Pharmakologische Zusatzbehandlung nach transluminaler Angioplastie

Zusammenfassung 1973 wurde die weltweit 1. klinische Studie über Azetylsalizyls?ure (ASS) unmittelbar vor und nach Angioplastie ausgeführt und zeigte eine Reduktion der Frührethromoboserate sowohl bei alleiniger Applikation als auch bei kombinierter Anwendung mit Heparin. Die optimale Nachbehandlung ist weiterhin ungekl?rt, es gibt sowohl Studien über die Vorteile der Antikoagulation als auch über die von Thrombozytenfunktionshemmern. Im iliakalen Bereich scheint die Applikation einer niedrigen Dosis ASS ausreichend zu sein. Im femoro-poplitealen Bereich dagegen gibt es die Information, da? insbesondere bei langstreckigen Obliterationen, die rekanalisiert wurden, der Einsatz von Langzeitantikoagulation sinnvoll ist. Es ist zu erwarten, da? die gemeinsame deutsch-?sterreichische Multicenterstudie hier eine weitere Kl?rung bringt.      

Implementation of a successful endovascular surgical program in a non-teaching tertiary-care centre in Ontario.

Endovascular surgical techniques have become an accepted standard of care for high-risk patients with abdominal aortic aneurysms and for certain patients with thoracic aortic pathology and peripheral arterial aneurysms. In Canada, endovascular surgery has been concentrated in tertiary-care academic teaching institutions. As the technology evolves and as expertise advances, the applicability of endovascular techniques will expand. With time, and as the demand for endovascular techniques rises, this expertise will increasingly need to be delivered by dedicated vascular surgical services in nonteaching institutions. The dissemination of endovascular surgical capabilities represent a unique challenge. We report the successful implementation of an endovascular surgical program in a tertiary-care nonteaching institution using a carefully planned preceptorship model. We review our initial 49 cases and discuss 6 factors important to the successful establishment of an endovascular surgical service: education, teamwork, strict selection of patients, use of a single stent-graft manufacturer, industry support and endovascular preceptorship. Our experience may be used as a model by other institutions in Canada.     

The persistence of interleukin-6 is regulated by a blood buffer system derived from dendritic cells

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Discordant immunologic and virologic responses to highly active antiretroviral therapy are associated with increased mortality and poor adherence to therapy

OBJECTIVE: To examine the independent association of discordant virologic and immunologic responses to highly active antiretroviral therapy (HAART) with mortality. METHODS: A population-based study of 1527 treatment-naive individuals initiating HAART used Cox proportional hazards modeling to determine the independent association of treatment response at 3 to 9 months with nonaccidental mortality. Logistic regression was used to examine associations with discordant responses. RESULTS: Viral load (VL)/CD4 discordant responses were seen in 235 (15.4%) of subjects, and VL/CD4 responses were seen in 179 (11.7%) of subjects. In adjusted Cox regression models, discordant responses were found to be independently associated with an increased risk of mortality (VL/CD4: relative hazard [RH] = 1.87, 95% confidence interval [CI]: 1.15 to 3.04; VL/CD4: RH = 2.47, 95% CI: 1.54 to 3.95). VL/CD4 discordance was found to be associated with increasing age, baseline HIV RNA load <100,000 copies/mL, baseline CD4 counts <50 cells/muL, the use of lamivudine (3TC)/zidovudine (ZDV), and poor adherence to therapy. VL/CD4 discordance was associated with younger age; injection drug use; baseline HIV RNA load >100,000 copies/mL; the use of 3TC/ZDV, didanosine (ddI)/3TC, or ddI/stavudine; and poor adherence to therapy. CONCLUSION: Discordant responses are independently associated with an increased risk of mortality and are, in turn, associated with poor adherence to therapy.     

Seasonal exacerbation of eosinophilic esophagitis histologic activity in adults and children implicates role of aeroallergens

Background

Disease activity may correlate with environmental aeroallergen exposure in eosinophilic esophagitis. The association between seasons and flares of eosinophilic esophagitis (EoE) histologic activity has not been extensively studied.

SEM of the proximal tubule of the adult rabbit kidney

The present study utilizes the scanning electron microscope (SEM) to reveal the surface morphology of proximal tubular cells and the parietal cells of Bowman's capsule of the adult rabbit nephron. To facilitate the examination of the basal surface of these cells, proximal tubules were dissected free and treated with collagenase to remove the basememt membrane. Other blocks of tissue were cryofractured to expose the lateral cell surfaces of the proximal tubules. Our investigation has shown that the lateral and basal surfaces of both the convoluted and straight segments of the proximal tubule have numerous processes. However, the arrangement and degree of branching is distinctly different in the two segments. The convoluted segment has large lateral ridges which form at the base of the microvilli and fan out to divide into lateral-basal processes. Many of the lateral-basal processes reach the basement membrane intact, interdigitating with complementary processes from adjacent cells. However, some of the lateral-basal processes branch into short, knobby projections (basal villi) which may also reach the basement membrane. Patches of basal villi are interspersed between broad regions of interdigitating lateralbasal processes. Therefore, in the convoluted segment, the lateral-basal processes form the major part of the basal cell surface. In tubular cells of the pars recta, unlike convoluted tubular cells, the majority of the ridges remain unbranched and pass directly to the basal surface where they divide into elaborate basal villi. Thus the basal surface of the pars recta cells is highly complex, appearing leaf-like, being a composite of numerous basal villi with a few lateral ridges. The basal surface of some parietal cells of Bowman's capsule have parallel ridges, which results in patches of striations.     

Prophylaxis and treatment of experimental lung metastases in mice after treatment with liposome-encapsulated 6-O-stearoyl-N-acetylmuramyl-L-α-aminobutyryl-D-isoglutamine

A new lipophilic muramyl dipeptide analog, 6-O-stearoyl-N-acetylmuramyl-L--aminobutyryl-D-isoglutamine, when incorporated in liposomes, was effective in both the prevention and eradication of experimental pulmonary metastases in mice. Multilamellar vesicles composed of synthetic phospholipids (phosphatidylglycerol and phosphatidylcholine) containing saturated myristoyl or unsaturated dioleoyl acyl chains were found to potentiate the antimetastatic activity of this glycopeptide. Prophylactic and therapeutic efficacy was observed against the three murine tumors tested: FSa, an immunogenic fibrosarcoma; NFSa, a nonimmunogenic fibrosarcoma; and B16 melanoma. Neither the administration of empty liposomes or free glycopeptide, nor their coadministration, had a significant antimetastatic effect. This approach is promising for the therapy of cancer metastases in humans, particularly in the prevention of metastatic seeding and in the treatment of micrometastases.This is contribution No. 180 from the Institute of Bio-Organic Chemistry, Syntex Research.     

Whole-genome sequence assembly for mammalian genomes: Arachne 2

We previously described the whole-genome assembly program Arachne, presenting assemblies of simulated data for small to mid-sized genomes. Here we describe algorithmic adaptations to the program, allowing for assembly of mammalian-size genomes, and also improving the assembly of smaller genomes. Three principal changes were simultaneously made and applied to the assembly of the mouse genome, during a six-month period of development: (1) Supercontigs (scaffolds) were iteratively broken and rejoined using several criteria, yielding a 64-fold increase in length (N50), and apparent elimination of all global misjoins; (2) gaps between contigs in supercontigs were filled (partially or completely) by insertion of reads, as suggested by pairing within the supercontig, increasing the N50 contig length by 50%; (3) memory usage was reduced fourfold. The outcome of this mouse assembly and its analysis are described in (Mouse Genome Sequencing Consortium 2002).