High- versus low-dose ACE inhibition in chronic heart failure: a double-blind, placebo-controlled study of imidapril

OBJECTIVES: To determine dose-related clinical and neurohumoral effects of angiotensin-converting enzyme (ACE) inhibitors in patients with chronic heart failure (CHF), we conducted a double-blind, placebo-controlled, randomized study of three doses (2.5 mg, 5 mg and 10 mg) of the long-acting ACE inhibitor imidapril. BACKGROUND: The ACE inhibitors have become a cornerstone in the treatment of CHF, but whether high doses are more effective than low doses has not been fully elucidated, nor have the mechanisms involved in such a dose-related effect. METHODS: In a parallel group comparison, the effects of three doses of imidapril were examined. We studied 244 patients with mild to moderate CHF (New York Heart Association class II-III: +/-80%/20%), who were stable on digoxin and diuretics. Patients were treated for 12 weeks, and the main end points were exercise capacity and plasma neurohormones. RESULTS: At baseline, the four treatment groups were well-matched for demographic variables. Of the 244 patients, 25 dropped out: 3 patients died, and 9 developed progressive CHF (3/182 patients on imidapril vs. 6/62 patients on placebo, p < 0.05). Exercise time increased 45 s in the 10-mg group (p = 0.02 vs. placebo), but it did not significantly change in the 5-mg (+16 s), and 2.5-mg (+11 s) imidapril group, compared to placebo (+3 s). Physical working capacity also increased in a dose-related manner. Plasma brain and atrial natriuretic peptide decreased (p < 0.05 for linear trend), while (nor)epinephrine, aldosterone and endothelin were not significantly affected. Renin increased in a dose-related manner, but plasma ACE activity was suppressed similarly (+/-60%) on all three doses. CONCLUSIONS: Already within 3 months after treatment initiation, high-dose ACE inhibition (with imidapril) is superior to low-dose. This is reflected by a more pronounced effect on exercise capacity and some of the neurohormones, but it does not appear to be related to the extent of suppression of plasma ACE.     

Normal relationships between cardiovascular variables in active orthostatism and clinostatism in postural change

OBJECTIVE: Autonomic modulation of hemodynamics, essential for the preservation of homeostasis, is well tested by the abrupt postural change from clinostatism to active orthostatism. The aim of this work was to study normal relationships between the cardiovascular variables in active orthostatism and those in clinostatism. METHODS: Hemodynamic parameters in clinostatism and orthostatism were easily measured in 20 healthy subjects of both sexes, aged between 33 and 78 years, without treatment, using the non-invasive thoracic electric bioimpedance method. RESULTS: Cardiovascular variables values in orthostatism are linearly related with their values in clinostatism. CONCLUSIONS: Results show that cardiovascular variables in active orthostatism are linearly related with their values in clinostatism, each variable being specially regulated. A clinostatism and orthostatism intraindividual correlation was obtained, which provides an easily accessible method of detection and interpretation of autonomic dysfunctions, without deleterious consequences for the subjects, which can be very useful for research on physiopathologic mechanisms.     

Multilayers of Ge nanocrystals embedded in Al2O3 matrix: Structural and electrical studies

In this paper, Ge/Al₂O₃ multilayer systems were grown by pulsed laser ablation. The grown samples were annealed at 900 °C to promote the formation of Ge nanocrystals. Rutherford backscattering spectroscopy and transmission electron microscopy confirmed the presence of a multilayer system. Grazing incidence small angles X-ray scattering technique demonstrates the formation of Ge nanoclusters formed between alumina layers. Room temperature I-V measurements showed weak carrier trapping in the system. This was explained by the leakage caused by Ge diffusion through the multilayer.     

Crystallinity Degree of Polyethylene Tubular Blown Films Evaluated by X-ray Diffraction and Density Methods: An Evaluation of the Interfacial Contribution

An experimental study is reported of the relationship between the degree of crystallinity of polyethylene tubular blown films obtained from x-ray diffraction and from density. The comparison shows that there are significant differences between the two techniques, and the values for percentage of crystallinity as determined by the density method are higher than those determined by the x-ray diffraction method. The main reason for these differences is the inclusion of the interfacial contribution to the measured density. The possible application of the analysis of the equation obtained for density crystallinity versus x-ray crystallinity in the evaluation of amorphous and crystalline domains in the interfacial region is discussed.     

