Valvuloplasty for aortic insufficiency.

Twenty-eight consecutive patients underwent aortic valvuloplasty for aortic insufficiency caused by leaflet prolapse. The technique involved triangular resection of the free edge of the prolapsing leaflet, annular plication at the commissure, and resection of a raphe when present in bicuspid valves. Mean age of the patients was 46.8 +/- 14.4 years. Twenty-six (92.7%) were male. Seventy-five percent of the patients had a bicuspid aortic valve; the remaining valves were tricuspid. The extent of aortic insufficiency was 3.6 +/- 0.8 by aortography, 3.1 +/- 0.1 by preoperative Doppler echocardiography, and 3.4 +/- 0.7 by intraoperative Doppler echocardiography. The amount of aortic insufficiency decreased from 3.4 +/- 0.7 to 0.6 +/- 0.5 intraoperatively, immediately after repair (p less than 0.001). Mean transvalvular gradient by echocardiography was 12.9 +/- 6.8 mmHg. There was one death in a patient who had an intraoperative cerebral vascular accident. Mean follow-up was complete at 6.9 months. One patient had a cerebral vascular accident and one patient required reoperation for recurrent aortic insufficiency caused by partial suture line dehiscence. In 15 patients with late echocardiograms, aortic insufficiency did not progress (0.7 +/- 0.6 in the hospital and 0.8 +/- 0.5 late). Aortic valve repair for aortic cusp prolapse effectively eliminates aortic insufficiency without causing aortic stenosis. At early follow-up the repair has been stable.

Inversion and processing of component and spatial-relational information in faces.

This study compared effects of inversion on perceptual processing of faces with distorted components (eyes and mouths) and faces distorted by altering spatial relations between components. In a rating task, participants inversion reduced the rated grotesqueness of spatially distorted faces but not that of faces with altered components. In a comparison task, pairs of faces were shown side by side; participants judged whether they were identical or different. Inversion greatly reduced the rate at which participants responded within 3 s to pairs that differed spatially, but not pairs that differed componentially. Also, latencies for detecting spatial differences were lengthened by inversion more than latencies for detecting componential differences. Results support the hypothesis that inversion impairs encoding of spatial-relational information more than, or instead of, componential information, depending on the task.

Recognition of transposed melodies: a key-distance effect in developmental perspective.

Four experiments examined the possibility of a key-distance effect in a transposition detection task. Subjects heard standard melodies followed by comparison melodies presented in the same key, a musically near key or a musically far key. The task was to recognize comparisons that were exact transpositions of the standards, rejecting nontranspositions. Results suggested a largely invariant key-distance effect with nontransposition comparisons (lures); same- and near-key lures evoked more false alarms than far-key lures. The variables of musical experience, age of subject, and familiarity of melody affected the level of transposition-recognition performance but did not consistently affect the size of the key-distance effect. The results support the psychological reality of key distance and are consistent with both musical and nonmusical-auditory theories of its effects. The key-distance effect was not found with transposition comparisons (targets), a result with implications for the separability of key and interval information in short-term memory for melodies.

Young and old faces in young and old heads: the factor of age in face recognition.

Research on aging and face recognition has shown age-related differences that are reflected most clearly in false-alarm errors. Elderly subjects exceed young adults in false recognitions that new faces are "old." To determine if this difference between young and elderly subjects might differ for young versus elderly faces, an experiment was conducted in which half of the young and elderly subjects studied and recognized young and middle-aged faces, and the remainder studied and recognized middle-aged and elderly faces. Replicating prior research, age-related deficits in recognition accuracy (d') were reduced with older faces, and this effect generalized from measures of face recognition to measures of face-picture recognition. However, the age-related increase in false recognitions of faces was not affected by face age.

Effects of aging and musical experience on the representation of tonal hierarchies.

