- Email: [email protected]
One symposium not listed
1. Kim SC. Implantable defibrillator therapy: does it really prolong life? How can we prove it? Am J Cmdrol 1993;71:1213-1218. 2. Connolly S, Yusuf S. Evaluation of the implantable cardioverter defibrillator in survivors of cardiac arrest: the need for randomized trials. Am J Cardiol 199269: 959-962.
One Symposium
Not listed
I read with interest the minutes of
The American Journal of Cardiology editorial board published in the June 15, 1993 issue. Table IX represents symposia published in AJC during the year 1992. However, the symposium on Management of Heart Failure in the 1990s: A Reassessment of the Role of Digoxin Therapy, published June 4, 1992 (Am J Cardiol 1992;69: lG-154G), did not appear in this table or the text. Mihal
Gheorghiade, MD Chicago, Illinois 30 August 1993
I enjoyed reading the article on the results of percutaneous balloon mitral valvuloplasty in young adults by Rothlisberger et al.’ However, I wish to point out the questionable use throughout the text of the word “dilatation,” e.g., “balloon dilatation catheter,” “incremental dilatation with the Inoue balloon” and “dilatation has been attempted even in patients with less pliable valves.” In each case, the proper word should be dilation, not dilatation. Historically, dilatation and dilation existed as competing forms and have been used interchangeably.2 But they really should not be. According to both Dorland’s and Webster’s dictionaries, dilation is “the action of dilating or stretching” or “the state of being dilated,” while dilatation is “the condition of being stretched or dilated or stretched beyond the normal” with Webster adding: “especially as a result of disease or abnormal relaxation.“” Etymologically, dilate is from the Latin word dilatare, with the stem dilatat-and the corresponding noun dilatatio; from this comes the English word dilatation.4 But -tion is a live suffix in English, and there is no reason why it should not be added
to the English verb dilate to give di-
latiork4 Too many medical writers chose the long (and more impressive?) word when there is a choice. We read of “employ” instead of “use,” “investigation” instead of “study,” and “dilatation’ ’ instead of “dilation.” In pharmacology, a vasodilator causes dilatation, not dilation of the blood vessels; balloon valvuloplasty is a catheter technique of dilation, not dilatation of a stenotic heart valve; dilatation, not dilation of the aortic root is a common complication of Marfan syndrome; dilation, not dilatation of a stenotic valve may sometimes result in dilatation, not dilation of its annulus. I hope that these examples serve to clarify once and for all that dilation and dilatation are neither synonymous nor interchangeable. Tsung 0. Cheng, MD Washington, D.C. 14 July 1993
1. Rothlisberger C, Essop MR, Skudicky D, Skoularieis - J. Wisenbaueh - T. Sareli P. Results of nercutaneons balloon mitral valvotomy in young adults. Am 1993;72:7.3-77. J Cardiol 2. Bloom DA, Mary RN, Hinman F Jr. Dilation vs. dilatation: a brief history. J Urn/ 1992: 147: 1682. 3. Cheng TO. Dilatory matter. Lower 1993;341: 1220. 4. Hughes A. A dilation on dilatation. Lancer 1993: 341:867.
Accuracy of Nongeometric Pulsed Doppler Cardiac Output De Domenico and colleagues’ achieved a relatively disappointing correlation (r = 0.82) using our2 nongeometic method for stroke volume determination. We had reported r = 0.97.2 The authors apparently missed our extended results in a larger series, with a new regression equation for ejection rate: ejection rat6 = 491 mean flow velocity - 61 ml/s,’ although even that improvement may not have altered their results significantly. The method depends critically on accurate determination of left ventricular ejection time, and this can be difficult without technically excellent Doppler recordings and relaxed suspension of respiration. Indeed, Australian investigators4 used our method in different patients from ours or De Domenico’s, reporting r = 0.97, with r = 0.77 for the geometric method.
Perhaps the authors could reexamine their left ventricular ejection time measurements. David H. Spodick, MD, DSc Worcester, Massachusetts 26 August 1993 1. De Domenico R, Zepellini R, Gheno G, Compostella L, lavemaro A, Cucchini F. Accuracy of a new, nongeometric pulsed Doppler method in cardiac output evaluation. Am .I Cardiol 1993;72:48%491. 2. Spodick DH, Koito H. Nongeometric Doppler stroke volume determination. Am J Cardiol 1989;63:883-884. 3. Koito H, Spodick DH. Relation of left ventricular ejection rate to ejectional flow velocity. Am J Noninvas Cardiol 1989.3:22&227. 4. Sajkov D, Cowi RJ, Bradley JA, Mahar L, McEvoy RD. Validation of new pulsed Doppler echocxdiographic techniques for assessment of pulmonary hemodynamics. Chest 1993; 103:1348-1353.
Modiied Most?
