2018. Although communion (working with, helping, and caring for others) is a basic human need, STEM careers are often (mis)perceived as being uncommunal. Across three naturalistic studies we found greater support for the communal affordance hypothesis, that perceiving STEM careers as affording greater communion is associated with greater STEM career interest, than two alternative hypotheses derived from goal congruity theory. Importantly, these findings held regardless of major (Study 1), college enrollment (Study 2), and gender (Studies 1-3). For undergraduate research assistants, mid-semester beliefs that STEM affords communion predicted end of the semester STEM motivation (Study 3). Our data highlight the importance of educational and workplace motivational interventions targeting communal affordances beliefs about STEM.

  9. A study of social information control affordances and gender difference in Facebook self-presentation.

    Kuo, Feng-Yang; Tseng, Chih-Yi; Tseng, Fan-Chuan; Lin, Cathy S

    2013-09-01

    Affordances refer to how interface features of an IT artifact, perceived by its users in terms of their potentials for action, may predict the intensity of usage. This study investigates three social information affordances for expressive information control, privacy information control, and image information control in Facebook. The results show that the three affordances can significantly explain how Facebook's interface designs facilitate users' self-presentation activities. In addition, the findings reveal that males are more engaged in expressing information than females, while females are more involved in privacy control than males. A practical application of our study is to compare and contrast the level of affordances offered by various social network sites (SNS) like Facebook and Twitter, as well as differences in online self-presentations across cultures. Our approach can therefore be useful to investigate how SNS design features can be tailored to specific gender and culture needs.

  10. What can be done with an egg? Creativity, material objects and the theory of affordances

    Glaveanu, Vlad Petre

    2012-01-01

    This article offers a reflection on the role of material objects in the creative process and explores the potential links between creativity and the theory of affordances (Gibson, ), conceptualized from a sociocultural perspective. From this standpoint, creativity can be defined as a process...... of perceiving, exploiting, and “generating” novel affordances during socially and materially situated activities. Illustrations are offered for each of the above from a research project investigating traditional Easter egg decoration activities in rural Romania. This brief case study exemplifies the discovery...... of existing action potentials, the generation of objects with novel affordances, and the transgression of conventional procedures, all resulting in creative forms of expression. In the end, some conclusions are drawn regarding the ways in which an affordance theory of creativity can enrich our understanding...

  11. Leveraging the Affordances of the Emerging 3d Internet for Entrepreneurial ”Next Practices”

    Frølunde, Lisbeth; Flåten, Bjørn-Tore

    of entrepreneurs within the creative industries, health services and business-to-business communication. These entrepreneurs are located in or stem from the Nordic countries (Iceland, Norway, Denmark, Sweden, and Finland). The collection methods are in-depth interviews and secondary data. Results/Implications Our...... related to the 3D Internet. Our theoretical basis is affordances, or the material and social properties of any technology in relation to affording actions by humans. Our first research question focuses on the perception of affordances by entrepreneurs: what does the 3D Internet offer or afford as a “space......” for entrepreneurial practices? Our second research question focuses on understanding how entrepreneurs utilize their social networks. Our approach to entrepreneurship is social-- concerned with the dynamics of social interactions and networked information ecology. Methods We are currently conducting 10 case studies...

  12. Are Housing Markets Decoupled? A Case Study of Residential Real Estate Affordability in Austria

    Florian PHILIPP

    2015-09-01

    Full Text Available Real estate arguably forms the most important asset to most households and the basis for their wealth. Around this context a model has been set up testing the relative affordability of real estate for the median household in Austria and the consequences of lower borrowing costs between 2004 and 2013 by vintage year. In this paper the hypothesis that the significant decline in base interest rates is not sufficient to offset the relative affordability loss caused by declining net household incomes and the simultaneous increase of real estate prices. To test this hypothesis a model has been set up comparing two different Housing Affordability Indices – one including and one excluding financing effects, having been compared via a multi factor model. Based on this calculation the author finds decreased base interest rates to offset relative affordability losses by only approximately 50%, verifying the hypothesis. The paper therefore argues for a potential decoupling of the residential housing market in Austria.