Chlorinated Polycyclic Aromatic Hydrocarbons Associated with Drinking Water Disinfection: Synthesis,Formation under Aqueous Chlorination Conditions and Genotoxic Effects

Polycyclic aromatic hydrocarbons (PAHs) are among the most persistent and toxic organic micropollutants present in water and several of them are mutagenic and carcinogenic. Although it has been shown that chlorinated derivatives of PAHs (Cl-PAHs) may be formed during the water chlorination procedure, little is known about their potential genotoxic and carcinogenic effects. The objectives of the present work were to prepare and characterize the major chlorinated derivatives of benzo[a]pyrene (BaP) and fluoranthene (Fluo), to develop an analytical methodology for their quantification in water samples and to analyse their potential genotoxicity. Chlorinated standards were prepared by a newly developed two phase method (water/n-hexane) using sodium hypochlorite. 6-Chloro-benzo[a]pyrene was selectively obtained from BaP, while 1,3-dichloro-fluoranthene and 3-chloro-fluoranthene were obtained from Fluo. All products were isolated and characterized by nuclear magnetic resonance and mass spectrometry. The formation of BaP- and Fluo-chlorinated derivatives under aqueous chlorination conditions was observed using a SPE-HPLC-FLD methodology. In addition, the cytotoxic and genotoxic activities of the three chlorinated derivatives were analyzed in comparison to their parent compounds, in a human-derived hepatoma cell line using the neutral red uptake and comet assays, respectively. The results showed that, at the equimolar doses of 100 and 125 μM, 6-Cl-BaP was able to induce a significantly higher level of DNA damage than BaP, suggesting a more potent genotoxic effect. In contrast, neither Fluo nor its chlorinated derivatives were genotoxic in the same cell line. The identification of new and possibly hazardous water chlorination by-product from PAHs emphasizes the need to minimize total organic carbon content of raw water and the implementation of safer water disinfection methods.     

Correlation between microhardness and optical anisotropies and crystallinity in lamellar regenerated cellulose

An experimental study about the effect of the crystallinity on the birefringence and microhardness of regenerated cellulose tubular films is reported. The degrees of crystallinity of samples varied between 0.53 and 0.66. It was demonstrated that for the polymeric films studied there was an excellent agreement between crystallinity and optical and microhardness anisotropies, showing that micro-indentation hardness, scarcely used but rapid and nondestructive, is a suitable technique for characterizing the degree of order in this polymer.     

Effect of temperature and heating rate on the sintering of leucite-based dental porcelains

The aim of this work was to determine the effect of temperature and heating rate on the densification of four leucite-based dental porcelains: two low-fusion (Dentsply-Ceramco and Ivoclar) and two high-fusion commercial porcelains (Dentsply-Ceramco). Porcelain powders were characterized by differential thermal analysis (DTA), X-ray diffraction (XRD), particle size distribution, helium picnometry, and by scanning electron microscopy. Test specimens were sintered from 600 to 1050 °C, with heating rates of 55 °C/min and 10 °C/min. The bulk density of the specimens was measured by the Archimedes method in water, and microstructures of fracture surfaces were analyzed by scanning electron microscopy (SEM). The results showed that densification of specimens increased with the increase in temperature. The increase in the heating rate had no effect on the densification of the porcelains studied. Both high-fusion materials and one of the low-fusing porcelains reached the maximum densification at a temperature that was 50 °C lower than that recommended by the manufactures.     

Recurrent-neural-network-based implementation of a programmablecascaded low-pass filter used in stator flux synthesis ofvector-controlled induction motor drive

The concept of programmable cascaded low-pass filter for stator flux vector synthesis by ideal integration of stator voltages at any frequency was introduced by Bose and Patel. A new form of implementation of this filter is proposed that uses a combination of recurrent neural network trained by Kalman filter and a polynomial neural network. The proposed structure is simple, permits faster implementation by digital signal processor, and gives improved performance     

A model-based parameter estimation approach for numerical analysisof single-mode optical fibers

An efficient numerical method is proposed and implemented for the analysis of propagation characteristics of single-mode optical fibers with arbitrary refractive index profile. The method follows the concept of the so-called model-based parameter estimation, and the Pade algorithm is used to construct a low-order rational approximant of the spectral domain Green's function, obtained by solving a hierarchy of static problems. The sought eigenfrequency and field distribution are then estimated by computing, respectively, the dominant pole and the related residual of the rational approximant. A number of profiles are analyzed and experiments show that very accurate results can be cheaply obtained through this technique