Eggs -
Who Benefits
The old cliche - “Which came tist, the chicken or the egg?” may presently be more appropriate than in the past, especially since increased speculation has occurred regarding the benefits of the recently introduced, so-called ‘ ‘modified eggs.” Perhaps the question should also include who benefits most, in addition to what benefits, if any, may be achieved by their use? The parties concerned are obvious, and other than the egg itself, must include the chicken, the consumer, the retailer and the producer. The letter that physicians received from Eggland’s Best begins by stating: “Your patients may be asking you about a neti egg they have been seeing on television. . . .” Indeed they are-not only asking, but also misinterpreting all of the vaguely illustrated news media presentations. The consumers’ basic conclusion, in my experience, is that they c.m consume these eggs ad libitum with virtual disregard of a properly prescribed diet. They also feel that they therefore need not worry about increasing their cholesterol levels by eating these eggs, in contrast to their eating ordinary (generic) eggs. The patients fail to absorb the fact that a strict low-fat, low-cholesterol diet must be adhered to. They also misinterpret the media advertisement and allow themselves to believe that they can actually lower their cholesterol by eating these eggs -and it is no wonder, READERS’COMMENTS 421
One Symposium
Not listed
I read with interest the minutes of
The American Journal of Cardiology editorial board published in the June 15, 1993 issue. Table IX represents symposia published in AJC during the year 1992. However, the symposium on Management of Heart Failure in the 1990s: A Reassessment of the Role of Digoxin Therapy, published June 4, 1992 (Am J Cardiol 1992;69: lG-154G), did not appear in this table or the text. Mihal
Gheorghiade, MD Chicago, Illinois 30 August 1993
I enjoyed reading the article on the results of percutaneous balloon mitral valvuloplasty in young adults by Rothlisberger et al.’ However, I wish to point out the questionable use throughout the text of the word “dilatation,” e.g., “balloon dilatation catheter,” “incremental dilatation with the Inoue balloon” and “dilatation has been attempted even in patients with less pliable valves.” In each case, the proper word should be dilation, not dilatation. Historically, dilatation and dilation existed as competing forms and have been used interchangeably.2 But they really should not be. According to both Dorland’s and Webster’s dictionaries, dilation is “the action of dilating or stretching” or “the state of being dilated,” while dilatation is “the condition of being stretched or dilated or stretched beyond the normal” with Webster adding: “especially as a result of disease or abnormal relaxation.“” Etymologically, dilate is from the Latin word dilatare, with the stem dilatat-and the corresponding noun dilatatio; from this comes the English word dilatation.4 But -tion is a live suffix in English, and there is no reason why it should not be added
to the English verb dilate to give di-
latiork4 Too many medical writers chose the long (and more impressive?) word when there is a choice. We read of “employ” instead of “use,” “investigation” instead of “study,” and “dilatation’ ’ instead of “dilation.” In pharmacology, a vasodilator causes dilatation, not dilation of the blood vessels; balloon valvuloplasty is a catheter technique of dilation, not dilatation of a stenotic heart valve; dilatation, not dilation of the aortic root is a common complication of Marfan syndrome; dilation, not dilatation of a stenotic valve may sometimes result in dilatation, not dilation of its annulus. I hope that these examples serve to clarify once and for all that dilation and dilatation are neither synonymous nor interchangeable. Tsung 0. Cheng, MD Washington, D.C. 14 July 1993
1. Rothlisberger C, Essop MR, Skudicky D, Skoularieis - J. Wisenbaueh - T. Sareli P. Results of nercutaneons balloon mitral valvotomy in young adults. Am 1993;72:7.3-77. J Cardiol 2. Bloom DA, Mary RN, Hinman F Jr. Dilation vs. dilatation: a brief history. J Urn/ 1992: 147: 1682. 3. Cheng TO. Dilatory matter. Lower 1993;341: 1220. 4. Hughes A. A dilation on dilatation. Lancer 1993: 341:867.
Accuracy of Nongeometric Pulsed Doppler Cardiac Output De Domenico and colleagues’ achieved a relatively disappointing correlation (r = 0.82) using our2 nongeometic method for stroke volume determination. We had reported r = 0.97.2 The authors apparently missed our extended results in a larger series, with a new regression equation for ejection rate: ejection rat6 = 491 mean flow velocity - 61 ml/s,’ although even that improvement may not have altered their results significantly. The method depends critically on accurate determination of left ventricular ejection time, and this can be difficult without technically excellent Doppler recordings and relaxed suspension of respiration. Indeed, Australian investigators4 used our method in different patients from ours or De Domenico’s, reporting r = 0.97, with r = 0.77 for the geometric method.
Perhaps the authors could reexamine their left ventricular ejection time measurements. David H. Spodick, MD, DSc Worcester, Massachusetts 26 August 1993 1. De Domenico R, Zepellini R, Gheno G, Compostella L, lavemaro A, Cucchini F. Accuracy of a new, nongeometric pulsed Doppler method in cardiac output evaluation. Am .I Cardiol 1993;72:48%491. 2. Spodick DH, Koito H. Nongeometric Doppler stroke volume determination. Am J Cardiol 1989;63:883-884. 3. Koito H, Spodick DH. Relation of left ventricular ejection rate to ejectional flow velocity. Am J Noninvas Cardiol 1989.3:22&227. 4. Sajkov D, Cowi RJ, Bradley JA, Mahar L, McEvoy RD. Validation of new pulsed Doppler echocxdiographic techniques for assessment of pulmonary hemodynamics. Chest 1993; 103:1348-1353.
Modiied Most?
Eggs -
Who Benefits
The old cliche - “Which came tist, the chicken or the egg?” may presently be more appropriate than in the past, especially since increased speculation has occurred regarding the benefits of the recently introduced, so-called ‘ ‘modified eggs.” Perhaps the question should also include who benefits most, in addition to what benefits, if any, may be achieved by their use? The parties concerned are obvious, and other than the egg itself, must include the chicken, the consumer, the retailer and the producer. The letter that physicians received from Eggland’s Best begins by stating: “Your patients may be asking you about a neti egg they have been seeing on television. . . .” Indeed they are-not only asking, but also misinterpreting all of the vaguely illustrated news media presentations. The consumers’ basic conclusion, in my experience, is that they c.m consume these eggs ad libitum with virtual disregard of a properly prescribed diet. They also feel that they therefore need not worry about increasing their cholesterol levels by eating these eggs, in contrast to their eating ordinary (generic) eggs. The patients fail to absorb the fact that a strict low-fat, low-cholesterol diet must be adhered to. They also misinterpret the media advertisement and allow themselves to believe that they can actually lower their cholesterol by eating these eggs -and it is no wonder, READERS’COMMENTS 421