IMPROVED PROCEDURE OF PURIFICATION OF INORGANIC PYROPHOSPHATASE FROM BACILLUS STEAROTHERMOPHILUS

An improved method for isolation of inorganic pyrophosphatase (EC 3.6.1.1.) from Bacillus stearothermophilus is described. The enzyme was purified to more than 90% after two chromatographic steps. A molecular weight of 140 000 daltons was estimated by density gradient centrifugation. The isoelectric point was found to be 4.0.     

A Study of Gastric Cancer in Egypt

Since stomach cancer is rare in Egypt, a study was conductedto try to determine the factors responsible for the low incidence.The study included epidemiological and pathological informationon 55 cases of stomach cancer collected from 1970 to 1977, representing0.33% of the admissions for malignancy in this period. Featuresof the Egyptian diet that could be behind the low incidenceare presented.     

An Accelerated Hemostasis Protocol following Transradial Cardiac Catheterization Is Safe and May Shorten Hospital Stay: A Single‐Center Experience

Introduction: Hemostasis following transradial cardiac catheterization is achieved by external pressure application using various devices, TR Band? being one. There is no standardized protocol for the application and removal of such devices. Objective: To assess the safety and feasibility of a more rapid (1 hour) initiation of TR Band? removal ([time to wean] TTW1) compared to a recommended 2 hour protocol (TTW2) in a controlled prospective study. Methods: 100 consecutive outpatients undergoing diagnostic transradial cardiac catheterization prospectively underwent an accelerated initiation of post‐procedure TR Band? removal (TTW1 group). The controls were a random historical cohort of 25 patients who had the conventional 2 hours to wean approach (TTW2). Results: The mean age was 62 years with a mean BMI of 29 kg/m²; 51% were hypertensive and 9% were on warfarin anticoagulation. As defined, the median times to TR Band? weaning were 60 minutes and 120 minutes for TTW1 and TTW2 groups, respectively, p < 0.001. TTW1 patients had more oozing leading to insignificant delay in the weaning process (16% vs 4% in the TTW2 group, p = NS). The total time, however, from TR Band? application to removal was significantly shorter in the TTW1 group compared to TTW2 (median of 120 minutes [mean 127] vs 180 minutes [mean 187], p < 0.001). There were no differences in any prespecified complications. Conclusion: A rapid 1‐hour commencement of TR Band? weaning following transradial diagnostic cardiac catheterization appears to be safe. It shortens the overall device removal time and may shorten hospital stay in day‐case procedures.     

Elevated intracellular level of basic fibroblast growth factor correlates with stage of chronic lymphocytic leukemia and is associated with resistance to fludarabine

Chronic lymphocytic leukemia (CLL) is characterized by delayed senescence and slow accumulation of monoclonal, small lymphocytes. Basic fibroblast growth factor (bFGF) is a pleiotropic cytokine that plays a role in hematopoiesis and apoptosis. Elevated bFGF levels have been detected in urine from patients with a variety of neoplastic diseases including various leukemias; however, the cellular source of the bFGF has not been determined. In this study, the intracellular bFGF level in lymphocytes of 36 patients with B-CLL and 15 normal donors was determined using an enzyme-linked immunoassay. In cells derived from patients with high-risk disease, the median level of intracellular bFGF was 381.5 pg/2 x 10(5) cells, compared with a median of 90.5 pg/2 x 10(5) cells in patients with intermediate disease. In patients with low- risk disease, the median bFGF level was 4.9 pg/2 x 10(5) cells, and in normal controls, it was 6.0 pg/2 x 10(5) cells. The difference in the bFGF levels was significant for the comparison between low- and intermediate-risk (P = .00119), low- and high-risk (P < .0001), and intermediate- and high-risk disease (P = .0001). Immunofluorescent stains of peripheral blood mononuclear cells confirmed CLL lymphocytes as a cellular source of bFGF. To evaluate the potential contribution of elevated intracellular bFGF levels to the phenotype of CLL cells, leukemic cells were cultured in vitro with an apoptotic stimulus (fludarabine). CLL cells with high intracellular levels of bFGF appeared to be more resistant to fludarabine treatment. The addition of bFGF to fludarabine-treated CLL cells resulted in a delay of apoptosis and prolonged survival. These data suggest that bFGF may contribute to the resistance of CLL cells to an apoptotic stimulus.     

