Stress-induced Defects Research Articles

Material Effects on Stress-Induced Defect Generation in Trenched Silicon-on-Insulator Structures

We have investigated the influence of the material properties of the silicon device layer on the generation of defects, and in particular slip dislocations, in trenched and refilled fusion-bonded silicon-on-insulator structures. A strong dependence of the ease of slip generation on the type of dopant species was observed, with the samples falling into three basic categories; heavily boron-doped silicon showed ready slip generation, arsenic and antimony-doped material was fairly resistant to slip, while silicon moderately or lightly doped with phosphorous or boron gave intermediate behavior. The observed behavior appears to be controlled by differences in the dislocation generation mechanism rather than by dislocation mobility. The introduction of an implanted buried layer at the bonding interface was found to result in an increase in slip generation in the silicon, again with a variation according to the dopant species. Here, the greatest slip occurred for both boron and antimony-implanted samples. The weakening of the implanted material may be related to the presence of a band of precipitates observed in the silicon near the bonding interface. © 2001 The Electrochemical Society. All rights reserved.

Identification of hemodynamically significant restenosis after percutaneous transluminal coronary angioplasty in acute myocardial infarction by transesophageal dobutamine stress echocardiography and comparison with myocardial single photon emission computed tomography.

Beside thrombolysis, percutaneous transluminal coronary angioplasty (PTCA) has become a well-established treatment for acute myocardial infarction. However, restenosis occurs in approximately 15%-40% of patients. Despite a frequently occurring infarct-related regional systolic dysfunction at rest, the identification of hemodynamically relevant restenosis seems important in terms of risk stratification, adequate treatment, and possible improvement of prognosis in these patients. This study was designed to assess the role of transesophageal dobutamine stress echocardiography and myocardial scintigraphy for identification of hemodynamically significant restenosis after PTCA for acute myocardial infarction. Multiplane transesophageal stress echocardiography (dobutamine 5, 10, 20, 30, and 40 micrograms/kg per min) studies and myocardial single photon emission computed tomography (SPECT) studies were performed in 40 patients, all of whom underwent PTCA in the setting of acute myocardial infarction > or = 4 months prior to the test. Repeated coronary angiography was performed in all study patients who showed stress-induced perfusion defects or wall-motion abnormalities, or both. Significant restenosis (> or = 50%) was angiographically found in 15 (37.5%) of 40 patients. Of these 15 patients, transesophageal dobutamine stress echocardiography identified restenosis in 12 (80%) and myocardial SPECT in 14 (93%), yielding diagnostic agreement in 70% of patients. Echocardiographic detection of restenosis was based mainly on a biphasic response to increasing doses of dobutamine. Sensitivity and specificity for identification of hemodynamically relevant restenosis in individual patients was 80% and 92%, respectively for dobutamine stress echocardiography versus 93% and 68% for myocardial SPECT. Both transesophageal dobutamine stress echocardiography and myocardial SPECT were highly sensitive in identifying significant restenosis after PTCA for acute myocardial infarction. Therefore, either test, as a single diagnostic tool or especially if performed together, are clinically valuable alternatives to coronary angiography for the detection of restenosis after PTCA for acute myocardial infarction.

Myocardial Blood Flow and Flow Reserve After Coronary Reimplantation in Patients After Arterial Switch and Ross Operation

