Clinical trials on intracoronary stenting

The stent is currently taking the lead in the treatment of obstructive coronary artery disease. The interest in this device is not only reflected by the relative number of patients referred for angioplasty and treated with a stent but also by the large number of clinical trials. These can be divided into trials assessing the safety and feasibility of the implantation of second generation or new stents, studies assessing novel treatment strategies and randomized clinical trials. With respect to the latter, they all compare stent implantation with balloon angioplasty. Of major importance will be the comparison of stent implantation with surgical revascularization of obstructive coronary artery disease. The increasing number of therapeutic options, however, confront the physician with the difficult choice and responsibility of selecting the most appropriate treatment. Therefore, systematic and objective evaluation of the available therapeutic approaches by means of appropriately designed trials is imperative. The purpose of this paper is to summarize and to put into perspective the various studies on intracoronary stenting. Distinction is made between observational studies testing a device or evaluating a new concept in intracoronary stenting and randomized clinical trials.     

Bouyant density, conversion formulae, and the mole percent guanosine + cytosine content of Desulfovibrio sp

A reevaluation of the original buoyant density conversion formula used to calculate the molar percentage guanosine + cytosine (% G + C) contents of the accepted species of genus Desulfovibrio has been undertaken. It would appear that the formula used gives values 4-5% lower than those obtained using formulae more generally cited in modern literature. Recalculations of % G + C content values for Lesulfovibrio DNA are presented using the formulae of three different workers, and are compared with those values originally used in the classification of genus Desulfovibrio.     

Surgical manpower: past and present reality, estimates for 2000

The growth in the number of board-certified surgeons in the 1970s, projections of the need for surgeons in the year 2000, and possible factors softening the impact of surgical expansion are discussed in detail. The best index for the optimal supply of surgeons in the United States is related to the phenomenon of local community needs.     

Autonomic straightening after gravitropic curvature of cress roots

Few studies have documented the response of gravitropically curved organs to a withdrawal of a constant gravitational stimulus. The effects of stimulus withdrawal on gravitropic curvature were studied by following individual roots of cress (Lepidium sativum L.) through reorientation and clinostat rotation. Roots turned to the horizontal curved down 62 degrees and 88 degrees after 1 and 5 h, respectively. Subsequent rotation on a clinostat for 6 h resulted in root straightening through a loss of gravitropic curvature in older regions and through new growth becoming aligned closer to the prestimulus vertical. However, these roots did not return completely to the prestimulus vertical, indicating the retention of some gravitropic response. Clinostat rotation shifted the mean root angle -36 degrees closer to the prestimulus vertical, regardless of the duration of prior horizontal stimulation. Control roots (no horizontal stimulation) were slanted at various angles after clinostat rotation. These findings indicate that gravitropic curvature is not necessarily permanent, and that the root retains some commitment to its equilibrium orientation prior to gravitropic stimulation.     

Macrophage apoptosis in muscle tissue in experimental autoimmune myasthenia gravis

BACKGROUND: In adhesive small bowel obstruction, the early recognition of complications such as strangulation or volvulus is essential to choose between surgical or conservative initial treatment. The objective of this study was to determine prospectively the contribution of computed tomography (CT) to decision making in the management of these patients. METHODS: Patients with suspected adhesive small bowel obstruction had CT at admission. Patients with CT signs of volvulus or strangulation and/or clinical signs of peritoneal irritation underwent urgent surgery; other patients had conservative initial treatment. RESULTS: Fifty-four patients were evaluated. CT demonstrated signs of strangulation or volvulus in 19 patients, including three with signs of peritoneal irritation. Within this group, urgent laparotomy was performed in 17 patients and confirmed the CT diagnosis in 16. Thirty-seven patients without clinical or CT signs of complications had initial conservative treatment; among them, seven of 12 with a distal obstruction determined by CT required a delayed operation for persisting obstruction, compared with two of 25 patients with a proximal obstruction (P < 0.01). CONCLUSION: CT is useful for the evaluation of adhesive small bowel obstruction, to detect accurately patients with complications who require urgent operation and to determine the location of the adhesion, which represents a significant prognostic factor for success of conservative treatment.     

Segmental Dynamics of Solid-State Poly(methylphenylsilane) by 1D and 2D Deuterium NMR

The segmental dynamics of solid-state poly(methylphenylsilane) were probed with deuterium solid-echo and two-dimensional exchange (2D-X) NMR via a methyl-d3 label. Between 25 and 50 degreesC, the spectra indicated that the polymer consisted of two fractions-a fast fraction with correlation times (tauc) below 10(-5) s and one with tauc's above 10 s. Above 50 degreesC, motion with tauc's around 10(-3) s was also detected. A minimization routine was developed to fit the 2D-X spectra to a model of isotropic rotational diffusion with a distribution of tauc's. The best fits were obtained with trimodal stretched-exponential distributions. The trimodal distributions consisted of a fast mode with tauc's around 10(-5) s, an intermediate mode with tauc's between 10(-4) and 0.3 s, and a slow mode with tauc's generally above 10 s. As the temperature increased from 56 to 90 degreesC, the fast fraction steadily increased from 21% to 50% while its average tauc remained around 10(-5) s; the intermediate fraction remained relatively constant at 23% while its average tauc decreased from 125 to 8 ms, and the rigid fraction decreased from 55% to 32% with an average tauc around 40 s. The fast fraction was attributed to amorphous segments, the rigid fraction to crystalline segments, and the intermediate fraction to segments that formed an interphase between the two.