Coronary Angioplasty of Bifurcational Lesions: Use of Simultaneous Over-the-Wire and Probe™ Systems

Different techniques have been used to perform coronary angioplasty of bifurcational lesions. Advantages and disadvantages of the kissing balloon technique, the single guiding-double wire technique, and the double Probe(tm) technique are reviewed. We describe a new technique for coronary angioplasty of bifurcational lesions through a single guiding catheter that has advantages of both the over-the-wire and the Probe(tm) systems.     

Health policy, epidemiology and power: the interest web

The relation between epidemiological research results and policy-making is reviewed. Apparently, traditional models of policy-making(incrementalism, mixed scanning synoptic planning) do not explainwhy research findings are hardly used in policy-making procedures. It is suggested that this phenomenon is related to three determinantsof policy-making: (i) a bias stemming from sets of causal, finaland normative assumptions and presuppositions; (ii) interestwebs of groups in certain domains; and (iii) the power of organizationsto monitor and communicate. The conclusion is that epidemiologistsshould engage in the policy-making process more consciouslyand conscientiously.     

The role of early neural activity in the maturation of turtle retinal function

In the developing vertebrate retina, ganglion cells fire spontaneous bursts of action potentials long before the eye becomes exposed to sensory experience at birth. These early bursts are synchronised between neighbouring retinal ganglion cells (RGCs), yielding unique spatiotemporal patterns: ‘waves’ of activity sweep across large retinal areas every few minutes. Both at retinal and extraretinal levels, these embryonic retinal waves are believed to guide the wiring of the visual system using hebbian mechanisms of synaptic strengthening. In the first part of this review, we recapitulate the evidence for a role of these embryonic spontaneous bursts of activity in shaping developing complex receptive field properties of RGCs in the turtle embryonic retina. We also discuss the role of visual experience in establishing RGC visual functions, and how spontaneous activity and visual experience interact to bring developing receptive fields to maturation. We have hypothesised that the physiological changes associated with development reflect modifications in the dendritic arbours of RGCs, the anatomical substrate of their receptive fields. We demonstrate that there is a temporal correlation between the period of receptive field expansion and that of dendritic growth. Moreover, the immature spontaneous activity contributes to dendritic growth in developing RGCs. Intracellular staining of RGCs reveals, however, that immature receptive fields only rarely show direct correlation with the layout of the corresponding dendritic tree. To investigate the possibility that not only the presence of the spontaneous activity, but even the precise spatiotemporal patterns encoded in retinal waves might contribute to the refinement of retinal neural circuitry, first we must clarify the mechanisms mediating the generation and propagation of these waves across development. In the second part of this review, we present evidence that turtle retinal waves, visualised using calcium imaging, exhibit profound changes in their spatiotemporal patterns during development. From fast waves sweeping across large retinal areas and recruiting many cells on their trajectory at early stages, waves become slower and eventually stop propagating towards hatching, when they become stationary patches of neighbouring coactive RGCs. A developmental switch from excitatory to inhibitory GABA_A responses appears to mediate the modification in spontaneous activity patterns while the retina develops. Future chronic studies using specific spatiotemporal alterations of the waves will shed a new light on how the wave dynamics help in sculpting retinal receptive fields.     

Primary malignant melanoma of the adrenal gland

Primary malignant melanoma of the adrenal gland is an established entity. Fewer than 20 cases have been reported in the published literature. Because of the high frequency of adrenal gland metastases from malignant melanoma and pigmented pheochromocytoma, several rigid diagnostic criteria have been established for accepting an adrenal melanoma as primary. A new case is reported in this article. This observation is an opportunity update the literature on the diagnostic difficulties in this rare pathology.     

Use of Sheath (Probing CatheterTM) to Enhance Efficacy of the ProbeTM Dilatation Catheter

Coronary angioplasty of very distal or subtotal lesions has been markedly improved with the recent development of the Probe^TM dilatation catheter. However, despite its very low profile, the Probe^TM has certain limitations. We describe a new device. the Probing Catheter^TM, that, in conjunction with the Probe^TM increases the success rate and facilitates coronary angioplasty of very distal or high grade lesions.     

Peer teaching pilot programme for caries prevention in underprivileged and migrant populations

Background.  Focused caries prevention programmes for migrant children often fail because there is an important barrier of linguistic and cultural diversity.
Aim.  The aim of this study was to evaluate whether a tailored peer teaching approach can improve oral health behaviours of underprivileged and/or multinational migrant first graders.
Design.  Two fourth grade classes (30 children, mean age 9.6) and two first grade classes (38 children, mean age 6.6) with high migrant background participated. The fourth graders took part in a preparatory course of oral health and developed a concept for tutoring first graders in oral health concepts as well as the Fones toothbrushing method. Later then, the fourth graders instructed the first graders during two lessons. Toothbrushing of each first grader was filmed before and 7 days after instruction. Toothbrushing time, method, and systematic were evaluated.
Results.  After instruction, circular toothbrushing movements and systematic toothbrushing were observed significantly more often ( P  = 0.0001); toothbrushing time did not change.
Conclusions.  This pilot study shows that tutoring by older peers of similar origin resulted in significant changes towards better oral health in underprivileged and/or multinational migrant first graders. Authentic role models could be provided, and communication and cultural barriers circumvented.     

REGULATION OF VITAMIN D: AN EVOLUTIONARY VIEW

The regulation of vitamin D metabolism by the kidney is now known to be multifactorial. Three regulatory factors are discussed: 1,25(OH)₂D₃ itself; parathyroid hormone, and phospate. The influence of 1,25(OH)₂D₃ probably depends on new protein synthesis, while the mode of action of phosphate is unknown. Parathyroid hormone is not essential for regulation but may have an important biological role. The direction of its effect varies, perhaps due to a complex inter-relation of changes in calcium and phosphorus metabolism and the level of kidney adenyl cyclase activity.     

Further studies into the Boc/solid-phase synthesis of Ser(P)- and Thr(P)-containing peptides

The Ser(P)-containing peptide corresponding to phospholamban 11-19, Ac-Ala-Ile-Arg-Are-Ala-Ser(P)-Thr-Ile-Glu-NH₂, was prepared by the use of Boc-Ser(PO₃Ph₂)-OH in Boc/solid-phase peptide synthesis followed by HF cleavage of the peptide from the polystyrene resin and subsequent platinum-mediated hydrogenolytic cleavage of the phenyl phosphate groups. A study of the HF deprotection step showed that extensive dephosphorylation of the Ser(PO₃Ph₂)-residue occurred using three commonly used HF conditions and gave rise to large quantities of the Ser-containing peptide. The subsequent study of model peptide systems under standard HF conditions established firstly that the extent of dephosphorylation was dependent on the HF-contact time, and secondly that the Ser(PO₃Ph₂) residue underwent dephosphorylation at a slightly higher rate than the Thr(PO₃Ph₂) residue. © Munksgaard 1994.     

Proposals for collaboration in European public health training

The drastic changes in European politics, economy, environmentand technology during the last decade have profoundly influencedthe role and scope of public health practice and training. Aresponse to training in public health was given by the Associationof Schools of Public Health in the European Region (ASPHER)and WHO by creating a joint task force in order to propose aEuropean Master's Degree in Public Health, based on the ‘healthfor all’ principles. Attempts to develop curricula andlearning materials were not very successful and, instead, apeer review system as a means of establishing a European standardin public health training, together with mutual recognitionand a common standard in professional qualifications has beensuggested. Principles, criteria and practical steps for thisPublic Health Education European Review(PEER) are outlined.