Coronary reimplantation is used in therapy for congenital heart disease, such as in the arterial switch (ASO) and Ross operations. The adequacy of myocardial perfusion may remain a matter of concern. The aim of the present study was to stratify the effect of coronary reimplantation on myocardial perfusion and to highlight the clinical relevance of any attenuation in myocardial perfusion. A total of 21 children with transposition of the great arteries at a mean interval of 11.2+/-2.9 years after ASO and 9 adolescents at a mean interval of 4.2+/-2.1 years after the Ross procedure were investigated. All patients were asymptomatic and had a normal exercise capacity. On stress echocardiography, 2 of the ASO patients had dyskinetic areas within the left ventricular myocardium, and 5 had adenosine-induced perfusion defects on positron emission tomography. No coronary obstruction was detected on coronary angiography in any patient, but a common finding was right coronary dominance and a small caliber of the distal part of the left anterior descending artery. Coronary flow reserve (CFR) was significantly reduced in all patients after ASO when compared with 10 normal healthy volunteers (age, 25.6+/-5.3 years). CFR was normal in the 9 patients who had the Ross operation (age, 19.2+/-7.6 years); exercise-induced perfusion defects were not detected in the Ross patients. Children after ASO are asymptomatic, without clinical signs of coronary dysfunction. In contrast to patients who had the Ross operation, stress-induced perfusion defects and an attenuated CFR were documented. The prognostic implications of these findings and the clinical consequences are unclear; nevertheless, close clinical follow-up of ASO patients is mandatory.

Random telegraph signal noise mechanisms in reverse base current of hot carrier-degraded submicron bipolar transistors: Effect of carrier trapping during stress on noise characteristics

We investigate physical mechanisms of random telegraph signal (RTS) noise in reverse base current of hot carrier-degraded polysilicon emitter bipolar junction transistors. RTS noise, analyzed in the time domain, is studied as a function of reverse base-emitter bias, temperature, and additional reverse-bias stress. Two-level RTS with a relative amplitude as high as 100% is observed at room temperature. The RTS amplitude varies exponentially with the applied reverse base-emitter voltage and depends weakly on temperature. The additional hot carrier stress is observed to induce changes in RTS amplitude and mean pulse widths (independent or correlated), and a disappearance/reappearance of the RTS fluctuations. The results are interpreted by a model where the RTS noise is caused by fluctuations of generation-recombination (g-r) parameters (i.e., capture cross sections and energy position in the gap) of a stress-induced complex bistable defect (CBD) at the Si/SiO2 interface. The complex defect is assumed to be either a two-state fast interface state or an interacting pair of a fast interface state with a slow neighboring border trap. The RTS amplitude is well explained by fluctuations in a single-defect electric-field-enhanced g-r rate between a finite value and naught. The RTS amplitude-bias characteristics and their temperature dependence are satisfactorily accounted for by an expression for a phonon-assisted tunneling current via a single deep-level state. The model parameters are the g-r parameters of the defect and its spatial position in the base-emitter p–n junction. The stress-induced changes in the RTS noise are attributed to the influence of log-time trapping of hot carriers on border states laying in the vicinity of a CBD center. The charged border traps interact with a CBD, changing both its g-r parameters and the RTS switching behavior. The variations in RTS parameters are related to the microscopic nature of the interaction and are discussed for the two types of the CBDs.

Reliability monitoring and screening issues with ultrathin gate dielectric devices

Installing appropriate quality and reliability monitoring procedures for ultrathin gate dielectrics is of utmost importance. Ensuring the integrity of VLSI products and unwavering customer satisfaction are the top priorities. Several key strategic avenues have been pursued to accomplish those priorities. First, basic tool and processing monitoring and measurement procedures are put into place for categories such as metallic contamination, foreign material control, and semiconductor stress-induced defects such as dislocations and stacking faults. Second, a new voltage ramp breakdown test, especially designed for ultrathin gate dielectrics, is installed based on a one-to-one correlation with TDDB testing, from which a fail criterion for minimum required breakdown voltage of the distribution is defined. The voltage ramp test is capable of identifying weaknesses or failures for either the intrinsic or extrinsic parts of the failure rate distribution. The voltage ramp test is installed at various processing levels starting with post silicide probing (PSP) utilizing very large guide area/perimeter structures (area>0.5 mm/sup 2//chip, and perimeter >1 meter/chip) with both shallow trench isolation (STI) and diffusion perimeters. Third, a voltage breakdown test is put into place for in-line charging effects at various processing levels. The structure used employs minimum polysilicon linewidth devices and contains a nonantenna reference device as well as a variety of antenna structures for various design levels starting with polysilicon and including all via, contact, and metal levels. Such a dielectric breakdown test for charging is also well correlated with other device failure mechanisms such as hot carriers. Fourth, a new methodology was adopted based on a one-to-one quantitative correlation between lifetime as derived from accelerated TDDB testing and the initial value of gate dielectric leakage at a predetermined value(s) of voltage(s). This excellent correlation was verified for gate dielectric thickness ranging from 10 nm to below 3 nm. Fifth, at product level, the standby I/sub ddQ/ and I/sub dd/ currents are measured and tracked for changes under accelerated stress conditions for numerous scan chains. This measurement is a good indicator of the defect level on products and the overall impact of ultrathin gate dielectric on product yield and reliability. Finally, various types of voltage screens and burn-in with duration ranging from few seconds to several hours (at wafer and packaged levels) can be implemented (at least on a selected set of products) to monitor and/ improve the reliability of the final assembly. Accordingly, the body of the text discusses the following topics: monitoring of gate dielectric reliability, monitoring of device stability, monitoring of thin dielectric initial leakage, semiconductor stress induced defects, metallic contamination, and reliability of integrated circuits.