Two experiments explored the representation of the tonal hierarchy in Western music among older (aged 60 to 80) and younger (aged 15 to 22) musicians and nonmusicians. A probe tone technique was used: 4 notes from the major triad were presented, followed by 1 note chosen from the 12 notes of the chromatic scale. Whereas musicians had a better sense of the tonal hierarchy than nonmusicians, older adults were no worse than younger adults in differentiating the notes according to musical principles. However, older adults were more prone than younger adults to classify the notes by frequency proximity (pitch height) when proximity was made more salient, as were nonmusicians compared with musicians. With notes having ambiguous pitch height, pitch height effects disappeared among older adults but not nonmusicians. Older adults seem to have internalized tonal structure, but they sometimes fail to inhibit less musically relevant information.

Aging and experience in the recognition of musical transpositions.

The authors examined the effects of age, musical experience, and characteristics of musical stimuli on a melodic short-term memory task in which participants had to recognize whether a tune was an exact transposition of another tune recently presented. Participants were musicians and nonmusicians between ages 18 and 30 or 60 and 80. In 4 experiments, the authors found that age and experience affected different aspects of the task, with experience becoming more influential when interference was provided during the task. Age and experience interacted only weakly, and neither age nor experience influenced the superiority of tonal over atonal materials. Recognition memory for the sequences did not reflect the same pattern of results as the transposition task. The implications of these results for theories of aging, experience, and music cognition are discussed.

Aging and memory for pictures of faces.

The hypothesis that pictorial aspects of face-recognition memory are lower in old age was tested in 2 studies. Young and elderly Ss viewed 48 face pictures, and then took a test containing identical copies of input faces, pictorially changed versions of input faces, and entirely new faces. Replicating prior findings, Experiment 1 showed that false recognitions of entirely new faces were higher among elderly Ss. However, there were no age differences in distinguishing identical from pictorially changed faces. Using a modified test, Experiment 2 showed that although the elderly Ss had good knowledge that changed faces were changed, they had relatively poor knowledge of how they were changed. There appears to be age differences in analytical matching of pictorial information against information in memory.

Identification of speeded and slowed familiar melodies by younger, middle-aged, and older musicians and nonmusicians.

There is a range of tempos within which listeners can identify familiar tunes (around 0.8 to 6.0 notes/s). Faster and slower tunes are difficult to identify. The authors assessed fast and slow melody-identification thresholds for 80 listeners ages 17-79 years with expertise varying from musically untrained to professional. On fast-to-slow (FS) trials the tune started at a very fast tempo and slowed until the listener identified it. Slow-to-fast (SF) trials started slow and accelerated. Tunes either retained their natural rhythms or were stylized isochronous versions. Increased expertise led to better performance for both FS and SF thresholds (r = .45). Performance declined uniformly across the 62-year age range in the FS condition (r = .27). SF performance was unaffected by age. Although early encoding processes may slow with age, expertise has a greater effect. Musical expertise involves perceptual learning with melodies at a wide range of tempos.

Cognitive impenetrability of memory for orientation.

This research produced evidence that an aspect of visual long-term memory--memory for lateral orientation of pictures--is constrained by a viewer-centered or egocentric reference frame. Subjects in Experiment 1 verbally encoded and then verbally recalled the locations of objects within scenic pictures. Recall of locations in terms of left-right directions (using a viewer-centered frame) exceeded recall of locations in terms of relative proximities to features of the room (using an environmental frame), even if the relative proximities had been verbalized at input. Subjects in Experiment 2 viewed half of a list of pictures directly and the remainder, reflected in a mirror. They then took a test in which they classified old pictures--all viewed directly--as "same-orientation" or "reversed". Performance was much better with a viewer-centered definition of same orientation (Does the picture appear the same way around?) than with an environmental definition (Is the picture the same way around on the screen?), even with forewarning of an environmental orientation test.

Remembering left-right orientation of pictures.

