Recanalisation of occluded peripheral arteries by excimer laser

Laser recanalisation was attempted in 24 patients with total segmental occlusions of the lower extremity arteries and the aortic arch branches. All patients were men aged 40-82 years, in 20 the lesions were caused by atherosclerosis, in three by Buerger's thromboangiitis and in one by postembolic occlusion. Angioplasty was performed using excimer lasers with a wavelength of 308 nm and with monofiber waveguides in the transcutaneous transcatheter mode. Recanalisation of the vessel throughout the length of the obliterated segment was successful in 13 out of 24 patients. In all patients with thromboangiitis, energy losses were less than in atherosclerotic occlusions and no problems were experienced in patients with severe calcification. A high percentage of failures is a result of imperfect technology and low effectiveness of control, this must be improved. The Vishnevsky Institute of Surgery in collaboration with the Institute of General Physics has been developing a method of recanalisation of occluded arteries using excimer laser radiation. This paper is a preliminary analysis of our first clinical results.     

Genetic association between the phospholipase A2 gene and unipolar affective disorder: a multicentre case-control study

The co-segregation in one pedigree of bipolar affective disorder with Darier's disease whose gene is on chromosome 12q23-q24.1, and findings from linkage and association studies with the neighbouring gene of phospholipase A2 (PLA2) indicate that PLA2 may be considered as a candidate gene for affective disorders. All relevant genetic association studies, however, were conducted on bipolar patients. In the present study, the possible association between the PLA2 gene and unipolar affective disorder was examined on 321 unipolar patients and 604 controls (all personally interviewed), recruited from six countries (Belgium, Bulgaria, Croatia, Germany, Greece, and Italy) participating in the European Collaborative Project on Affective Disorders. After controlling for population group and gender, one of the eight alleles of the investigated marker (allele 7) was found to be more frequent among unipolar patients with more than three major depressive episodes than among controls (P<0.01); genotypic association was also observed, under the dominant model of genetic transmission (P<0.02). In addition, presence of allele 7 was correlated with a higher frequency of depressive episodes (P<0.02). These findings suggest that structural variations at the PLA2 gene or the chromosomal region around it may confer susceptibility for unipolar affective disorder.     

Diabetes education: a chance to improve well-being of Turkish people with type 2 diabetes

To examine the influence of diabetes education on well-being, 255 patients with type 2 diabetes were recruited according to whether they attended a diabetes education program (n=126) or not (n=129). In patients who had participated in the program, the mean anxiety score was significantly lower, whereas positive well-being and general well-being scores were significantly higher than for patients who had not participated. Factors related to lower well-being included: being female, taking insulin, not attending a diabetes education program and having HbA(1c) level greater than 8%. The odds of having better well-being were two-fold higher in patients participating the diabetes education program compared with those who had not. Diabetes education has a crucial role in improving the well-being of patients with type 2 diabetes. All patients with diabetes should be encouraged to attend a diabetes education program.     

Epidermoid carcinoma of the male urethra. Case report

A case of voiding difficulties was investigated. Other than usual prostatic obstruction or urethral stricture, a small mass at the anterior region of the bulbous urethra was present. Detailed investigation by urethroscopy, biopsy, CT imaging and ultrasonography revealed epidermoid carcinoma of the urethra.