Assessment of the effect of revascularization early after CABG using ECG-gated perfusion single-photon emission tomography.

When an arterial graft is used, reversible perfusion defects on single-photon emission tomography (SPET) perfusion images are occasionally observed early after coronary artery bypass graft surgery (CABG), owing to the restricted flow capacity. The purpose of this study was to determine whether the functional information obtained with electrocardiography (ECG)-gated perfusion SPET could be helpful in evaluating the effect of revascularization early after CABG. Twenty-three patients (18 men and 5 women, mean age 65+/-9 years) underwent stress/re-injection thallium-201 ECG-gated SPET before and 4 weeks after CABG (13 with exercise and 10 with dipyridamole). Patency of all grafts was confirmed by coronary angiography 1 month after CABG. Cardiac functional data including the left ventricular ejection fraction (LVEF) and the transient ischaemic dilatation (TID) ratio were analysed using a commercially available automated program. The conventional stress and re-injection tomograms were interpreted by means of a five-point scoring system in a nine-segment model. Stress-induced reversible 201Tl perfusion defects were present in 64% of the myocardial segments bypassed by patent arterial grafts, in contrast to 42% of the myocardial segments bypassed by patent venous grafts (chi2=7.8, P=0.005). Of the 23 patients, 12 showed improvement in summed ischaemic scores (group 1), while 11 had no change or deterioration (group 2), although all grafts were patent on postoperative catheterization. The TID ratio improved in both group 1 and group 2 before and after CABG (1.14+/-0.13 vs 0.99+/-0.07, P=0.001 and 1.09+/-0.07 vs 0.94+/-0.05, P=0.002, respectively). However, LVEF did not significantly improve in group 1 or group 2 after CABG (42.5%+/-9.9% vs 47.5%+/-11.8%, and 52.1%+/-7.5% vs 53.1%+/-5.9%, respectively). Perfusion imaging or LVEF assessment is of limited value early after CABG. The TID ratio obtained with ECG-gated perfusion SPET may be a useful marker to evaluate the effect of revascularization early after surgery.

Deformation microfabrics of clay gouge, Lewis Thrust, Canada: a case for fault weakening from clay transformation

Abstract A sequence of bentonite and shale samples in a gouge zone of the Lewis Thrust (Alberta, Canada) that display increasing degree of transformation of clay minerals toward the hanging wall of the thrust has been studied by X-ray diffraction (XRD), X-ray texture goniometry (XTG), scanning electron microscopy (SEM), and transmission and analytical electron microscopy (TEM-AEM), to examine the relations among mineral transformations, microfabrics and fault zone properties. TEM images of authigenic clays show abundant smectite in shale away from the hanging wall, characterized by anastomosing layers with an average orientation that parallels bedding, coexisting with uncommon R 1 illite-smectite (I-S). In the sample nearest the hanging wall, by contrast, the dominant clay is mixed-layered, illite-rich ilite-smectite ( R 1 I-S), coexisting with discrete illite, occurring in individual packets of relatively straight layers with well-defined boundaries. Deformed clay packets are common. Pore space, where packets intesect at high angles to one another and to bedding, is abundant ( c. 25%). The microfabric and proportion of illite of intermediate samples are transitional to these end-members. Inter-layered bentonite samples show properties that are similar to those of shale. TEM observations are supported by quantification of the fabrics using XTG, which shows that the intensity of clay preferred orientation decreases significantly with increasing illitization. These relations imply that faulting was the cause of mineral transformations and formation of secondary pore space. The illitization reaction rate was enhanced both by stress-induced defects in clays, and by increased water/rock ratio resulting from deformation-related pore space, resulting in lowering of the effective stress. The deformation-enhanced reaction thus created a positive feedback for further faulting in clay gouge, leading to enhanced weakening of the fault zone.