In a study of recognition memory for pictures, we observed an asymmetry in classifying test items as "same" versus "different" in left-right orientation: Identical copies of previously viewed items were classified more accurately than left-right reversals of those items. Response bias could not explain this asymmetry, and, moreover, correct "same" and "different" classifications were independently manipulable: Whereas repetition of input pictures (one vs. two presentations) affected primarily correct "same" classifications, retention interval (3 hr vs. 1 week) affected primarily correct "different" classifications. In addition, repetition but not retention interval affected judgments that previously seen pictures (both identical and reversed) were "old". These and additional findings supported a dual-process hypothesis that links "same" classifications to high familiarity, and "different" classifications to conscious sampling of images of previously viewed pictures.

Percutaneous transluminal coronary angioplasty of native coronary arteries via saphenous vein grafts.

We analyzed the immediate and long-term outcome of percutaneous transluminal angioplasty (PTCA) of native coronary arteries via saphenous vein grafts (SVG) in 30 patients. The mean age of the grafts was 69 months. Angioplasty was successful in 27 (90%) patients. One patient died following emergency bypass surgery. There were no distal embolizations and one non-Q myocardial infarction. Follow-up angiography was performed in 12 patients, which revealed restenosis in three patients. At a mean follow-up of 20 months, cumulative survival was 93%. Freedom from myocardial infarction, repeat bypass surgery, and death was 80%. We conclude that PTCA of native coronary arteries via SVG is a safe alternative to repeat CABG in selected patients.

Transesophageal echocardiography in the critical care unit.

Transthoracic echocardiography may be of limited value for patients in intensive care units because of suboptimal patient positioning, surgical wounds, and mechanical ventilation. By contrast, transesophageal echocardiography provides a new window for cardiac imaging, even in critically ill patients. We report our indications based on findings comparing transesophageal and transthoracic echocardiography in 112 studies in intensive care units. The transesophageal approach diagnosed 131 significant findings, compared to only 95 (73%) found transthoracically. Transesophageal echocardiography was superior to the transthoracic approach in patients with significant (higher than 2+) mitral regurgitation, with improved detection in 10 (9%) cases (p less than 0.05). Transesophageal echocardiography also provided additional information in the evaluation of vegetations, diseases of the aorta, visualization of the left ventricle, intracardiac masses, intracardiac thrombi, and congenital heart disease. Transesophageal echocardiography provides a useful diagnostic tool for evaluation of critically ill patients.

Aging and lineup performance at long retention intervals: effects of metamemory and context reinstatement.

Young (18-30 years) and older (62-79 years) adults (N = 96) engaged in a 20-min live interaction with the future target in a lineup task. One month later, participants were interviewed about the events in the prior encounter (with or without context reinstatement), and then they saw a target-present (TP) or target-absent (TA) lineup. The lineup was followed by the Benton Face Recognition Test (A. Benton, A. Sivan, K. Hamsher, N. Varney, & O. Spreen, 1994), which correlated positively with accuracy in TP, especially for young adults. False identification in TA was associated with (a) higher scores on a memory self-efficacy scale and (b) higher recall of information about the initial event, although only for seniors. Results suggested that age-related increases in false identification generalize to ecologically valid conditions and that seniors' performance on lineups is negatively related to verbal recall as well as to self-reports of satisfactory experiences with memory in life.

Effects of label distinctiveness and label testing on recognition of complex pictures.

Two experiments examined the effects of label retrieval upon subsequent recognition of complex, scenic pictures. Contrary to past research, i.e., Bahrick and Boucher's 1968 study, retrieval of labels which accompanied pictures at input was associated with high recognition of "same-photo" (copy) cues but not false recognition of similar "same-scene" cues on a subsequent "photo" recognition test. The label-retrieval effect can be attributed to actual rehearsal of pictorial information and not to item selection. In addition, the beneficial effects of label retrieval did not vary with the informational content of the label itself, i.e., its power to distinguish between same-photo and same-scene items. However, the effects of label-type as well as label retrieval varied with recognition test instructions. In a "scene" recognition test, requiring recognition of both same-photo and same-scene items, effects of label-type were stronger than in the "photo" test, while effects of label retrieval were not significant. The results highlight the complexity of the relationships between label retrieval and picture recognition and suggest several factors which might determine such relationships.

