Measurement of left ventricular (LV) filling pressure is useful in decision making and prediction of outcomes in various cardiovascular diseases. Invasive cardiac catheterization has been the gold standard in LV filling pressure measurement, but carries the risk of complications and has a similar predictive value for clinical outcomes compared with non-invasive LV filling pressure estimation by echocardiography. A variety of echocardiographic measurement methods have been suggested to estimate LV filling pressure. The most frequently used method for this purpose is the ratio between early mitral inflow velocity and mitral annular early diastolic velocity (E/e'), which has become central in the guidelines for diastolic evaluation. This review will discuss the use the E/e' ratio in prediction of LV filling pressure and its potential pitfalls.
Cardiac Catheterization ; Cardiac Catheters ; Cardiovascular Diseases ; Decision Making ; Echocardiography ; Echocardiography, Doppler

Transesophageal echocardiography(TEE) was performed during pharmacologic stress with dobutamine for evaluation of coronary artery disease in 15 patients (12 men, 3 women ; mean age, 70 years) with inadequate transthoracic echocardiographic images. In five patients, additional indications for TEE were present. Dobutamine was administered according to a standard protocol with a maximum dose of 40microg/kg per minute. Angina and an increase in simple ventricular ectopy were noted in one patient each, but no other complication or side effect was noted. Images (midesophageal four-and two-chamber views ad transgastric short-and long-axis views) were satisfactory for interpretation in 14 patients. In one patient, the apex could not be optimally visualized. Five patients (33%) had resting wall motion abnormalities. Wall motion abnormality developed in three patients(20%) and worsened in two(13%). Dobutamine stress TEE findings were normal in eight patients. Coronary angiography in two patients revealed significant stenosis corresponding to stress-induced wall motion abnormalities. Dobutamine stress TEE is a safe, feasible, well-toerated alternative to conventional stress echocardiography for detecting myocardial ischemia.
Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Dobutamine* ; Echocardiography ; Echocardiography, Stress ; Echocardiography, Transesophageal* ; Feasibility Studies* ; Female ; Humans ; Male ; Myocardial Ischemia

Heart failure is a major clinical problem in developed countries with about half of heart failure patients exhibiting decreased left ventricular systolic function. The correct identification and prompt treatment of some specific etiologies can reverse heart failure, and recognition of myocardial recovery may avoid long-term therapy. However, the echocardiographic patterns of patients with a variety of etiologies of heart failure are similar, so the selective use of other imaging techniques is necessary for identification of specific etiologies. The role of repeat imaging in monitoring the therapeutic response is controversial, as is the cessation of medical therapy in patients demonstrating recovery.
Cardiomyopathies ; Developed Countries ; Echocardiography ; Heart Failure ; Humans

BACKGROUND: Right ventricular (RV) dysfunction in ischemic cardiomyopathy (ICM) is associated with poor prognosis, but RV assessment by conventional echocardiography remains difficult. We sought to validate RV global longitudinal strain (RVGLS) and global longitudinal strain rate (RVGLSR) against cardiac magnetic resonance (CMR) and outcome in ICM. METHODS: In 57 patients (43 men, 64 +/- 12 years) with ICM who underwent conventional and strain echocardiography and CMR, RVGLS and RVGLSR were measured off-line. RV dysfunction was determined by CMR [RV ejection fraction (RVEF) < 50%]. Patients were followed over 15 +/- 9 months for a composite of death and hospitalization for worsening heart failure. RESULTS: RVGLS showed significant correlations with CMR RVEF (r = -0.797, p < 0.01), RV fractional area change (RVFAC, r = -0.530, p < 0.01), and tricuspid annular plane systolic excursion (TAPSE, r = -0.547, p < 0.01). RVGLSR showed significant correlations between CMR RVEF (r = -0.668, p < 0.01), RVFAC (r = -0.394, p < 0.01), and TAPSE (r = -0.435, p < 0.01). RVGLS and RVGLSR showed significant correlations with pulmonary vascular resistance (r = 0.527 and r = 0.500, p < 0.01, respectively). The best cutoff value of RVGLS for detection of RV dysfunction was -15.4% [areas under the curve (AUC) = 0.955, p < 0.01] with a sensitivity of 81% and specificity 95%. The best cutoff value for RVGLSR was -0.94 s-1 (AUC = 0.871, p < 0.01), sensitivity 72%, specificity 86%. During follow-up, there were 12 adverse events. In Cox-proportional hazard regression analysis, impaired RVGLS [hazard ratio (HR) = 5.46, p = 0.030] and impaired RVGLSR (HR = 3.95, p = 0.044) were associated with adverse clinical outcome. CONCLUSION: Compared with conventional echocardiographic parameters, RVGLS and RVGLSR correlate better with CMR RVEF and outcome.
Cardiomyopathies ; Echocardiography ; Follow-Up Studies ; Heart Failure ; Heart Ventricles ; Hospitalization ; Humans ; Male ; Prognosis ; Sensitivity and Specificity ; Vascular Resistance ; Ventricular Dysfunction, Right*

The authors have decided to remove one of the authors, Serpil C. Erzurum, MD, who was cited as the 5th author on the original manuscript.