Prognostic value of myocardial perfusion tomographic imaging in patients after percutaneous transluminal coronary angioplasty.

The authors assessed the prognostic value of stress myocardial perfusion tomographic imaging (SPECT) in patients with recurrent angina or inconclusive results of exercise electrocardiographic tests after successful percutaneous transluminal coronary angioplasty (PTCA). After PTCA, 70 patients (54 men, 16 women; 41 after myocardial infarction; mean age, 56 +/- 9 years) underwent TI-201 or Tc-99m sestamibi SPECT studies. SPECT patterns were divided into normal (n = 25), fixed defects (n = 15), and reversible or combined fixed plus reversible defects (n = 30). A cardiac event was defined as either cardiac death, nonfatal myocardial infarction, or unstable angina requiring further revascularization. During an average follow-up of 25 +/- 10 months, two patients had severe outcomes (one cardiac death and one nonfatal myocardial infarction), and revascularization was required in 13 patients. In patients with normal SPECT or fixed defects, the annual event rate was low (1.2%), with only one revascularization. In patients with reversible or combined defects, the annual event rate was significantly greater (22.4%; chi square = 17.32, P = 0.00003). Normal perfusion or fixed defects predict a benign prognosis in patients after successful PTCA. The presence of stress-induced reversible defects appears to be the best predictor of future cardiac events.

Hydrogen and its Complexes in Silicon

In this study the technique of Laplace transform (high resolution) deep level transient spectroscopy combined with the uniaxial stress method has been used to study a symmetry and the defect reconfiguration kinetics (the stress induced alignment) of some forms of hydrogen-related centres. We have confirmed the trigonal symmetry of the defect related to the isolated bond centred hydrogen. When hydrogen decorates the vacancy-oxygen pair (the A centre) the apparent defect orthorhombic symmetry is not lowered as a result of a very high hydrogen jumping rate between two unsaturated broken bonds of the vacancy. We also show that the stress-induced defect alignment in some cases can be related to the same microscopic mechanism of the hydrogen motion as it is for the diffusion process. PACS numbers: 68.55.Ln, 71.55.Cn, 73.40.Lq

Molecular-dynamics simulation of thermal stress at the (100) diamond/substrate interface: Effect of film continuity

We propose an approach to modeling the mismatch-induced residual thermal stress in microscopic film/substrate systems using an atomistic simulation. Criteria for choosing model parameters necessary for successful prediction of macroscopic stress-induced phenomena (quantitatively characterized by a reduction in binding energy) are discussed. The model is implemented in a molecular-dynamics simulation of compressive thermal stress at the (100) diamond/substrate interface. The stress-induced binding-energy reduction obtained in the simulation is in good agreement with our model. The effect of sample size and local amorphization on obtained stress values is considered and the maximum on the stress-strain dependence is explained in terms of the ``thermal spike'' behavior. Similarly to results from plasma deposition experiments, the dominant stress-induced defect is found to be the tetrahedrally coordinated amorphous carbon (ta-C). At higher film continuities these defects are partially converted into $〈100〉$ split interstitials; at lower stresses transformation of a small fraction of ta-C into the graphitic ${\mathrm{sp}}^{2}$ configuration takes place. The penetration depths and the distribution of the stress-induced defects are determined. The influence of residual stress on diamond thermal conductivity is studied; defects formed due to stress are shown to reduce the thermal conductivity, this effect being partially offset by the counteracting influence of stress on the phonon density of states.