Resilient liner vs. clip attachment effect on peri‐implant tissues of bar‐implant‐retained mandibular overdenture: a 1‐year clinical and radiographical study

Purpose: The aim of this study was to compare between the effects of resilient liner and clip attachments of bar‐implant‐retained mandibular overdenture on peri‐implant tissues. Materials and methods: In a randomized‐controlled clinical trial, 30 edentulous male patients (mean age 62.5 years) were equally assigned to two groups. In each patient, two implants were inserted in the canine area of the mandible using a two‐stage surgical protocol. After 3 months, the implants were connected with resilient bars. Mandibular overdentures were retained to the bars with either clips (group I) or silicone‐resilient liners (group II). Peri‐implant tissues were evaluated clinically (with regard to plaque scores, gingival scores and probing depths) and radiographically (with regard to peri‐implant vertical and horizontal alveolar bone changes). Evaluations were performed at the time of overdenture insertion (T0), 6 months (T6) and 12 months (T12) after overdenture insertion. Results: After 12 months of using bar‐implant‐retained mandibular overdenture, the resilient liner attachment had significantly decreased peri‐implant plaque score, gingival score, probing depth, vertical and horizontal bone loss when compared with the clip attachment. Conclusion: Within the limitations of this study, and in terms of peri‐implant tissue health of bar‐implant‐retained mandibular overdenture, we recommend resilient liner rather than clip attachment. To cite this article:
Elsyad MA, EL Shoukouki AH. Resilient liner vs. clip attachment effect on peri‐implant tissues of bar‐implant‐retained mandibular overdenture: a 1‐year clinical and radiographical study.
Clin. Oral Impl. Res. 21 , 2010; 473–480
doi: 10.1111/j.1600‐0501.2009.01879.x     

Application of the “Hybrid Approach” to Chronic Total Occlusion Interventions: A Detailed Procedural Analysis

Objective

To assess the outcomes of the “hybrid” approach to chronic total occlusion (CTO) percutaneous coronary interventions (PCIs).

Background

The “hybrid approach” to CTO PCI advocates appropriate and early change of crossing strategy to maximize success, safety, and efficiency.

Methods

We prospectively recorded and analyzed detailed step‐by‐step procedural data in 73 consecutive CTO PCI cases performed by a single operator between July 2011 and August 2012.

Results

Technical success was achieved in 66 of 73 cases (90.4%). Mean patient age was 65 ± 7 years, and 30% had prior coronary artery bypass surgery. Dual injection was used in 78%. The primary approach was retrograde in 9 cases (12.5%) and antegrade in 64 cases (87.5%), of whom 25 cases (39.1%) underwent retrograde attempt after failed antegrade approach. The initial crossing approach was successful in 40 cases (54.8%), but 32 cases (44%) required 3.6 ± 1.4 approach changes (range 2–7). Antegrade wire escalation, antegrade dissection/reentry, and retrograde crossing were utilized in 97.2%, 46.6%, and 46.6% of cases, respectively. Among successful cases, the final CTO crossing technique was antegrade wire escalation in 50.0%, antegrade dissection/reentry in 24.2%, and retrograde in 25.8%. The mean procedure time, fluoroscopy time, and air kerma radiation exposure until CTO crossing or stopping the procedure were 66 ± 55 minutes, 25 ± 23 minutes, and 2.3 ± 1.9 Gray, respectively. Three patients (4.1%) had a major complication.

Conclusion

In the “hybrid approach” to CTO PCI, changes in crossing strategy were needed in approximately half the cases, resulting in high success and low complication rates. (J Interven Cardiol 2014;27:36–43)