Serial clinical and angiographic follow-up after phosphorylcholine-coated stent implantation

The efficacy of drug-eluting stents (DES) has been proven, but concerns about late complications after DES have been raised. Polymers that do not increase inflammatory or hypersensitivity reactions which may contribute to late complications are needed for new generation DES. To evaluate the safety and efficacy of phosphorylcholine-polymer coating, we investigated serial clinical and angiographic outcomes after phosphorylcholine-coated stent placement. Seventy-five consecutive patients treated with a BiodivYsio phosphorylcholine-coated stent for de novo lesions at our institute between October 2001 and August 2002 were enrolled. Six-month follow-up angiography was performed in 71 lesions (94.7%), and angiographic restenosis was found in 19 lesions (26.8%). Target lesion revascularization (TLR) was performed in 10 lesions (14.1%). Eighteen-month follow-up angiography was performed in 58 (95.1%) of the remaining 61 lesions (excluding TLR lesions), and angiographic restenosis was found in only 3 lesions. The cumulative MACE-free survival rate was 86.3%, 83.6%, and 78.6% at 6-month, 18-month, and 8-year follow-up, respectively. There were no episodes of stent thrombosis. Late loss decreased significantly from 0.74 ± 0.40 mm (6-months) to 0.51 ± 0.46 mm (18-months) (P < 0.0001). Phosphorylcholine-coated stent implantation was associated with acceptable clinical and angiographic results. Phosphorylcholine-coating may be an ideal polymer for new generation DESs.     

A coded summation method to measure evoked responses of Human Beings

Human Beings have several kinds of responses evoked by different kinds of stimuli. Examples include auditory evoked responses, visual evoked responses, and etc. Evoked responses appear in electroencephalograms (EEGs) and are measured by an EEG. These evoked responses have a smaller amplitude wave and an averaged summation method (ASM) is widely used to measure this phenomenon. The ASM, however, is not entirely suitable to measure a signal hidden behind nonstationary data with a high ratio. Because the number of average summation cycles has to increase in order to improve the signal-to-noise ratio, increased time is required to measure a signal. The nonstationarity of data also increases the danger that a measured signal has several distortions caused by nonstationarity. These facts indicate the necessity for a short period measurement to obtain an evoked response. At the same time, the short period measurement realizes a reduction of load for measured person. In this paper, a process called a coded summation method (CSM) is proposed. This method has the ability to measure an evoked response within 1/4, ～ 1/12 of the time that is required by the usual ASM. The CSM transforms the original data into codes and then follows with a summation and an averaging for the coded data. The CSM is applied to two kinds of actual cases; the measurement of auditory slow vertex responses and visual evoked responses. Through the trials and discussions about the results in these two cases, an algorithm is derived to determine several CSM parameters the effectiveness of CSM is evaluated by being compared with the traditional ASM technique.     

Transient autoantibodies with elevated complement levels in common viral diseases

Autoantibodies including rheumatoid factor (RF), anti-DNA antibody (ADA), and anti-nuclear factor (ANF) in addition to cold agglutinin and heterophil antibody titers were tested for in a total of 219 patients with common viral diseases. The diseases included varicella, influenza, measles, mumps, herpes zoster, hand-foot-mouth syndrome, and exanthem subitum . A high incidence of RF (23%) was demonstrated in varicella patients, and ADA and ANF (16% and 12%, respectively) were most frequently detected in the influenza cases. Those autoantibodies were most frequently found in patients with influenza. Each serum complement component and total hemolytic complement (CH50) were also assayed. Elevated levels of the fourth (C4) and ninth (C9) components of complement, along with elevated CH50, were observed in most patients. Follow-up studies indicated that those autoantibodies as well as other antibodies disappeared 3 to 8 weeks after the onset of infection. The present study indicates that substantial but transient alterations in the immune system accompanied by autoimmune phenomena and elevated levels in the complement components can occur in viral infections.     

Long-term follow-up review of cases of Parkinson's disease after unilateral or bilateral thalamotomy

Follow-up reviews were carried out on 86 of 103 patients with Parkinson's disease who underwent unilateral or bilateral ventrolateral (VL) thalamotomy in the period from 1964 to 1969. Of these 86 patients, 64 received unilateral surgery, and 22 bilateral surgery. The follow-up periods were at least 10 years from the operation (from the second intervention in cases with bilateral procedures). In the group that received unilateral surgery, no progression after surgery was seen in three of six patients classified preoperatively in Grade I (Hoehn and Yahr's Grade 1), nine of 20 patients in Grade IIa (Hoehn and Yahr's Grade 2), 13 of 23 patients in Grade IIb (Hoehn and Yahr's Grade 3), and six of 15 patients in Grade III (Hoehn and Yahr's Grade 4). In the group that received bilateral surgery, one of three patients in Grade I and one of 11 patients in Grade IIa before the second intervention maintained continuous full social activities for over 10 years after the second surgery without any medication. In addition, eight of 11 patients classified preoperatively in Grade IIa and five of eight patients in Grade IIb seemed to show no progression after the second operation; four of 22 patients stopped taking their medication because of improvement in their symptoms. No patient who received bilateral surgery had progression of the disease to death. Observations suggested the efficacy of thalamic surgery, not only for improvement of motor symptoms but also for reducing progression of the disease, although no control study was made. Thalamotomy is still used to treat Parkinson's disease as an alternative to current medical treatments, such as L-dopa therapy.