Contributions of nuclear cardiology to diagnosis and prognosis of patients with coronary artery disease.

In the past decade, significant advances have been made in the ability to image the heart with radionuclide tracers under stress and resting conditions in patients with suspected or known coronary artery disease (CAD) for the detection of ischemia, determination of prognosis, assessment of myocardial viability, preoperative risk assessment for patients undergoing noncardiac surgery, and evaluation of the efficacy of revascularization in patients undergoing coronary artery bypass surgery or an interventional procedure.1 For many years, planar imaging and SPECT with 201Tl constituted the only scintigraphic techniques available for detecting CAD and assessing prognosis in patients undergoing stress perfusion imaging. The major limitation of 201Tl scintigraphy is the high false-positive rate observed in many laboratories, which is attributed predominantly to image attenuation artifacts and variants of normal that are interpreted as defects consequent to a significant coronary artery stenosis. Although quantification of 201Tl images improves specificity, the false-positive rate remains problematic, particularly in women and in obese patients. Breast attenuation artifacts in women are sometimes difficult to distinguish from perfusion abnormalities secondary to inducible ischemia or myocardial scar. In recent years, new 99mTc-labeled perfusion agents have been introduced into clinical practice to enhance the specificity of SPECT and to provide additional information regarding regional and global left ventricular systolic function via ECG gating of images. It was immediately apparent that the quality of images obtained with these new 99mTc-labeled radionuclides was superior to that of images obtained with 201Tl because of the more favorable physical characteristics of 99mTc imaging with a gamma camera. With 99mTc, doses of ≈10 to 20 times higher than those that are feasible with 201Tl can be administered, yielding images with higher count density. 99mTc demonstrates less scatter and attenuation than 201Tl, which is associated …

Prognostic value of thallium-201 single-photon emission computed tomography for patients with multivessel coronary artery disease after revascularization (the Emory Angioplasty versus Surgery Trial [EAST

The aim of this study was to investigate the relation between reversible thallium single-photon emission computed tomography (SPECT) myocardial perfusion defects at 1-year after revascularization and quantitative indexes in Emory Angioplasty versus Surgery Trial (EAST) and outcomes 3 years after revascularization in 336 patients. EAST was a randomized controlled trial assessing cardiac outcomes for angioplasty versus bypass surgery for patients with multivessel coronary artery disease. During this prospective trial, a substudy included the evaluation of the prognostic value of reversible defects on quantitative thallium SPECT. At 1-year after revascularization, 336 patients underwent SPECT thallium-201 stress myocardial perfusion and 3-hour delayed imaging. Subsequent events, percutaneous transluminal coronary angioplasty, coronary artery bypass graft surgery, myocardial infarction, and death, were recorded at 3 years. A stress-induced reversible thallium-201 defect was defined using a quantitative index of a reversibility score >30% and severity score >500. Reversible defects were observed more frequently in the percutaneous transluminal coronary angioplasty than in the coronary artery bypass graft surgery treatment groups (46% vs 27%, p <0.001). A total of 123 patients had stress-induced, reversible thallium defects and more events than patients with other perfusion results (freedom from all events was 81.3% vs 94% [p <0.001], and freedom from myocardial infarction and death 88.3% vs 95.5% [p = 0.031]). Quantitative thallium SPECT at 1 year after revascularization risk stratifies patients as to their likelihood of major cardiac outcomes.

Gated Tc-99m sestamibi SPECT versus stress-rest SPECT in detecting coronary artery disease: correlation with coronary angiography in patients without myocardial infarction.

