In situ saphenous vein bypass grafts: angiographic evaluation and interventional repair of complications

In situ saphenous vein grafts are being used with increasing frequency for bypass procedures involving the femoral and popliteal arteries. Complications of these procedures include anastomotic stenoses and persistent arteriovenous fistulae that may result in failure of the graft. Balloon angioplasty and embolotherapy with detachable balloons were employed successfully in three or four recent cases of patients with complications from in situ grafts. Tailored angiography is essential for evaluating in situ grafts, and interventional techniques are extremely useful for managing complications.     

A sensitive bioluminescent immunoinhibition test for CK-B subunit activity and a CK-MB specific ELISA compared: correlation with agarose electrophoresis and influence of CK-isoenzyme profile on results

Searching for alternatives to the imprecise spectrophotometric tests for low-concentration creatine kinase (EC 2.7.3.2) isoenzyme MB (CK-MB), we investigated the analytical performance of two potentially superior approaches--a bioluminescent immunoinhibition assay (I, LKB-Wallac) and an ELISA (enzyme-labeled immunosorbent assay) technique (II, Hybritech)--in comparison with an electrophoretic method (III, Beckman). Only I showed good between-day precision (CV 8.3%) at the upper reference limit, allowing reproducible assay of CK-B subunit activity down to at least 3 U/L. In conditions where CK isoenzyme assays remained unaffected by CK-MM concentrations, test results were proportional to the amount of CK-MB in the sample up to at least 50 U/L for I, 120 micrograms/L for II, and 100 U/L for III (r greater than 0.998 by linear regression analysis). For CK-MB-positive samples, the data by I correlated more closely with values by III (n = 24; r = 0.994) than did results by II (n = 15; r = 0.909), but both methods were equally effective in discriminating between samples with or without electrophoretically supranormal CK-MB activity (93% sensitivity). II was entirely CK-MB specific, whereas CK-B activity by I was consistently (18/18) increased in CK-MB-negative samples containing CK-BB (n = 6; r = 0.996) or macro CK, types 1 or 2 (n = 12; r = 0.930). I is highly sensitive for screening for increased non-MM CK activity, the nature of which should be subsequently clarified by electrophoresis.     

The intra-arterial ultrasonography as an exclusive exploration method to determine atherosclerotic lesions of the arterial wall in a preclinical stage.

An intravascular ultrasonography of the peripheral arterial system was applied following on the coronarography to 56 patients suffering from one or several critical stenoses on the coronary arteries. Though the clinical vascular examination and the subsequent noninvasive examination of the peripheral arterial system of all these patients turned out to be completely normal, the intra-arterial ultrasonography was able to reveal important atherosclerotic alterations in the wall of the abdominal aorta and of the iliac arteries in the case of 51 of these patients. The intra-arterial ultrasonography appears to be a very sensitive method of exploration, permitting atherosclerotic changes of the arterial wall to be detected at a very early pre-clinical stage, even long before these anomalies could have caused a specific pattern of complaints.     

Growth and menarcheal status of elite female gymnasts.

The growth and maturity status of 201 elite female gymnasts was considered. The subjects were participants at the 24 World Championship Artistic Gymnastics in 1987. In addition to age at menarche, weight, stature, biacromial, and bicristal breadths, the sitting height/stature ratio, and the Health-Carter anthropometric somatotype of gymnasts 13-20 yr of age were compared with reference data for a nationally representative sample of Flemish girls. Median age at menarche (probit analysis) in gymnasts is 15.6 +/- 2.1 yr compared with 13.2 +/- 1.2 yr in Flemish girls. Anthropometric dimensions increase with age until about 16 yr and then tend to plateau. In contrast to body size, there is little variation in somatotype with age. Compared with adolescent girls, elite gymnasts are considerably shorter and lighter with narrower shoulders and hips, but the differences are more apparent after 17 yr. Elite gymnasts do not differ from nonathletes in relative leg length, but they have proportionally broader shoulders relative to hips. Differences in somatotype occur primarily in endomorphy (especially lower in gymnasts) and to a lesser extent in mesomorphy (higher in gymnasts).