Influence of various antithrombotic therapy methods on the incidence of subacute coronary stent occlusions, hemorrhagic complications and length of hospitalization

BACKGROUND: The clinical benefit of coronary stenting is reduced by the risk of thrombotic stent occlusion as well as hemorrhagic complications of intensive antithrombotic therapy. We compared the influence of different antithrombotic therapies on the incidence of post-interventional complications and in-hospital stay duration. METHODS: After successful placement of a coronary stent, 334 consecutive patients were given different antithrombotic treatments in addition to aspirin 100 mg/d indefinitely: (1) phenprocoumon for 3 months (n = 47), (2) low molecular weight heparin 2 x 100 U/kg/d s.c. for 4 weeks (n = 90), (3) ticlopidine 2 x 250 mg/d and low molecular weight heparin 2 x 100 U/kg/d s.c. for 4 weeks (n = 72) and (4) ticlopidine 2 x 250 mg/d for 4 weeks (n = 125). RESULTS: Major events were subacute stent thrombosis in 17 patients (5%), and severe hemorrhagic complication in 20 patients (5.9%). The incidence of subacute stent thrombosis in groups 1 to 4 was 10.6%, 11%, 1.4% and 0.8% respectively. The use of ticlopidine was associated with a significant lowering of stent occlusions in univariate and multivariate analysis (p = 0.0013). Additional uni- and multivariate predictors were stent placement as a "bail-out" procedure (p = 0.033) and in patients with acute coronary syndrome (p = 0.049). Anticoagulant therapy was associated with a higher incidence of severe hemorrhagic complications (p < 0.01) and a prolonged in-hospital stay (p = 0.01). CONCLUSIONS: These results confirm that anti-thrombotic therapy with aspirin and ticlopidine combines low rates of subacute stent occlusion and hemorrhagic complications. Treatment with phenprocoumon and low molecular weight heparin does not improve the rate of subacute stent occlusion but increases hemorrhagic complications. Very low rates of stent occlusion permit short in-hospital stays with concomitant reduction in cost.     

Trading genes along the silk road: mtDNA sequences and the origin of central Asian populations

Central Asia is a vast region at the crossroads of different habitats, cultures, and trade routes. Little is known about the genetics and the history of the population of this region. We present the analysis of mtDNA control-region sequences in samples of the Kazakh, the Uighurs, the lowland Kirghiz, and the highland Kirghiz, which we have used to address both the population history of the region and the possible selective pressures that high altitude has on mtDNA genes. Central Asian mtDNA sequences present features intermediate between European and eastern Asian sequences, in several parameters-such as the frequencies of certain nucleotides, the levels of nucleotide diversity, mean pairwise differences, and genetic distances. Several hypotheses could explain the intermediate position of central Asia between Europe and eastern Asia, but the most plausible would involve extensive levels of admixture between Europeans and eastern Asians in central Asia, possibly enhanced during the Silk Road trade and clearly after the eastern and western Eurasian human groups had diverged. Lowland and highland Kirghiz mtDNA sequences are very similar, and the analysis of molecular variance has revealed that the fraction of mitochondrial genetic variance due to altitude is not significantly different from zero. Thus, it seems unlikely that altitude has exerted a major selective pressure on mitochondrial genes in central Asian populations.     

Automatic phase stepping in fiber-optic ESPI by closed-loop gainswitching

In this paper, we describe a new technique for automatic phase stepping in fiber-optic Electronic Speckle Pattern Interferometry (ESPI), useful in both single-point and imaging configurations. The proposed technique is based on closed-loop switching of the gain sign in the control loop used to stabilize the reference wavefront phase, with the aid of a Proportional-Integral (P.I.) controller. Simulation and experimental results are compared, showing that by a synchronization signal or by a proper choice of the feedback loop parameters, a sequence of π/2 steps of the reference wavefront phase, all of the same sign, is obtained, The residual fluctuation of each phase step amounts to ±2.5 mr over a bandwidth of 200 Hz. This level of phase stability is well suited for ESPI applications     

Selective Actinide Extraction with a Tri‐Synergistic Mixture Using a Centrifugal Contactor Battery

Abstract

The reprocessing of spent nuclear fuels produces a quantity of high‐level liquid waste (HLLW), which is subsequentely vitrified. The most important contributors to the long‐term radiotoxicity of the vitrified HLLW are the so‐called minor actinides (MAs), which are neptunium, americium, and curium. This paper presents the results obtained during some extraction tests of americium(III) in a synthetic liquid waste representative of that coming from the PUREX and DIAMEX processes, obtained by dissolving the respective nitrate salts of the lanthanides(III) in a diluted solution of nitric acid and spiked with ²⁴¹Am and ¹⁵²Eu. The extraction process employed a tri‐synergistic organic extractant mixture and a centrifugal contactor battery of eight stages.     