It is possible to simultaneously evaluate wall thickening and perfusion abnormalities with radionuclide techniques that use tracers such as Tc-99m MIBI. We presumed that detection of wall thickening by gated MIBI SPECT imaging in the presence of a stress-induced perfusion defect correlates with reversibility of that defect on resting images. Therefore, the aim of our study was to analyze, in patients without myocardial infarction, resting wall thickening and stress perfusion imaging as an alternative to conventional stress-rest imaging. The patients (n = 44) underwent an exercise (n = 37) or pharmacologic (n = 7) stress protocol. All patients had previous coronary angiography within 3 months. Stress-rest MIBI SPECT and gated MIBI SPECT studies were analyzed by visual scoring. The sensitivity and specificity of segmental analysis of both stress-rest MIBI SPECT perfusion and gated MIBI SPECT studies for the overall detection of coronary artery disease were, respectively, 71% and 96%. For patient evaluation for detection of coronary artery disease, stress-rest MIBI SPECT perfusion and gated MIBI SPECT studies showed a sensitivity rate of 96% for both and specificity rates of 84% and 79%, respectively. Our data revealed close agreement between reversible perfusion defects on stress-rest MIBI SPECT scans and significant wall thickening on gated MIBI SPECT stress images in patients without previous myocardial infarction (95%). Gated MIBI SPECT stress, without resting studies, which provide an assessment of wall motion and wall thickening, potentially allows stress defect reversibility to be evaluated in patients without previous myocardial infarction.

Diagnostic and prognostic value of vasodilator stress echocardiography in asymptomatic Type 2 diabetic patients with positive exercise thallium scintigraphy: a pilot study.

To assess the diagnostic and prognostic value of vasodilator stress echocardiography in Type 2 diabetic patients with positive exercise perfusion scintigraphy. Of an initial cohort of 50 asymptomatic Type 2 diabetic patients undergoing exercise single photon emission computed tomography (SPECT) thallium scintigraphy, 24 had a positive thallium scan, with a reversible perfusion defect. All these 24 underwent high dose (up to 0.84 mg/kg in 10 min) dipyridamole echocardiography and coronary angiography independently of stress echocardiography results. All patients were then followed for 61+/-22 months. Coronary angiography showed normal coronary arteries in 11 patients and significant (> 50% visually assessed diameter reduction in a major vessel) coronary artery disease in 13. Stress echocardiography showed 92% sensitivity and 100% specificity for non-invasive detection of coronary artery disease. During follow-up, five patients experienced cardiac events: heart failure in one, angina with subsequent revascularization in two, and myocardial infarction in two. Event-free survival was 100% in the 12 patients with negative and 58% in the 12 patients with positive stress echocardiography (P = 0.08 by Mantel-Cox test). In asymptomatic Type 2 diabetic patients with stress-induced perfusion defects, vasodilator stress echocardiography is an excellent diagnostic and prognostic tool proven with long-term follow-up.

Comparison of exercise, dipyridamole, adenosine, and dobutamine stress with the use of Tc-99m tetrofosmin tomographic imaging

Purpose. The purpose of this study was to compare defect extent and severity and myocardial uptake with exercise and pharmacologic stress with technetium-99m (Tc-99m) tetrofosmin tomographic myocardial perfusion imaging. Background. Detection of stress-induced myocardial perfusion defects depends on both a disparity in blood flow between normal and stenotic vessels and the extraction fraction and linearity of myocardial uptake of the tracer. There are limited clinical data for exercise or pharmacologic stress with Tc-99m tetrofosmin tomographic myocardial perfusion imaging. Methods. Thirty-one patients with coronary artery disease and 7 with a <5% likelihood of coronary artery disease underwent on separate days Tc-99m tetrofosmin single-photon emission computed tomographic imaging at rest and after exercise, dipyridamole, adenosine, and dobutamine stress. Images were interpreted by a blinded consensus of 3 experienced readers with a 17-segment model and 5-point scoring system. Results. Compared with exercise, the summed stress score was smaller with dipyridamole ( P <.01), and the reversibility score was smaller with both dipyridamole ( P <.01) and dobutamine ( P <.05), whereas the number of abnormal and reversible segments was less with both dipyridamole ( P <.01 and P <.001, respectively) and dobutamine (both P <.05). No significant differences were found in the summed stress or reversibility scores and the number of abnormal or reversible segments between exercise and adenosine. Conclusions. Compared with exercise, defect extent, severity, and reversibility are less with dipyridamole and dobutamine with Tc-99m tetrofosmin single photon emission computed tomographic imaging.