  13. Quantitative myocardial blood flow with Rubidium-82 PET

    Hagemann, Christoffer E; Ghotbi, Adam A; Kjær, Andreas

    2015-01-01

    Positron emission tomography (PET) allows assessment of myocardial blood flow in absolute terms (ml/min/g). Quantification of myocardial blood flow (MBF) and myocardial flow reserve (MFR) extend the scope of conventional semi-quantitative myocardial perfusion imaging (MPI): e.g. in 1......) identification of the extent of a multivessel coronary artery disease (CAD) burden, 2) patients with balanced 3-vessel CAD, 3) patients with subclinical CAD, and 4) patients with regional flow variance, despite of a high global MFR. A more accurate assessment of the ischemic burden in patients with intermediate...

  14. 52 Genetic Loci Influencing Myocardial Mass

    van der Harst, Pim; van Setten, Jessica; Verweij, Niek

    2016-01-01

    changes in myocardial mass and conduction, and are associated with increased risk of heart failure and death. OBJECTIVES: This meta-analysis sought to gain insights into the genetic determinants of myocardial mass. METHODS: We carried out a genome-wide association meta-analysis of 4 QRS traits in up to 73......BACKGROUND: Myocardial mass is a key determinant of cardiac muscle function and hypertrophy. Myocardial depolarization leading to cardiac muscle contraction is reflected by the amplitude and duration of the QRS complex on the electrocardiogram (ECG). Abnormal QRS amplitude or duration reflect...

  15. The prognostic importance of creatinine clearance after acute myocardial infarction

    Sørensen, C R; Brendorp, B; Rask-Madsen, C

    2002-01-01

    AIMS: The purpose of this study was to assess renal dysfunction as an independent predictor of mortality after acute myocardial infarction. METHODS: The study population was 6252 patients with a myocardial infarction admitted alive from 1990 to 1992. The mortality status was obtained after at least.......9-1.3) respectively. CONCLUSION: Renal dysfunction is an important risk factor after acute myocardial infarction. When the risk is adjusted for available competing risk factors only severely reduced renal function is associated with an important and independent risk of mortality after acute myocardial infarction...

  16. Inferior ST-Elevation Myocardial Infarction Associated with Takotsubo Cardiomyopathy

    Koeth, Oliver; Zeymer, Uwe; Schiele, Rudolf; Zahn, Ralf

    2010-01-01

    Takotsubo cardiomyopathy (TCM) is usually characterized by transient left ventricular apical ballooning. Due to the clinical symptoms which include chest pain, electrocardiographic changes, and elevated myocardial markers, Takotsubo cardiomyopathy is frequently mimicking ST-elevation myocardial infarction in the absence of a significant coronary artery disease. Otherwise an acute occlusion of the left anterior descending coronary artery can produce a typical Takotsubo contraction pattern. ST-elevation myocardial infarction (STEMI) is frequently associated with emotional stress, but to date no cases of STEMI triggering TCM have been reported. We describe a case of a female patient with inferior ST-elevation myocardial infarction complicated by TCM. PMID:20811565

  17. Inferior ST-Elevation Myocardial Infarction Associated with Takotsubo Cardiomyopathy

    Oliver Koeth

    2010-01-01

    Full Text Available Takotsubo cardiomyopathy (TCM is usually characterized by transient left ventricular apical ballooning. Due to the clinical symptoms which include chest pain, electrocardiographic changes, and elevated myocardial markers, Takotsubo cardiomyopathy is frequently mimicking ST-elevation myocardial infarction in the absence of a significant coronary artery disease. Otherwise an acute occlusion of the left anterior descending coronary artery can produce a typical Takotsubo contraction pattern. ST-elevation myocardial infarction (STEMI is frequently associated with emotional stress, but to date no cases of STEMI triggering TCM have been reported. We describe a case of a female patient with inferior ST-elevation myocardial infarction complicated by TCM.