No abstract available.
Alopecia* ; Minoxidil*

OBJECTIVES: Isolated cleft lip with or without cleft palate (CL/P) is among the most common human birth defects, with a prevalence of approximately 1 in 700 live births. The B-Cell Leukemia/lymphoma 3 (BCL3) gene has been suggested as a candidate gene for CL/P based on association and linkage studies in some populations. This study tests for an association between markers in BCL3 and isolated, non-syndromic CL/P using a case-parent trio design, while considering parent-of-origin effects. METHODS: Forty case-parent trios were genotyped for two single nucleotide polymorphisms (SNPs) in the BCL3 gene. We performed a transmission disequilibrium test (TDT) on individual SNPs, and the FAMHAP package was used to estimate haplotype frequencies and to test for excess transmission of multi-SNP haplotypes. RESULTS: The odds ratio for transmission of the minor allele, OR (transmission), was significant for SNP rs8100239 (OR=3.50, p=0.004) and rs2965169 (OR=2.08, p=0.027) when parent-of-origin was not considered. Parent-specific TDT revealed that SNP rs8100239 showed excess maternal transmission. Analysis of haplotypes of rs2965169 and rs8100239 also suggested excess maternal transmission. CONCLUSIONS: BCL3 appears to influence risk of CL/P through a parent-of-origin effect with excess maternal transmission.
Adolescent ; Adult ; Algorithms ; Alleles ; Chi-Square Distribution ; Child ; Child, Preschool ; Chromosomes, Human, Pair 19/genetics ; Cleft Lip/*genetics ; Cleft Palate/*genetics ; Female ; Genetic Markers ; Genetic Predisposition to Disease ; Genotype ; Haplotypes ; Humans ; Infant ; Korea ; Male ; Monte Carlo Method ; Odds Ratio ; Polymorphism, Single Nucleotide/*genetics ; Risk Factors ; Young Adult

No abstract available.
Brain Neoplasms* ; Brain* ; Child* ; Humans

PURPOSE: Sodium-4-phenylbutyrate (Na-4-PB) is an analogue of phenylacetate, which is a well-known redifferentiating agent. In vitro and in vivo studies on this agent have been done and the clinical relevance of Na-4-PB has been studied in other malignancies, but not in thyroid cancer. We investigated the effect of Na-4-PB on cell proliferation and differentiation in thyroid cancer cell lines. METHODS: We used 5 thyroid cancer cell lines: TPC-1, FTC-133, FTC-236, FTC-238 and XTC-1. MTT assay and flowcytometry were used to measure the agent's antiproliferative effects and the cell cycle change. We evaluated the PPARgamma expression via western blotting and the mRNA expressions of NIS, Tg and CD 97 were determined by performing RT-PCR. Troglitazone, a potent PPARgamma agonist, was used in combined treatment with Na-4-PB. RESULTS: Na-4-PB inhibited cell proliferation in a dose and time dependent manner in all 5 thyroid cancer cell lines. By performing flowcytometry in the FTC-133 and TPC-1 cell lines, we identified that the antiproliferative effect of Na-4-PB was associated with an increased apoptotic cell population. Treatment with Na-4-PB upregulated the PPARgamma expression, but the combined treatment of Na-4-PB with troglitazone did not seem to be synergistic for the antiproliferative effect. Treatment with Na-4-PB downregulated the CD97 mRNA expression and it upregulated the NIS and Tg mRNA expressions in both the FTC-133 and TPC-1 cell lines. CONCLUSION: Na-4-PB inhibited thyroid cancer cell proliferation by inducing apoptosis in a dose dependent manner. Treatment with Na-4-PB increased the expression of PPARgamma and it upregulated such differentiation markers as NIS and Tg, and it downregulated CD97, a dedifferentiation marker. Na-4-PB should be further evaluated as a new potential therapeutic agent for patients with thyroid cancer.
Antigens, Differentiation ; Apoptosis ; Blotting, Western ; Cell Cycle ; Cell Line ; Cell Proliferation ; Chromans ; Histone Deacetylase Inhibitors ; Humans ; Phenylacetates ; PPAR gamma ; RNA, Messenger ; Thiazolidinediones ; Thyroid Gland ; Thyroid Neoplasms

OBJECTIVE: The aim of this study was to evaluate the amount of tooth movement and histologic changes with different corticotomy designs and micro-osteoperforation in rabbits. METHODS: The sample consisted of 24 rabbits divided into three experimental groups (triangular corticotomy [TC] and indentation corticotomy [IC] with flap, and flapless micro-osteoperforations [MP]) and a control. A traction force of 100 cN was applied by connecting the first premolars to the incisors. The amount of tooth movement was measured. Kruskal-Wallis test was used to assess differences in tooth movement between the groups. Micro-computed tomography, hematoxylin and eosin staining, and tartrate-resistant acidic phosphatase (TRAP) analysis were performed. Analysis of variance was applied to assess differences in TRAP-positive osteoclast count between the groups. RESULTS: The amount of tooth movement increased by 46.5% and 32.0% in the IC and MP groups, respectively, while the bone fraction analysis showed 69.7% and 8.5% less mineralization compared to the control. There were no significant intergroup differences in the number of TRAP-positive osteoclasts. CONCLUSIONS The micro-osteoperforation group showed no significant differences in the amount of tooth movement compared to the corticotomy groups, nor in the TRAP-positive osteoclast count compared to both corticotomy groups and control.