Amino-terminal phosphorylation of c-Jun regulates stress-induced apoptosis and cellular proliferation.

c-Jun is a major component of the heterodimeric transcription factor AP-1 and is essential for embryonic development, as fetuses lacking Jun die at mid-gestation with impaired hepatogenesis and primary Jun-/- fibroblasts have a severe proliferation defect and undergo premature senescence in vitro. c-Jun and AP-1 activities are regulated by c-Jun N-terminal phosphorylation (JNP) at serines 63 and 73 through Jun N-terminal kinases(JNKs). JNP is thought to be required for the anti-apoptotic function of c-Jun during hepatogenesis, as mice lacking the JNK kinase SEK1 exhibit liver defects similar to those seen in Jun-/- fetuses. To investigate the physiological relevance of JNP, we replaced endogenous Jun by a mutant Jun allele with serines 63 and 73 mutated to alanines (Jun(tm1wag); hereafter referred to as JunAA). Here we show that primary JunAA fibroblasts have proliferation- and stress-induced apoptotic defects, accompanied by reduced AP-1 activity. JunAA mice are viable and fertile, smaller than controls and resistant to epileptic seizures and neuronal apoptosis induced by the excitatory amino acid kainate. Primary mutant neurons are also protected from apoptosis and exhibit unaltered JNK activity. Our results provide evidence that JNP is dispensable for mouse development, and identify c-Jun as the essential substrate of JNK signalling during kainate-induced neuronal apoptosis.

Formation of high-conductivity NiSi 2 layers on Si at zero-mismatch temperature by high-current Ni-ion implantation

and Si lattices at 380 °C, which was defined as zero-mismatch temperature. The implantation was conducted with a metal vapor vacuum arc (MEVVA) ion implanter at an extraction voltage of 45 kV. Based on a thermal conduction estimation, a temperature rise of 380 °C required the Ni-ion current density to be 35 μA/cm2. For the Si(111) wafers, the high conducting NiSi2 layers were indeed directly formed after Ni-ion implantation with this specific current density to a normal dose of 2×1017 ions/cm2 and the resistivity was as low as 9 μΩ cm. For the Si(111) wafers pre-covered with a 10-nm Ni overlayer, the resistivity of the NiSi2 layers obtained under the same conditions decreased down to about 6 μΩ cm. The superior electrical property of the NiSi2 was thought to be related to its formation temperature, i.e. at a zero-mismatch temperature of 380 °C, which resulted in minimizing the stress and stress-induced defects involved in its formation as well as cooling process.

The noninvasive prediction of cardiac mortality in men and women with known or suspected coronary artery disease

PURPOSE: The association between myocardial perfusion imaging defects and cardiac mortality in women is undefined. We examined whether myocardial perfusion imaging predicted cardiac mortality in men and women and compared this with other variables influencing prognosis. SUBJECTS AND METHODS: Six academic institutions with high-volume nuclear cardiology laboratories consecutively studied 5,009 men aged 62 ± 12 years (mean ISD) and 3,402 women aged 66 ± 11 years with symptomatic known or suspected coronary artery disease undergoing exercise (n = 7,486) or pharmacologic stress (n = 925) myocardial perfusion imaging. A pretest clinical risk index was calculated from age, history of myocardial infarction, diabetes, hypertension, and hypercholesterolemia. Myocardial perfusion images were analyzed for stress-induced defects or any defect in the territories of the three major coronary arteries. RESULTS: Stress-induced perfusion defects were seen in 39% of men and 25% of women ( P = 0.0001). Extensive stress-induced or fixed defects (>2 vascular territories) were less common in women than men (10% vs 19%, and 4% vs 18%, both P = 0.0001). During a mean of 2.4 ± 1.5 years of follow-up, 143 patients died of cardiac causes. The clinical risk index and number of territories with perfusion defects were associated with cardiac mortality in women and men. In women undergoing exercise myocardial perfusion imaging, the number of abnormal territories remained the strongest correlate of mortality after adjustment for exercise variables. CONCLUSIONS: The results of myocardial perfusion imaging are important, independent predictors of survival in both women and men.

