Surgical treatment of heart failure in patients with primary and ischemic dilated cardiomyopathy.

OBJECTIVE: The aim of this study was to show hemodynamic and clinical improvement of heart failure after reductive annuloplasty of double (mitral and tricuspid) orifices (RADO) in the treatment of ischemic (IDCM) and primary (PDCM) dilated cardiomyopathy. MATERIALS AND METHODS: From November 1986 to July 15, 2002, 341 patients underwent operations for dilated cardiomyopathy. The IDCM group consisted of 231 patients (68%) with a mean ejection fraction (EF) of 23.3%. From July 1991 to July 15, 2002, the 110 patients in the PDCM group (mean EF, 22.9%) underwent such operations. RESULTS: The postoperative 30-day mortality rate was 5.9% for the entire patient population, 7.3% for the IDCM group, and 2.7% for the PDCM group. Follow-up survival rates were 61.5% +/- 4.0% at 5 years and 38.2% +/- 8.0% at 14 years for the IDCM group and 43.9% +/- 5.6% at 5 years and 21.3% +/- 8.5% at 10 years for the PDCM group. CONCLUSION: RADO corrects remodeling of the fibrous skeleton of the heart, changes the spherical geometry of the left ventricle, improves the hemodynamic action of the left and right ventricles, and slows down the progression of heart failure. We recommend the RADO procedure as an important associated procedure in the surgical treatment of IDCM and as a new surgical alternative for treating the early stage of PDCM immediately after the first decompensation.

Merging national forest and national forest health inventories to obtain an integrated forest resource inventory--experiences from Bavaria, Slovenia and Sweden.

BACKGROUNDS, MATERIAL AND METHODS: To meet the demands of sustainable forest management and international commitments, European nations have designed a variety of forest-monitoring systems for specific needs. While the majority of countries are committed to independent, single-purpose inventorying, a minority of countries have merged their single-purpose forest inventory systems into integrated forest resource inventories. The statistical efficiencies of the Bavarian, Slovene and Swedish integrated forest resource inventory designs are investigated with the various statistical parameters of the variables of growing stock volume, shares of damaged trees, and deadwood volume. The parameters are derived by using the estimators for the given inventory designs. The required sample sizes are derived via the general formula for non-stratified independent samples and via statistical power analyses. The cost effectiveness of the designs is compared via two simple cost effectiveness ratios. RESULTS: In terms of precision, the most illustrative parameters of the variables are relative standard errors; their values range between 1% and 3% if the variables' variations are low (s%<80%) and are higher in the case of higher variations. A comparison of the actual and required sample sizes shows that the actual sample sizes were deliberately set high to provide precise estimates for the majority of variables and strata. In turn, the successive inventories are statistically efficient, because they allow detecting the mean changes of variables with powers higher than 90%; the highest precision is attained for the changes of growing stock volume and the lowest for the changes of the shares of damaged trees. Two indicators of cost effectiveness also show that the time input spent for measuring one variable decreases with the complexity of inventories. CONCLUSION: There is an increasing need for credible information on forest resources to be used for decision making and national and international policy making. Such information can be cost-efficiently provided through integrated forest resource inventories.

[Echocardiographic evaluation of left ventricular morphology and function in active sportsmen].

INTRODUCTION: Echocardiography is a noninvasive, reliable method for evaluation of left ventricular morphology and function. Judo and wrestling are sports characterized by intensive and high physical and isometric effort, while football is characterized by long-term physical isotonic effort. The key compensatory mechanism with both groups of sportsmen is left ventricular hypertrophy. The aim of this study is evaluate left ventricular morphology and function in a group of judo players, wrestlers and football players during competition season and their interactive comparation. MATERIAL AND METHODS: 42 judo players and wrestlers and 43 football players were examined. RESULTS: An increase in thickness of the septum and posterior wall was established in both groups of sportsmen, but the thickness was statistically more significant in judo players. On the other hand, in football players, a statistically significant left ventricular end-diastolic volume index enlargement was found, compared to reference values and compared to end-diastolic volume index in judo players and wrestlers. High left ventricular ejection fraction was established in both groups, but it was statistically significantly higher in football players. Left ventricular mass index was statistically increased in both groups, but it was higher in judo players and wrestlers.