Transluminal balloon angioplasty, stents, and atherectomy

Arterial bypass grafting for occlusive disease is still considered the gold standard in the treatment of arterial occlusive disease. However, less invasive methods are available for select patients. Percutaneous balloon angioplasty has been shown to be effective in focal iliac artery stenosis, with patency rates of 50% to 90% at 5 years. Patency rates for femoropopliteal lesions are generally less than 50% at 2 years. Complications seen with balloon angioplasty often can be treated with arterial stents. Stents can be categorized into balloon-expandable, which provide a rigid scaffold to support the artery, self-expanding, which exert radial force to resist external compression, and thermal expanding stents, which allow for the use of a smaller introducer sheath. Another treatment option is atherectomy, in which the offending lesion is removed instead of fracturing and dilating the lumen. Although overall initial results of atherectomy have not been favorable, short lesions with eccentric atheroma or intimal hyperplasia, such as those seen in dialysis access fistulas or vein graft stenoses, may respond well.     

Aldosterone and dexamethasone stimulate calcineurin activity through a transcription-independent mechanism involving steroid receptor-associated heat shock proteins

1. PD 81,723 has been shown to enhance binding of adenosine to A1 receptors by stabilizing G protein-receptor coupling ('allosteric enhancement'). Evidence has been provided that in the perfused hearts and isolated atria PD 81,723 causes a sensitization to adenosine via this mechanism. 2. We have studied the effect of PD 81,723 in guinea-pig isolated atrial myocytes by use of whole-cell measurement of the muscarinic K+ current (I[K(ACh)]) activated by different Gi-coupled receptors (A1, M2, sphingolipid). PD 81,273 caused inhibition of I[K(ACh)] (IC50 approximately 5 microM) activated by either of the three receptors. Receptor-independent I[K(ACh)] in cells loaded with GTP-gamma-S and background I[K(ACh)], which contributes to the resting conductance of atrial myocytes, were equally sensitive to PD 81,723. At no combination of concentrations of adenosine and PD 81,723 could an enhancing effect be detected. 3. The compound was active from the outside only. Loading of the cells with PD 81,723 (50 microM) via the patch pipette did not affect either I[K(ACh)] or its sensitivity to adenosine. We suggest that PD 81,723 acts as an inhibitor of inward rectifying K+ channels; this is supported by the finding that ventricular I(K1), which shares a large degree of homology with the proteins (GIRK1/GIRK4) forming I[K(ACh)] but is not G protein-gated, was also blocked by this compound. 4. It is concluded that the functional effects of PD 81,723 described in the literature are not mediated by the A1 adenosine receptor-Gi-I[K(ACh)] pathway.     

Time series modeling and spectrum analysis for chatter mode in endmilling dynamics

To analyze the chatter mechanics, the power spectrum of a time series method was analyzed by considering cutting and structural dynamics. In this study, several time series models such as AR (burg, least square, yule walker, geometric lattice, instrument variable), ARX (arx, iv4), ARMAX, ARMA, Box Jenkins, Output Error were modeled and compared with one another. Finally, it was proved that arx, armax and iv4 are more desirable and reliable algorithms than the others for the calculation of the chatter mode in the endmilling operation. The cutting forces Fx and Fz have more powerful effects on the chatter than Fy in the sense that there is no shifting or pseudo mode in the power spectrum.     

Effect of sodium nitroprusside on compound action potential thresholds in the gerbil cochlea

OBJECTIVE: Trials that do not allow rejection of the null hypothesis of no treatment effect may have had an inappropriate design. Trials are virtually never assessed for correlation between responses to different treatment modalities. METHODS: Using a hypothetical example and several published studies we examine the influence of correlation levels between treatment modalities on the sensitivity of testing. RESULTS: The level of correlation between responses to different treatment modalities is a major determinant of the sensitivity both of crossover and parallel group clinical trials. CONCLUSIONS: It is very relevant to assess a priori correlation levels between responses to the different treatment modalities of a trial. If a negative correlation is anticipated, a crossover design is likely to lack sensitivity. If a positive correlation is anticipated a parallel-group design seems less appropriate, because it would lack the extra sensitivity of accounting for the positive correlation. Both designs would seem suitable for approximately zero correlations (e.g. comparison vs baseline or vs placebo under the assumption that the number of placebo responders is negligible.     

Acquired autoimmune thrombocytopenia post-bone marrow transplantation for severe combined immunodeficiency

Children with severe combined immunodeficiency (SCID) have profoundly diminished humoral and cellular immunity resulting in death during infancy unless immune reconstitution occurs by bone marrow transplantation (BMT). Thrombocytopenia post-bone marrow transplantation can be seen in relation to infection, graft-versus-host disease (GVHD) and rarely, as an autoimmune phenomenon due to immune dysregulation. We report two cases of severe AITP following BMT for SCID. Both cases developed large intracerebral hemorrhages from which one died. Autoimmune thrombocytopenia in this setting can be life-threatening and we recommend early and active intervention.     

Surface and normal ensembles for surface reconstruction

The majority of the existing techniques for surface reconstruction and the closely related problem of normal reconstruction are deterministic. Their main advantages are the speed and, given a reasonably good initial input, the high quality of the reconstructed surfaces. Nevertheless, their deterministic nature may hinder them from effectively handling incomplete data with noise and outliers. An ensemble is a statistical technique which can improve the performance of deterministic algorithms by putting them into a statistics based probabilistic setting. In this paper, we study the suitability of ensembles in normal and surface reconstruction. We experimented with a widely used normal reconstruction technique [Hoppe H, DeRose T, Duchamp T, McDonald J, Stuetzle W. Surface reconstruction from unorganized points. Computer Graphics 1992;71-8] and Multi-level Partitions of Unity implicits for surface reconstruction [Ohtake Y, Belyaev A, Alexa M, Turk G, Seidel H-P. Multi-level partition of unity implicits. ACM Transactions on Graphics 2003;22(3):463-70], showing that normal and surface ensembles can successfully be combined to handle noisy point sets.     

Parasitic Bipolar Junction Transistors in a Floating-Gate MOSFET for Fluorescence Detection

In this letter, we examined whether the parasitic bipolar junction transistors (BJTs) in the MOSFET fabricated by the standard CMOS process can play a role as a fluorescence detector. To suppress the action of two vertical parasitic BJTs, the gate and n-well were tied in the parasitic BJTs, and the body node was connected to the drain. The proposed device was compared with the inherent and the parasitic diodes in the MOSFET. It had 100 times higher photocurrents than the diodes in the MOSFET. In addition, it was applied for the detection of the fluorescent signal, and could detect near 10 nM of Alexa 546. Therefore, CMOS-process-compatible parasitic BJTs can be used as a photodetector in an integrated fluorescence detector.