Remembering environmental sounds: The role of verbalization at input.

Two experiments investigated the role of verbalization in memory for environmental sounds. Experiment i extended earlier research (Bower & Holyoak, 1973) showing that sound recognition is highly dependent upon consistent verbal interpretation at input and test. While such a finding implies an important role for verbalization, Experiment 2 suggested that verbalization is not the only efficacious strategy for encoding environmental sounds. Recognition after presentation of sounds was shown to differ qualitatively from recognition after presentation of sounds accompanied with interpretative verbal labels and from recognition after presentation of verbal labels alone. The results also suggest that encoding physical information about sounds is of greater importance for sound recognition than for verbal free recall, and that verbalization is of greater importance for free recall than for recognition. Several alternative frameworks for the results are presented, and separate retrieval and discrimination processes in recognition are proposed.

Familiarity and recognition of faces in old age.

Elderly persons exceed young adults in false recognitions of new faces. One account claims there are age-related deficits in memory for context of encounter with faces. Because of these deficits, elderly persons frequently recognize faces on the basis of perceived familiarity (i.e., resemblance to face representations in memory), which is high for some new faces. To test this context-recollection hypothesis, we had young adult and elderly subjects judge whether faces: (1) had been seen previously in a test (though no face was repeated), and (2) were subjectively familiar (though no face was famous). The elderly exceeded the young subjects in seen-before judgements (false recognitions), and only the elderly showed a positive correlation between false recognitions and subjective familiarity. In Experiment 2, this finding was extended from false recognitions to correct recognitions, supporting the view that elderly persons, compared to young adults, rely more on resemblance in recognizing faces.

Inversion and configuration of faces.

If the mouth and eyes of a face are inverted, the altered construction appears grotesque when upright, but not when upside-down. Three studies of this "Thatcher illusion" employed faces that were grotesque when upright because: (a) their eyes and mouths had been inverted ("Thatcherized" faces), (b) their eyes and mouths had been moved (spatially distorted faces), or (c) they had grotesque posed expressions. Inversion reduced the apparent grotesqueness of both Thatcherized and spatially distorted faces, but not grotesque-expression faces. Moreover, Thatcherized and distorted faces, although not grotesque-expression faces, were judged as more similar to normal, smiling faces when face-pairs were inverted than when they were upright. Similarity ratings to inverted face-pairs were correlated with latencies of response to these pairs in a task that encouraged attention to components (e.g., mouths, eyes) rather than wholistic properties. Similarity ratings to upright face-pairs showed no such correlation, and this and other findings suggested that although similarity ratings to upright faces are based on wholistic information, similarity ratings to inverted faces are based largely on components. The Thatcher illusion reflects a disruption of encoding of wholistic information when faces are inverted.

Age differences in picture memory with resemblance and discrimination tasks.

Previous research on recognition memory has examined age-related effects on knowledge of the difference between lures and input items (e.g., false alarm rate), but has not examined age-related effects on knowledge of the resemblance between lures and input items. In the present experiment, subjects in two age groups (means = 19.3 years and 63.8 years) saw a list of scenic pictures, followed by a recognition test containing same-photo items, each a copy of an input picture, same-scene items, each from the same original scene as an input picture, and different-scene items. The task was to categorize each test picture as same-photo, same-scene or different-scene. There were no reliable age differences on standard recognition measures of hits and false alarms. However, younger subjects were better than older subjects at detecting the resemblance between same-scene items and input items, although this age difference was less apparent when the initial encoding provided experience with resemblance detection. The results have implications regarding age effects in picture memory and in recognition memory generally.