Stress-induced reversible and mild-to-moderate irreversible thallium defects: are they equally accurate for predicting recovery of regional left ventricular function after revascularization?

In patients with coronary artery disease, stress-redistribution-reinjection thallium scintigraphy provides important information regarding myocardial ischemia and viability. Although both reversible and mild-to-moderate irreversible thallium defects retain metabolically active, viable myocardium, we hypothesized that stress-induced reversible thallium defects may better differentiate reversible from irreversible regional left ventricular dysfunction after revascularization. Twenty-four patients with chronic coronary artery disease underwent prerevascularization and postrevascularization exercise-redistribution-reinjection thallium single photon emission CT, gated MRI, and radionuclide angiography. After revascularization, mean left ventricular ejection fraction increased from 30+/-9% to 37+/-13% at rest (P<0.001). Before revascularization, abnormal contraction at rest was observed in 56 of 110 reversible and 20 of 37 mild-to-moderate irreversible thallium defects (51% and 54%, respectively). After revascularization, regional contraction improved in 44 of 56 reversible compared with 6 of 20 mild-to-moderate irreversible thallium defects (79% and 30%, respectively; P<0.001). The final thallium content (maximum tracer uptake on redistribution-reinjection images) was significantly higher in regions with reversible defects that improved than in those that did not improve after revascularization (86+/-16% versus 66+/-9%, P<0.001). In contrast, final thallium content was similar in regions with mild-to-moderate irreversible defects that improved and in those that did not improve after revascularization (69+/-9% versus 65+/-10%, P=NS). Furthermore, when asynergic regions were grouped according to the final thallium content, at 60% threshold value, functional recovery was observed in 83% of regions with reversible defects compared with 33% of regions with mild-to-moderate irreversible defects (P<0.001). These findings suggest that although both reversible and mild-to-moderate irreversible thallium defects after stress retain viable myocardium, the identification of reversible thallium defect on stress in an asynergic region more accurately predicts recovery of function after revascularization. Even at a similar mass of viable myocardial tissue (as reflected by the final thallium content), the presence of inducible ischemia is associated with an increased likelihood of functional recovery.

Assessment of myocardial viability: Dobutamine echocardiography and thallium-201 single-photon emission computed tomographic imaging predict the postoperative improvement of left ventricular function after bypass surgery

The aim of this study was to evaluate the usefulness of dobutamine echocardiography and quantitative thallium-201 single photon emission computed tomography myocardial scintigraphy with reinjection in the detection of viable myocardium in patients with coronary artery disease and reduced left ventricular function, which will improve after aortocoronary bypass surgery. Forty-eight patients (47 men, aged 61 ± 6 years) with angiographically documented reduced left ventricular function (ejection fraction 35 ± 14, 63% with chronic transmural myocardial infarction) were examined by dobutamine two-dimensional echocardiography (before and during low dosage), 201Tl , and gated radionuclide ventriculography before and 3 ± 2 months after aortocoronary bypass surgery. Four of 55 areas classified viable before operation were revascularized inadequately and discarded. Global left ventricular ejection fraction at rest rose from 35% ± 14% before operation to 40% ± 13% ( p < 0.05) after operation. Stress-induced perfusion defects involved 40% ± 19% of the left ventricle circumference after stress and showed a significant reduction of size to 23% ± 14% ( p < 0.01) at rest, 4 hours later, and after reinjection. This value fell to 16% ± 12% ( p < 0.05) 3 months after aortocoronary bypass surgery. We conclude that both dobutamine echocardiography (sensitivity 95%, specificity 80%, positive predictive value 87%, negative predictive value 88%) and 201Tl studies (sensitivity 87%, specificity 98%, positive predictive value 97%, negative predictive value 93%) are suitable and comparable accurate methods for predicting improvement in systolic function 3 months after revascularization in a selected population with a high prevalence of viable but hypokinetic or akinetic myocardium. (Am Heart J 1998;136:463-75.)