Impact of scar thickness on the assessment of viability using dobutamine echocardiography and thallium single-photon emission computed tomography - A comparison with contrast-enhanced magnetic resonance imaging

OBJECTIVES We sought to determine whether the transmural extent of scar (TES) explains discordances between dobutamine echocardiography (DbE) and thallium single-photon emission computed tomography (Tl-SPECT) in the detection of viable myocardium (VM). BACKGROUND Discrepancies between DbE and Tl-SPECT are often attributed to differences between contractile reserve and membrane integrity, but may also reflect a disproportionate influence of nontransmural scar on thickening at DbE. METHODS Sixty patients (age 62 +/- 12 years; 10 women and 50 men) with postinfarction left ventricular dysfunction underwent standard rest-late redistribution Tl-SPECT and DbE. Viable myocardium was identified when dysfunctional segments showed Tl activity >60% on the late-redistribution image or by low-dose augmentation at DbE. Contrast-enhanced magnetic resonance imaging (ceMRI) was used to divide TES into five groups: 0%, 75% of the wall thickness replaced by scar. RESULTS As TES increased, both the mean Tl uptake and change in wall motion score decreased significantly (both p < 0.001). However, the presence of subendocardial scar was insufficient to prevent thickening; >50% of segments still showed contractile function with TES of 25% to 75%, although residual function was uncommon with TES >75%. The relationship of both tests to increasing TES was similar, but Tl-SPECT identified VM more frequently than DbE in all groups. Among segments without scar or with small amounts of scar (50% were viable by SPECT. CONCLUSIONS Both contractile reserve and perfusion are sensitive to the extent of scar. However, contractile reserve may be impaired in the face of no or minor scar, and thickening may still occur with extensive scar. (C) 2004 by the American College of Cardiology Foundation.

Demographic effects on the use of vertical sources of guidance by managers in widely differing cultural contexts

Data provided by 7380 middle managers from 60 nations are used to determine whether demographic variables are correlated with managers’ reliance on vertical sources of guidance in different nations and whether these correlations differ depending on national culture characteristics. Significant effects of Hofstede’s national culture scores, age, gender, organization ownership and department function are found. After these main effects have been discounted, significant although weak interactions are found, indicating that demographic effects are stronger in individualist, low power distance nations than elsewhere. Significant non-predicted interaction effects of uncertainty avoidance and masculinity-femininity are also obtained. The implications for theory and practice of the use of demographic attributes in understanding effective management procedures in various parts of the world are discussed.

Effects of the juxtaposition of carbonaceous slit pores on the overall transport behavior of adsorbed fluids

It is a common approximation in the modeling of adsorption in microporous carbons to treat the pores as slit pores, whose walls are considered to consist of an infinite number of graphitic layers. In practice, such an approximation is appropriate as long as the number of graphitic layers in the wall is greater than three. However, it is understood that pore walls in microporous carbons commonly consist of three or fewer layers. As well as affecting the solid-fluid interaction within a pore, such narrow walls permit the interaction of fluid molecules through the wall, with consequences for the adsorption characteristics. We consider the effect that a distributed pore-wall thickness model can have on transport properties. At low density we find that the only significant deviation in the transport properties from the infinite pore-wall thickness model occurs in pores with single-layer walls. For a model of activated carbons with a distribution of pore widths and pore-wall thicknesses, the transport properties are generally insensitive to the effects of finite walls, in terms of both the solid-fluid interaction within a pore and fluid-fluid interaction through the pore walls.

Grammatorcynicola n. g. (Bucephalidae : Dolichoenterinae) from Grammatorcynus spp. (Scombridae) on the Great Barrier Reef, Australia

A new trematode genus, Grammatorcynicola n. g. (Bucephalidae: Dolichoenterinae), and two new species, G. brayi n. sp. and G. nolani n. sp. from the intestines of the scombrids, Grammatorcynus bicarinatus and Gr. bilineatus respectively, are reported from the Great Barrier Reef, Australia. Grammatorcynicola n. g. is placed in the Dolichoenterinae, as the pharynx is in the anterior quarter of the body, the caecum is tube-like and extends to the posterior quarter of the body, the cirrus-sac is small relative to the size of the worm when compared with other bucephalids and the pars prostatica is curved. Grammatorcynicola n. g. differs from other dolichoenterine genera in having a simple sucker-like rhynchus, the ovary anterior to the testes and by not having a particularly thick cirrus-sac wall.

Assessing the cellular transmembrane electrical potential difference on the hepatic uptake of palmitate

Understanding the driving forces for the hepatic uptake of endogenous and exogenous substrates in isolated cells and organs is fundamental to describing the underlying hepatic physiology/pharmacology. In this study we investigated whether uptake of plasma protein-bound [H-3]-palmitate across the hepatocyte wall is governed by the transmembrane electrical potential difference (PD). Uptake was studied in isolated hepatocytes and isolated perfused rat livers (IPL). Protein-binding and vasoactive properties of the different perfusates were determined using in vitro heptane/buffer partitioning studies and the multiple indicator dilution (MID) technique in the IPL, respectively. Altering hepatocyte PD by perfusate ion substitution resulted in either a substantial depolarization (-14 +/- 1 mV, n = 12, mean +/- S.E., substituting choline for Na+) or hyperpolarization (-46 +/- 3 mV, n = 12, mean +/- S.E., substituting nitrate for Cl-). Perfusate ion substitution also affected the equilibrium binding constant for the palmitate-albumin complex. IPL studies suggested that, other than with gluconate buffer, hepatic [H-3]-palmitate extraction was not affected by the buffer used, implying PD was not a determinant of extraction. [H-3]-Palmitate extraction was much lower (p < 0.05) when gluconate was substituted for Cl- ion. This work contrasts with that for the extraction of [H-3]-alanine where hepatic extraction fraction was significantly reduced during depolarization. Changing the albumin concentration did not affect hepatocyte PD, and [H-3]-palmitate clearance into isolated hepatocytes was not affected by the buffers used. MID studies with vascular and extravascular references revealed that, with the gluconate substituted buffer, the extravascular volume possibly increased the diffusional path length thus explaining reduced [H-3]-palmitate extraction fraction in the IPL.