Occlusion of large atrial septal defects with a centering buttoned device: early clinical experience

A feasibility clinical study was conducted for the transcatheter occlusion of large ostium secundum atrial septal defects with the centering buttoned device. The centering buttoned device is a modification of the regular buttoned device in which a centering counter-occluder is sutured at the central 40% portion of the occluder. During centering it is stretched, forming a parachute-shaped structure and pulling the occluder over the center of the defect. During buttoning, the counter-occluder forms a double figure eight, opposing the right atrial side of the atrial septum. Occlusion was performed in 12 patients aged 6 to 56 years. All had been rejected for transcatheter occlusion by the regular buttoned device, because of either their defect size or the lack of adequate septal rim. The defect size varied between 23 and 31 mm, and the device size varied between 45 and 60 mm. Nine had immediate effective occlusions of their defects and three residual shunts. One patient with unbuttoning had hemolysis at 2 weeks and underwent surgery. Early results of the transcatheter occlusion of large atrial septal defects are promising, and larger clinical trials are justified.     

Nitrone spin-traps block calcium channels and induce pulmonary artery relaxation independent of free radicals

Free radicals react with nitrones to form stable nitroxides which can be identified by ESR spectroscopy. Unfortunately, little is known regarding the pharmacological properties of these compounds. In this study, three commonly used nitrones, 5,5-dimethylpyrroline-N-oxide (DMPO), alpha-phenyl-tert-butylnitrone (PBN), and alpha-(4-pyridyl 1-oxide)-N-tert-butylnitrone (POBN), were found to induce relaxation of preconstricted isolated rat pulmonary artery rings. Additional experiments with PBN indicated that vasorelaxation could not be attributed to production of endothelial derived factors, prostaglandins, or free radicals. Patch-clamp techniques revealed reversible calcium channel blockade with PBN at a concentration below that needed to detect free radicals. Calcium channel blockade probably accounts for the vasorelaxation observed in the isolated ring preparations described here, and should be considered when using nitrone spin-traps both in in vivo and clinical studies.     

A patient's perspective on the management of peptic esophageal stricture: experience and results in 113 consecutive cases

A retrospective analysis of 113 consecutive cases of benign esophageal stricture, all secondary to gastroesophageal reflux, 100 treated conservatively, 13 treated surgically, has been carried out in conjunction with a postal questionnaire of patients. Patients were requested to grade both their swallowing ability and the acceptability of their treatment. Of those responding to questionnaire, 88% of patients treated conservatively found their treatment acceptable or better, and 72% were left with either no or minimal restriction of diet. There was no correlation between either the total number or frequency of dilatations and the result achieved. Similarly, patient satisfaction appears largely independent of these variables. Doctors should be wary of taking recurrence of a stricture after initial dilatation as indicating a poor eventual outcome or a dissatisfied patient. There was no difference in terms of either the result or patient satisfaction between conservatively treated and surgically treated patients.     

Radar detection of low-altitude targets in a maritime environment

Results from a unique analytical and experimental effort to assess low-altitude, short-range, radar detection capabilities in an evaporation ducting environment are presented. Within the horizon, the duct may shift the location of the last interference null several kilometers in range, which may cause nondetection at ranges where detection is expected and detection at ranges where detection is not expected. In addition, the evaporation duct may reduce the signal strength at ranges near the last interference peak so that detection of low-altitude, small-size, targets may not be possible until the target is much closer. At ranges near and beyond the horizon, radar signal strength depends both on the surface layer and on the mixed layer. To accurately model propagation in this region, knowledge of both surface layer and upper air meteorology Is required. An empirical model to merge the surface layer with the mixed layer has been developed. Comparisons of measured to calculated detection range indicate that the assumption of a standard atmosphere minimizes the variance of the difference between the detection ranges whereas ranges calculated using the measured surface meteorological conditions and a modified surface layer model minimizes the median of the difference     

Determination of the short-range order structure of Au-25 At. Pct Fe using wide-angle diffuse synchrotron X-Ray scattering

The short-range order (SRO) structure of a Au-25 at. pct Fe single crystal was studied using wide-angle diffuse synchrotron X-radiation scattering at room temperature. Two heat treatments were investigated: a 400 °C aging treatment for 2 days and a 440 °C treatment for 5 days, both preceded by solution treatment in the single-phase field and water-quenched to room temperature. Evolution of the SRO structure with aging was determined by fitting the two sets of Cowley-Warren (C-W) SRO parameters to a pair of 140,608-atom models. The microstructures, although quite disordered, showed a trend with aging for an increasing volume fraction of an Fe-enriched and an Fe-depleted environment. The Fe-enriched environment displayed a preference for Fe segregation to the {110} and {100} face-centered cubic (fcc) matrix planes. A major portion of the Fe-depleted environment was found to contain elements (and variations of these elements) of the Dl_a ordered superstructure. The SRO contained in the Fe-depleted environment may be best described in terms of the standing concentration wave packet (SCWP) model. This study provides, for the first time, a quantitative real-space view of the atomic arrangements, which make up both environments in the SRO structure of Au-25 at. pct Fe. Formerly Graduate Research Assistant, University of Illinois, Urbana, IL.     

NMR spectroscopy of human post mortem cerebrospinal fluid: distinction of Alzheimer''s disease from control using pattern recognition and statistics

Mutations of ras oncogenes in 37 human stomach cancers and 13 adenomas were investigated with regard to the histological phenotypes using polymerase chain reaction (PCR), allele-specific oligonucleotide hybridization and/or direct sequencing of the PCR products. The ras mutation was found only in one case (2.7%), the histology of which was poorly differentiated adenocarcinoma. We found no mutation in stomach adenomas. The mutation consisted of a guanine-to-adenine transition in the first base of codon 13 of c-Ki-ras which replaced wild-type glycine with serine, indicating that a putative glycine-to-aspartic acid change is not necessarily the critical event for c-Ki-ras gene activation in codon 13. These results further confirm the infrequency of ras mutation in stomach tumors and also suggest that ras mutations are not specific to the differentiated type of stomach cancer.