Elevated soluble intercellular adhesion molecule 1 in the serum of patients with polymyalgia rheumatica: influence of steroid treatment

OBJECTIVE: To determine the levels of serum soluble intercellular adhesion molecule 1 (sICAM-1) in patients with polymyalgia rheumatica (PMR) and/or giant cell arteritis (GCA) prior and during steroid therapy. METHODS: Sixteen patients with PMR and/or GCA had complete clinical and laboratory investigations at diagnosis before treatment and 9 patients were followed during 6 months of steroid therapy. Serum sICAM-1 levels were measured by ELISA: RESULTS: Serum ICAM-1 levels were higher in the patient group compared to a control population. No significant correlation was found between serum sICAM-1 levels and other indices of disease activity. After steroid administration, a dramatic fall in serum sICAM-1 levels was observed at the end of the first week and persisted until the end of the study period, paralleling clinical and laboratory disease remission. CONCLUSION: Serum sICAM-1 levels paralleled disease activity in PMR and/or GCA. Steroid treatment induced a rapid normalization of the serum sICAM-1 levels.     

Recent achievements in the development of partitioning processes of minor actinides from nuclear wastes obtained in the frame of the NEWPART European programme (1996–1999)

Partitioning of long-lived minor actinides (americium and curium) from the nuclear wastes issuing the reprocessing of nuclear spent fuels, in order to transmute them into short-lived nuclides or to condition them into stable crystalline matrices, was the subject of intense research within the NEWPART research program of the European 4^th Frame Work Program, FWP (1996–1999). The target waste considered was the acidic raffinate (HAR) issuing the reprocessing of the used nuclear fuels by the PUREX process. A two step separation process based on liquid-liquid extraction was designed. The first step consists in the co-separation of the mixture of trivalent actinides and lanthanides from the HAR by extraction with a malonamide extractant (DIAMEX process), while the second step concerns the actinides(III)/lanthanides(III) group separation (SANEX process). Several DIAMEX and SANEX processes were developed and successfully tested with cold, spiked and genuine high active effluents. The research carried out also included basic and fundamental works in order to better understand the relationships between the structures of the extractants and their affinities for the target metal ions. The lecture highlighted both the basic and applied aspects of the research. This work will be pursued (PARTNEW program) within the 5^th FWP of the European Union during the period 2000–2003.     

Serum chemokines in patients with psoriatic arthritis treated with cyclosporin A

OBJECTIVE: To investigate the possible effects of neuropeptide Y on steroid release by human granulosa cells in culture. DESIGN: Prospective study. SETTING: A university laboratory and the division of obstetrics and gynecology in a hospital. PATIENT(S): Sixteen normally ovulating women. INTERVENTION(S): Ovulation induction for IVF-ET with an LH-releasing hormone analogue and gonadotropins. MAIN OUTCOME MEASURE(S): E2 and progesterone were assayed in the media conditioned by granulosa cells with the use of a double-antibody RIA. RESULT(S): Neuropeptide Y stimulates E2 production in a dose-dependent fashion. Preincubation for 3 hours with hCG led to a statistically significant increase in neuropeptide Y-induced E2 secretion. In contrast, whereas 3 hours of preincubation with 10(-7) mol/L of neuropeptide Y did not elicit a statistically significant increase in hCG-induced E2 secretion, coincubation for 48 hours significantly increased hCG-stimulated secretion. Unlike E2, progesterone secretion did not undergo any statistically significant or dose-dependent variation after treatment with neuropeptide Y. CONCLUSION(S): Neuropeptide Y plays a role in human ovarian steroidogenesis directly at the level of the granulosa cells of the follicles in the early stage of luteinization. In this way, neuropeptide Y could play an important role in controlling the positive feedback effect exerted by the ovarian steroids on LH-releasing hormone and gonadotropins in humans.