  18. Myocardial Perfusion Spect Imaging in Dextrocardia: A Case Report

    Semra Özdemir

    2013-08-01

    Full Text Available The myocardial perfusion scintigraphy acquisition and analysis present some technical differences in the rare dextrocardia cases. Here we report a case of a 38 year-old woman with dextrocardia who had been applied myocardial perfusion scintigraphy. Presented case showed that the thoracic and abdominal organs had a mirror image with situs inversus totalis type dextrocardia. The incidence of coronary heart disease and life span of people with situs inversus totalis are the same as the normal population. So we may apply myocardial perfusion scintigraphy to this patient group. The current case is presented in order to remind the special applications of myocardial perfusion SPECT imaging in patients with dextrocardia.

  19. Combretastatin A4 disodium phosphate-induced myocardial injury

    Tochinai, Ryota; Nagata, Yuriko; Ando, Minoru; Hata, Chie; Suzuki, Tomo; Asakawa, Naoyuki; Yoshizawa, Kazuhiko; Uchida, Kazumi; Kado, Shoichi; Kobayashi, Toshihide; Kaneko, Kimiyuki; Kuwahara, Masayoshi

    2016-01-01

    Histopathological and electrocardiographic features of myocardial lesions induced by combretastatin A4 disodium phosphate (CA4DP) were evaluated, and the relation between myocardial lesions and vascular changes and the direct toxic effect of CA4DP on cardiomyocytes were discussed. We induced myocardial lesions by administration of CA4DP to rats and evaluated myocardial damage by histopathologic examination and electrocardiography. We evaluated blood pressure (BP) of CA4DP-treated rats and effects of CA4DP on cellular impedance-based contractility of human induced pluripotent stem cell-derived cardiomyocytes (hiPS-CMs). The results revealed multifocal myocardial necrosis with a predilection for the interventricular septum and subendocardial regions of the apex of the left ventricular wall, injury of capillaries, morphological change of the ST junction, and QT interval prolongation. The histopathological profile of myocardial lesions suggested that CA4DP induced a lack of myocardial blood flow. CA4DP increased the diastolic BP and showed direct effects on hiPS-CMs. These results suggest that CA4DP induces dysfunction of small arteries and capillaries and has direct toxicity in cardiomyocytes. Therefore, it is thought that CA4DP induced capillary and myocardial injury due to collapse of the microcirculation in the myocardium. Moreover, the direct toxic effect of CA4DP on cardiomyocytes induced myocardial lesions in a coordinated manner. PMID:27559241

  20. Health Migration: Crossing Borders for Affordable Health Care

    Jennifer Miller-Thayer

    2010-10-01

    Full Text Available Approximately 45.7 million people in the United States are uninsured and unknown numbers of this population are underinsured, severely limiting their access to medical care. To address this problem, people use innovative strategies to increase their access through cross-border care options. The U.S.-Mexico border provides unique challenges and opportunities for health care in this context. The lower cost of medical and dental procedures and medications in Mexico makes that country an attractive alternative for low-income populations in the United States. Thus segments of the U.S. population practice transnational medical consumerism in an attempt to optimize their health by using the resources available in both countries. This practice has economic benefits for the people who access health care at an affordable rate and for the medical markets of the country providing the care. Drawing on data collected in the field in 2002, 2004, and 2005, this paper presents some of the complexities and dynamics of medical pluralism occurring at the U.S.-Mexico border.Environ 45,7 millions de personnes vivant aux Etats-Unis n’ont pas de couverture sociale et nombreux sont celles à être sous-assurées, ce qui limite considérablement leur accès aux soins. Face à ce problème, les Américains font preuve d'ingéniosité pour améliorer leur accès aux soins : ils se font soigner au-delà des frontières. Dans ce contexte, la frontière entre les Etats-Unis et le Mexique offre des opportunités uniques de soins. Le Mexique constitue en effet une alternative séduisante pour les Américains à faible revenu, car les tarifs des actes médicaux et dentaires, et des médicaments, sont nettement inférieurs à ceux en vigueur aux Etats-Unis. Ainsi, certains Américains pratiquent le consumérisme médical transnational et recourent aux ressources disponibles dans les deux pays afin d’optimiser leur santé. Cette pratique présente des avantages économiques